200 million people have to have their teeth straightened?
But there are only more than 6,000 orthodontists in China
China News Weekly reporter/Yuan Suwen intern/Yu Haoqing
Published in the 1042nd issue of "China News Weekly" on May 2, 2022
With every bite of the chicken feet, Lin Yan (pseudonym) became more anxious.
She couldn't bite down on brittle bones, and when she chewed on the muscles, her teeth couldn't cut straight because of the soft roots, which made her feel out of control.
Five years ago, Lin Yan put on braces.
Under the pulling of the steel wire and rubber band, the originally tacit understanding of the upper and lower teeth began to shift.
Two years ago, the braces were taken off, but a new order was not formed. When gnawing, I couldn't exert myself, and when I relaxed, they bumped against each other, and a "black triangle" appeared in the lower teeth.
The floppy teeth were tucked in the retainer, which has so far failed to stabilize.
After "breaking up" with the doctor, Lin Yan went to other hospitals for examination and found that she had "internal injuries": the gums had receded, and half of the alveolar bone that provided a solid foundation for the lower teeth had disappeared, which was almost irreversible.
"If I don't straighten my teeth, my teeth may not fall out at 80 years old." She is only 35 years old this year. Before wearing braces, she "can eat ice cubes with empty mouth", and now when she opens her mouth, her right jaw joint will "creak" , "warm up" your chin before nibbling on an apple.
What caused Lin Yan to pay such an irreversible price was the desire to improve her appearance.
Teeth are related to the beauty of one-third of the face. Studies have shown that the prevalence of malocclusion in Chinese adults exceeds 70%. With the growth of the middle-class population in China, the trend of "orthodontic fever" has been scraping for several years.
The pursuit of straighter teeth, whiter teeth and better appearance has accumulated hundreds of millions of demands.
On the other side of the huge demand is the lack of professional doctors - there are only a few thousand doctors trained in standardized orthodontics, and due to the lack of a nationwide specialist certification system in China, professional orthodontists are difficult to identify.
In the brand profiles of various dental clinics, patients are easily lost. Like Lin Yan, patients who wear braces easily and cause damage after a long period of braces are not isolated cases.
In the air of over-commercialization, patients are prone to mistake themselves as "consumers", but dental implants are not an ordinary consumption behavior, and the cost is not only money, but also three to five years, and irreparable bodily injury.
Patients in secondary correction clinic
Lin Yan wanted to defend her rights and wanted to know how to remedy it.
She contacted Xu Baohua, the chief dental physician at the China-Japan Friendship Hospital, on Weibo, and obtained permission with a plus sign.
At 2:00 pm on April 6th, lying on the dental chair in the hospital, Lin Yan took off the retainer to take out the dental film, and asked the nurse to take pictures. After the initial consultation, she went downstairs to take a CT scan to find out the condition of the alveolar bone. .
In Beijing China-Japan Friendship Hospital, Xu Baohua opened the only "secondary correction clinic" in the country.
Xu Baohua has been re-elected as a standing member of the Orthodontics Professional Committee of the Chinese Stomatological Association for several consecutive terms. He is also a professor of orthodontics at Peking University, a professor at Peking Union Medical College, a professor at Capital Medical University and a professor at Beijing University of Traditional Chinese Medicine.
He studied under the masters of Peking Medicine such as Fu Minkui and Lin Jiuxiang. In the 1990s, he went to the University of Hong Kong for further studies and studied under the internationally renowned orthodontic expert Professor Urban Hagg. He worked in Peking University Stomatological Hospital for 18 years.
Every Wednesday and Saturday afternoon, he and his team "rescue" patients who need secondary corrections in the consultation room, which he calls "specialty medicine."
This specialty medical treatment stems from peer consultation requests.
Xu Baohua told "China News Weekly" that at first, he only consulted some intractable diseases, but in recent years, there have been more and more failure cases in the consultation, and many patients have found him, asking him to judge whether the previous correction is reasonable, so, He simply opened a secondary correction clinic.
