A heated debate was sparked by the recent visit to Grahamstown of Dr John Mew. The British dental practitioner is a vocal proponent of an alternative to orthodontic treatment, called orthotropics. In Grocott's Mail of 25 July 2014 we published an account of his visit, and his ideas. Here we publish a response by the South African Society of Orthodontists to that article, and Mew's subsequent reply.
A heated debate was sparked by the recent visit to Grahamstown of Dr John Mew. The British dental practitioner is a vocal proponent of an alternative to orthodontic treatment, called orthotropics. In Grocott's Mail of 25 July 2014 we published an account of his visit, and his ideas. Here we publish a response by the South African Society of Orthodontists to that article, and Mew's subsequent reply.
'Keep your mouth closed' – expert
Staff reporter
Want to be better-looking? Don't leave your mouth open.
That's the advice of visiting dental expert John Mew, Head of the London School of Facial Orthotropics, who visited Grahamstown for one week.
The internationally renowned specialist in facial structure is working with Grahamstown dentist Dr Dittmar Eichhoff on the very latest techniques for straightening teeth and realigning jaws and making you better looking while they're at it.
In an interview with Grocott’s Mail, he said that his decades of research and practice as a facial surgeon and orthodontist had led him to believe that the best approach to treating dental and facial problems is orthotropics, a non-invasive method utilising neither braces nor surgery.
This discovery resulted in a treatment called Face Growth Guidance (FGG), which uses an appliance called the Biobloc instead of braces. The Biobloc can be removed by the patient but comes equipped with a timer to ensure that it is kept in place long enough to be effective. The therapy is recommended as an option to braces and surgery to establish straight teeth and balanced jaws, faces and airways.
Mew said that the problem with this treatment is that it needs to begin when the patient is very young, but that if there is a minor problem it can be used on older people.
"This type of treatment is more likely to be a success with children as young as four to seven years of age as their faces and teeth are at a developing stage,” he said. “With adults it could be difficult because once the bones have grown incorrectly it may be hard to correct them and you may have to perform surgery."
Mew said that some medical and dental problems are caused by the misalignment of the upper and lower jaws, but that it also affected people’s attractiveness. He said parents could help their children avoid later problems by training them to keep their mouths shut except when eating and talking.
“Essentially the reason why so many people have such bad looking faces, and lots of people do, is because they hang their mouth open,” he said.
Mew qualified as a dentist in 1953 and then went on to study maxilo-facial surgery and orthodontics in 1965. During this period his work and research convinced him that many facial problems appear to have environmental origins—the main one being letting your jaw hang open.
“We all want to have a good looking face and although it is nicer to have straight teeth it’s much better to have a good looking face,” Mew said.
From here he will travel to Johannesburg and Pretoria to lecture students at the University of the Witwatersrand and University of Pretoria dental schools.
* In the original article, published in our print edition on 25 July 2014, Grocott's Mail mistakenly referred to Dr Eichhoff as an orthodontist instead of a dentist. In this version the writing and editing error has been corrected.
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Concerns about orthodontic treatment claims
It was with some concern that the South African Society of Orthodontists (SASO) took note of the article published in your newspaper on 25th July 2014 entitled “Keep your mouth closed”.
SASO represents the orthodontic specialty in South Africa and is a specialist group within the South African Dental Association (SADA) and is recognised by the Health Professions Council of South Africa (HPCSA).
Your article has a number of inaccuracies, the most important of which I would like to clarify:
1. In order to register with the Health Professions Council as an orthodontist, a dentist is required to undergo four years of additional full-time study in a recognised university post-graduate programme which would lead to a specialist qualification registerable with the HPCSA.
2. The article makes a number of claims which cannot be substantiated by current scientific evidence.
For example, one procedure is described as being “the very latest” — this is a large claim which cannot be substantiated.
The “decades of research” mentioned in the article have never been published in any major refereed scientific journal and therefore have also not been subjected to the necessary scrutiny that is required for them to be accepted within the profession.
3. Regarding the optimal age for treatment of children, there is abundant published data in this regard which clearly outlines the best time for addressing various different problems.
This information compares different approaches and the success related to the timing of treatment.
Dr Mark Wertheimer, President, South African Society of Orthodontists
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John Mew replies
I share the concern expressed last week by Dr Mark Wertheimer, President of the South African Society of Orthodontists, about general dentists who undertake orthodontic treatment (with braces especially) without proper training. However, I personally have been impressed by the number of general dentists who go to great trouble and expense to undertake additional training, in protocols other than the use of braces, to straighten teeth.
Irregular teeth and jaws are undoubtedly a biological problem that did not exist until we adopted our current life-style. But for the last hundred years the orthodontic cure has essentially been mechanical (braces) and sometimes surgical. I am sure that Dr Wertheimer would agree with me that these methods (braces and surgery) do have some unfortunate side effects and the teeth usually become irregular again unless a retention appliance is worn permanently. I am sure that frequent long-term relapse and adverse facial changes following fixed appliances (braces) is why many parents and general dentists look for alternate orthodontic methods.
Dr Wertheimer rightly raises the matter of scientific evidence. I myself have published many papers and scientific articles in the refereed dental press but of more concern, many of the leading scientists in the world have criticised the orthodontic speciality for its standard of scientific rigour. In fact, there is little evidence to show that current orthodontics with fixed appliances (braces) is of significant long-term benefit to patients.
I would urge all orthodontists to look at more natural methods or they may be overtaken by others using treatments such as Orthotropics, which may be more difficult but offer a permanent correction by changing oral posture and, as Grocotts Mail reported, “trains children to keep their mouth closed from an early age helping them achieve an attractive adult facial appearance”.
Professor John Mew
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