Many private institutions accompany patients for consultation, and Xu Baohua plays the role of a consultant, providing consultation to patients and providing remedial solutions to institutions.
"No matter who made the mistake, I will treat everyone equally." Xu Baohua said that many institutional staff will call him to ask him to help and say good things before taking a patient for consultation, but as a doctor, he only provides professional and objective opinions to avoid Intervention in patient and institutional disputes.
While waiting for the examination, Lin Yan swiped her mobile phone to show her records of each follow-up visit.
She got her braces on October 8, 2017, a Sunday, and 1,641 days have passed since then - April 6, 2022.
"I was at the point of a bull's horn." Before wearing braces, Lin Yan loved to laugh. Her two rows of teeth were neatly arranged, but she was still not satisfied. She felt that her upper incisors were wider, her chin was wide and protruding, and she had a slight underbite, that is, her lower jaw. The development exceeds the upper jaw, commonly known as "the earth wraps the sky".
Lin Yan wants to be beautiful.
She has interviewed many doctors, and it is always difficult to find one that she is satisfied with in terms of the effect and price promised by the doctor.
Tian Yuehong, who had worked in the oral cavity of Peking University, suggested that she give up orthodontics.
Tian Yuehong told her that the adult's occlusion has become stable during the growth process, and orthodontics first destroys this stability, and then arranges and reorganizes. If her teeth are not disordered and the occlusion is no problem, there is no need to take risks. Or change your face.
In hindsight, Lin Yan regretted not listening to Tian Yuehong's advice.
Later, she saw an advertisement of a clinic in "Brace House". "Free filming, free examination, and free orthodontic plan" moved her. With the mentality of not going for nothing, she went to experience the free service.
The person who examined her was a middle-aged female doctor. On the advertisement page, she was introduced as a "professional committee member of the Chinese Stomatological Association", and Lin Yanxin took it seriously.
The reporter checked the official website of the Orthodontic Professional Committee of the Chinese Stomatological Association, and there was no such person's name.
On the medical certificate written by the female doctor for Lin Yan, it was written that she "has scattered gaps".
If you only look at the written materials, it is easy to conclude that Lin Yan's appeal is only to close her teeth, but Lin Yan told reporters that the reason she chose that doctor was because the other party promised her that she could improve her profile.
She showed a photo taken on the day of the consultation. It was her profile. Because her mouth was slightly open, her chin was a few millimeters back than when she closed her mouth. Lin Yan said that the doctor promised to take her chin back to The photo effect, this one hit her.
"No doctor told me that I can adjust (chin) from this angle before. What I drilled at the time was that I was willing to spend time and energy to correct it, so as to achieve the effect of improving the profile even a little bit."
On the day the "effect photo" was taken, Lin Yan paid 25,000 yuan and put on ceramic self-locking fixed braces.
After that, she went to the doctor for follow-up consultation every month, and the doctor adjusted the wire for her to increase the pulling force.
It was not until April 2020 two and a half years later that she found that her upper teeth had bit the brackets adhered to the surface of her lower teeth. The doctor removed the brackets of her lower teeth, but the gap between the upper teeth was not closed at that time, so the doctor cut the upper teeth brackets. For the rear wire, only the wire that closes the six teeth in front is left, and the gap between the front teeth is closed to the side.
On August 27, 2020, she had her upper braces removed and has been wearing retainers ever since.
Lin Yan's lower teeth had a black triangle-like gap, which was a sign of gingival recession.
CT showed that the height of her lower labial plate was only a third of its normal height, implying that the alveolar bone had receded irrevocably.
Xu Baohua suggested her gum transplantation to maintain the stability of her lower teeth, but it could not cure the symptoms but not the root cause, "it can last for about seven years", and for her alveolar bone that has disappeared, the existing clinical technology seems powerless.
In Xu Baohua's clinic, similar patients are not uncommon.
In medical disputes, the identification of causation requires a complicated process of proof, but he basically determined that many of these patients were improperly designed and wrongly applied in the previous orthodontic treatment, resulting in alveolar bone resorption, gingival recession, and finally exposure of the root of the tooth. Triangle", even loose.
Compared with adolescents, adults face a greater risk of alveolar bone recession during orthodontic procedures.
Yang Lei, doctor of stomatology from Fourth Military Medical University and director of the Orthodontics Department of Beijing Ruitai Stomatological Hospital, told reporters that the human jaw has plasticity, which is the basis for the establishment of orthodontics.
Adolescents are in a period of vigorous growth and development, the plasticity of the alveolar bone is relatively strong, and the reconstruction ability of the jaw bone is the strongest, and the risk is relatively low.
With age, the movement of the teeth with the same force can cause more problems, such as periodontitis, periodontal recession, gingival recession, and root resorption.
Gingival recession is associated with alveolar bone recession.
According to Yang Lei, orthodontics is accompanied by alveolar bone remodeling, which includes resorption and regeneration. For children and adolescents, the ability of rebirth is far greater than the ability of resorption, so there is almost no possibility of alveolar bone resorption; for some adults , If excessive force is applied during orthodontics, the amount of alveolar bone resorption is greater than the amount of new generation, and alveolar bone recession will occur, which in turn causes the recession of the gums attached to it.
Hundreds of millions of people need teeth straightening?
In the opinion of orthodontists, most people need teeth straightening, and the result of teeth straightening should be to protect the periodontal and make the teeth stronger, rather than damage the alveolar bone and make the teeth loose earlier.
"The original goal of orthodontics was to establish a stable occlusal function, followed by the pursuit of beauty." Yang Lei said.
However, the increasing demands of urbanites for neatness and whiteness make the pursuit of beauty go ahead of the pursuit of health.
According to an industry report, when a survey was conducted on "oral troubles" among the population, nearly 50% of the people chose "the teeth are not neat enough and need to be corrected".
Lin Yan is a girl who loves to laugh, she has always minded her wide chin.
Among the beauty templates created by internet celebrities and celebrities, one of the standard features of a beautiful girl is a small pointed chin.
Because of the doctor's promise to "close the chin", she put on braces impulsively. She always pays attention to all kinds of medical and aesthetic information and wants to raise the base of her nose.
A wide chin is a pain in the bottom of her heart, and correcting her face shape is the main purpose of her wearing braces.
Orthodontics, however, should be a treatment behavior, and the disease targeted is called malocclusion.
Since 1983, China has carried out a national oral health epidemiological survey every 10 years or so.
In 2015, with the support of the former National Health and Family Planning Commission, the fourth national oral epidemiological survey was launched.
The project team surveyed 172,000 people in 31 provinces and cities across the country and selected five representative age groups.
A survey report published in 2018 shows that the incidence of malocclusion in China is as high as 72%.
In Xu Baohua's view, the incidence of malocclusion in mainland China is basically the same as in the world.
He recalled that when he was a graduate student at the University of Hong Kong, he conducted a survey on the oral conditions of Hong Kong people and found that the incidence of malocclusion in Hong Kong people was about 70%.
50% of the respondents have pathological jaws that need to be corrected, while 20% of them are not pathological, but affect the appearance.
"From the perspective of pure health, at least 50% of the population need correction, but now with the improvement of living standards, people's pursuit of temperament and image has increased, so it is believed that the other 20% of non-pathological jaws are due to aesthetics. The reason is also the need for orthodontics." Xu Baohua said that in 2013, he went to the University of Pennsylvania to study and learned that 70% of children in Pennsylvania have orthodontic treatment, and in California and New York, 80% of children have orthodontic treatment. And 30% of American adults have orthodontic treatment.
Human teeth are rooted on the periodontium, and the periodontal tissue includes the gingiva, periodontal ligament and alveolar bone, and the alveolar bone tightly wraps the root of the tooth.
Protecting the periodontal can maintain the stability of the teeth and prevent the phenomenon of "old teeth".
In the opinion of orthodontists, for pathological jaws, failure to correct them can lead to trauma and compromise the health of periodontal tissues.
Xu Baohua introduced that if the teeth are messy and the brushing is not clean, it will easily lead to gingivitis and periodontitis, which will destroy the alveolar bone and cause the teeth to loosen prematurely. This can cause chronic damage to the gums and periodontium, and over time also shake the foundations of the teeth.
He treated a 22-year-old boy with periodontal problems due to crowded teeth and tiger teeth, unclean brushing and perennial occlusal trauma.
Liu Weitao is the chief medical officer of Saide Sunshine Stomatology and a standing member of the Orthodontics Committee of the Chinese Stomatological Association. He obtained a doctorate in orthodontics from Peking University Stomatological Hospital and served as the deputy chief physician.
He told China News Weekly that survey data shows that the incidence of malocclusion in Chinese adolescents and adults is between 71% and 73%, and in foreign countries, the proportion is also 60% to 70%.
Some people multiply China's total population by 70% to easily obtain the market demand for orthodontics of 1 billion people, but this is unscientific.
The orthodontic population should first be considered.
Liu Weitao explained that although the industry believes that "it is never too late for orthodontics", the most suitable age is still between 12 and 45 years old. This part of the population is about 700 million people. If 70% of them need correction, it is roughly It is estimated that there are 500 million people.
"This is the size of the population in China that needs to be corrected. But the need for correction does not mean that it must be corrected. There are more than 300 million people in the United States, and more than 200 million people need to be corrected, but he does not say that they will all be corrected." So, Taking into account the willingness of 500 million people to correct their teeth, and referring to the 50% willingness to correct their teeth in the urban survey, the number of people who need correction in China and who have the will to correct them should be around 200 million people.
Liu Weitao said.
However, considering the high cost of orthodontics, the minimum cost is about 20,000 yuan, and the number of people who can afford orthodontic consumption will only be smaller, but with the development of the economy and the improvement of people's living standards, the demand for orthodontics The increase is also a general trend.
A small group of real orthodontists
Xu Baohua divides the reasons for secondary correction cases into three categories.
The first category is relapse, usually after correction in childhood and relapse in adulthood.
The second category is mistakes caused by inexperienced orthodontists. For some mistakes, "doctors don't know why." For example, before treatment, the communication between doctors and patients about the standard of "beauty" is not clear, which may cause disputes at the end of treatment. and difficult to solve.
"For example, the patient thinks it's acceptable, and the doctor says, 'I think it looks good,' and disputes arise."
The third category, which he believes is the most common cause of orthodontic errors or failures, is "general practitioners who do not have orthodontic clinical professional skills to carry out orthodontics". This situation exists not only in private chain clinics, but also in In a public general hospital, such as a Shanxi patient, who failed after being corrected in a local top three hospital.
"I have used invisible braces for four or five years."
For the hundreds of millions of Chinese orthodontists, the number of doctors who are truly trained in orthodontics is not that many.
When you walk into the dental clinic and express your wishes for a dental procedure, it is likely that a general practitioner will guide you.
For example, Lin Yan, the female doctor who promised to improve her face shape, later checked that she was probably just an ordinary dentist before engaging in orthodontics, engaged in "extraction and inlay", that is, tooth extraction, filling, and inlay.
"Now the orthodontic awareness of patients with dental and jaw deformities has awakened, and many general practitioners have also 'awakened' and want to do corrections." Xu Baohua believes that a large number of general practitioners have begun to engage in orthodontics with only manufacturer certification. Orthodontics, facing a large number of people who want orthodontics, this problem cannot be ignored.
In China, in terms of discipline classification, stomatology and clinical medicine are side by side. The second-level disciplines under stomatology include general stomatology, oral medicine, oral surgery, and orthodontics.
Xu Baohua pointed out that if general dentists do not undergo systematic professional training in orthodontics, they cannot be competent for orthodontic treatment.
In many developed countries, orthodontics is usually defined as continuing education after graduation due to its strong professionalism.
Xu Baohua took the Anglo-American system as an example. Stomatologists are divided into general practitioners and specialists. Orthodontists are specialists and require special training and certification.
After graduation, undergraduate students majoring in stomatology need to spend two to three years to study for postgraduate studies in orthodontics. The postgraduate stage is mainly clinical training, and after graduation, they will obtain the orthodontic specialist certificate.
At present, China does not have a specialist doctor system, so there is no nationally certified specialist doctor license.
The certification of the Orthodontics Professional Committee of the Chinese Stomatological Association is currently relatively authoritative. Xu Baohua said that as of November last year, the number of orthodontists certified by the professional committee was 6,041, of which half of them had obtained a postgraduate degree or above in orthodontics.
For those who have obtained a master's degree in orthodontics, the special committee stipulates that they only need to engage in orthodontic work for one year and publish their professional papers or scientific research results to be selected.
"Actually, one year is not enough to see a case." Xu Baohua said that the average time for each orthodontic case to seek medical treatment is about two to three years, and one year of clinical experience is not enough to create a qualified orthodontic specialist. The reason for this regulation may be It is to take into account the urgent needs of the current market.
However, this does not mean that other GPs have lost the opportunity to become regulars.
According to the membership certification standards of the Chinese Orthodontic Committee, non-orthodontic postgraduate doctors can also pass the certification if they have certain professional titles and work experience.
These criteria include obtaining a senior or director technical title, engaging in orthodontic practice for 5 or 8 years, and having attended at least 1 year of orthodontic specialist training, and published some research results.
The "regular army" has only a few thousand people, but there are nearly 100,000 dental hospitals.
According to the "2020 Oral Medical White Paper" released by the Eggshell Research Institute, a subsidiary of the Internet medical platform Arterial.com, according to incomplete statistics, the total number of oral medical institutions in the country is close to 100,000, of which private oral medical institutions dominate, accounting for about 80%. %.
According to "iiMedia Research | 2021 China Stomatological Hospital Industry Segmentation and General Trend Analysis Report", 88% of China's dental medical institutions are dental clinics, 11% are general hospitals, and only 1% are dental clinics. Specialist hospital.
However, from the perspective of the number of visits, half of the people will choose the dental department of a general hospital.
Once certain conditions are met, a doctor who is licensed as a licensed physician can open a clinic.
There are no express regulations on whether dental clinics can carry out orthodontics, which means that in China, general dentists can carry out orthodontics in their clinics.
Xu Baohua revealed that there are currently nearly 200,000 dental doctors in China, distributed in public hospitals and nearly 100,000 dental clinics.
"Walking into a clinic and doing orthodontics for you is likely to be a general practitioner. They may have only briefly studied orthodontics in the hospital, and some people have not even studied formally."
Some orthodontists are not even qualified as doctors.
In August 2021, the Chinese Stomatological Association issued the "Statement on Resolutely Resisting the Chaos in Oral Medical Cosmetology", which directly pointed at the Special Committee for Dental Beauty established by the "China Hairdressing and Cosmetology Association".
This statement is aimed at the concept of "esthetician" that appeared in the market at that time.
Some orthodontic equipment distribution agencies are trying to "de-doctor", and they promote free technical training as long as the agency fee is paid. After 3 days of technical training and repeated practice for more than 15 days, they will have the level of human operation." You can become a contracted esthetician", "As long as you have 4 teeth, you can make a return, and what you do after that is the net profit."
Low-cost mass-produced "estheticians" will also reduce the cost of orthodontic treatment and attract patients who pursue "cost-effectiveness", but there are huge risks behind them.
"It's like consumers who buy leather clothes and don't know whether they are true or false." An industry source described the market chaos.
How to identify an orthodontist?
Xu Baohua pointed out that a doctor with a practicing doctor's qualification certificate and a practicing doctor's certificate can only prove that he is a stomatologist, and to further identify whether he is a professional orthodontist, the following three points need to be comprehensively considered: whether he is a postgraduate degree in orthodontics, Whether you have studied in a well-known university or hospital for more than one year and obtained a certificate, and whether you are a member of the Orthodontics Committee of the Chinese Stomatological Association.
"If you can't meet one of these three points, you're not an orthodontist."
Behind the Braces Battle
Zhou Yanheng is a professor at Peking University. He served as the director of the Department of Orthodontics at Peking University from 2010 to 2015. In 2007, he founded Said Sunshine Clinic.
Orthodontics in China originated in the period of the Republic of China and was temporarily suspended during the "Cultural Revolution".
In 1981 after the reform and opening up, Zhou Yanheng's tutor, Fu Minkui, a professor at Peking University School of Stomatology, became the first batch of Chinese people to go to the United States to receive orthodontic training.
Fu Minkui went to Northwestern University in Chicago in 1981, received two years of orthodontic training, and obtained the certificate of orthodontist.
After Fu Minkui returned to China, he introduced the "standard square wire bow", the latest fixed correction technology at that time.
Compared with movable aligners, the control of fixed aligners is more precise. "Fixed aligners are like train tracks, and teeth are like trains. They must walk on the tracks. As long as the tracks are well designed, there can be higher efficiency and efficiency. Better results." Zhou Yanheng said.
As a new generation of orthodontic experts, Zhou Yanheng turned his attention to invisible braces.
Different from traditional braces with stick brackets and wires, invisible braces are composed of transparent dental membranes. The design concept is that, by regularly replacing the braces by the patient, the irregular teeth can be gradually guided to the straight ones.
The inventor of invisible braces is Aiqi Technology, a North American company. After its product Invisalign was launched in 1997, it has become a topic of discussion in the orthodontic field.
Zhou Yanheng has devoted himself to the research of Invisalign for many years. In his opinion, his team can use Invisalign to correct almost 100% of patients with malocclusion.
As a disciple of orthodontic expert Professor Lin Jiuxiang from Peking University, Xu Baohua has a different point of view.
He believes that invisible braces do have the advantages of good patient experience and long intervals between follow-up visits, but there are also obvious shortcomings.
"At present, there is no research that can fully clarify the force point and magnitude of the orthodontic force exerted by invisible braces on teeth." Xu Baohua said, compared with traditional wire braces, invisible braces rely on wrapping the surface of the teeth. The size is not precise enough, and the focus is often uncertain.” This reduces the efficiency of orthodontics, often requires restarting treatment for tooth extraction cases, and prolongs orthodontic treatment.
"As for fixing a bracket and an arch wire, the force point is there. I want to apply force to this force point, and the force is very accurate." Xu Baohua said that he does not reject invisible braces, but will It is emphasized that the indication should be carefully selected according to the needs of the patient and the situation of the dentofacial deformity.
He believes that about 70% of patients are suitable for orthodontics with invisible braces, and another 30% of orthodontic patients, such as patients with typical skeletal dental deformities and patients with periodontal disease, are more suitable for labial fixed appliances or lingual invisible orthodontics device.
Among the failed cases of secondary correction clinics, there are many users of invisible braces.
In Xu Baohua's view, most of the main reasons for the failure of invisible correction have a lot to do with the doctor's technique, while a few cases of invisible correction failure are due to inconsistent indications and need to be changed to fixed aligners.
Care obtained a double doctorate in orthodontics from Peking University. During his doctorate, he studied Invisalign, which has not yet been listed in China, and now works in the Sunshine Dental Clinic of Saide.
As one of the senior doctors of invisible braces in China, I care that invisible braces are more beautiful orthodontic tools, but compared with fixed braces, they put forward higher requirements for both doctors and patients.
Caring has also treated a large number of patients with invisible braces who need secondary corrections, "all of whom were blind in other institutions." She said that due to the long orthodontic cycle, these patients did not feel any problems when they first put on the braces. It is often a year or two after the problem is detected.
At the beginning, when general practitioners performed orthodontics, they often used words to weaken the importance of orthodontists. "They will deliberately exaggerate the role of braces and weaken the role of doctors, saying that Invisalign is an American technology and has specialized technicians to design.”
Faced with these voices of doubts about the "de-doctor-like" of invisible orthodontics, Xu Li, vice president and managing director of Aiqi Technology China, said, "Invisible orthodontics is a serious medical practice, and patients need to be treated by professional doctors. Under the guidance of safe and effective invisible orthodontic treatment." He emphasized that Aiqi is well aware of the importance of doctors participating in each stage of invisible orthodontic treatment.
Physician involvement is critical in assessing a patient's oral health and suitability for orthodontic treatment, guiding patients through treatment choices, and achieving optimal outcomes.
In fact, invisible braces rely more on the ability of the designer of the orthodontic plan.
The correction of many invisible braces fails from the initial design process.
"The person who designed the plan must be very familiar with Newton." Care said, because the force that pushes the teeth to move is completely different from the wire braces, it takes more experience from the doctor to make the teeth move obediently according to the established plan and achieve the final effect.
She mentioned that she often hears examples of patients who don't move their teeth the way they were supposed to when they're one-third or halfway through their invisible braces treatment.
Invisible braces also put forward higher requirements on the self-discipline of patients.
Every time a braces plan is designed for a patient, care must be personally emphasized to the patient on the precautions for wearing.
She explained that invisible braces have the advantage of being beautiful and easy to clean, but because they have to be removed when eating and cleaned regularly, patients need to carry out stricter self-management.
"For teenagers, we require more than 20 hours of wear a day, and for adults, we require 22 hours of wear a day. This thing is simple to say, but it is not easy to implement." Care said, even for the orthodontist himself , it's a little bit painful to do this.
In the spring of 2020, Caring designed a set of invisible braces correction plan for himself.
When she actually put the braces on, she realized how difficult it was to hold on for 22 hours.
"Take off your braces when you eat, brush your teeth and wear braces after eating. Repeat this three times a day, and keep it within two hours in total." .
Concern believes that a qualified orthodontist must take the patient's behavior management in mind.
She refers to the patients who seek follow-up consultation as "comrades in arms". In her consultation room, she often discusses with patients how to ensure the time to wear braces, such as eating with braces.
"I can't bite things with braces, and I eat a meal for 40 minutes. I feel like a donkey. I grind and grind, but I can't chew." But this is the price paid for correction, and you can't eat with braces. Too hard things, such as hazelnuts, salt and pepper shrimp and crabs, also don't eat curry and drink red wine, that will stain.
Different from the view in the industry that "invisible braces can only solve simple cases", we have solved many complex cases with invisible braces.
But whether it is invisible braces or traditional fixed braces, she stressed that doctors' rich experience and strict management of patients are the keys to the success of orthodontics.
Lin Yan originally planned to use two or three years to fix her teeth, but now it is the fifth year of her teeth surgery, and she still does not dare to remove the retainer.
It is not uncommon for patients to be unable to take off their braces after wearing them. Therefore, concepts such as "orthodontic treatment is a lifelong career" have appeared in the market. Moving and repairing the position of the teeth may have irreversible consequences.
"I have been calling for the first time to straighten the teeth to look after the teeth." In Xu Baohua's secondary orthodontic clinic, there are also patients who he cannot recover.
For example, Lin Yan, due to inappropriate correction force and occlusal trauma, the height of her lower incisor alveolar bone is only one-third now, and she is no longer eligible for secondary correction.
If improper orthodontics cause long-term occlusal trauma, adults are more likely to cause alveolar bone resorption, and the standard for secondary correction suggested by Xu Baohua is that the height of the alveolar bone should be one-half or more.
After the consultation, Lin Yan sat in the waiting chair outside the clinic, reluctant to leave for a long time.
She felt lost and didn't know where to go.
She kept sliding her fingers on the phone screen, trying to swipe out an expert's number source.
The expert claimed online that the alveolar bone can be repaired using stem cell transplantation, which is her only hope at the moment.
But in fact, the treatment is still in the clinical trial stage and has not been officially approved by the state.
"China News Weekly" 2022 Issue 16
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