The economics of appliance therapy

By Rob Veis, DDS

Doctor, how am I going to eat or go out in public? I hate this flipper, and I just can't afford implants or a bridge now. Isn't there anything you can do for me?

Little Jimmy, age eight doesn't seem to have enough room for all his teeth. In fact, two of them appear to be in cross-bite. Could you explain to Jimmy's parents why he doesn't have enough room for all his teeth? Even more important, could you treat Jimmy's problem?

A patient comes in with a horizontal fracture just above the crest of the bone in tooth #8. Because of the patient’s high lip line, it is clear that an extraction or osseous surgery would severely compromise an esthetic result. Could you save tooth #8?

Every day we are faced with new challenges that effect how we deliver our care. Early tooth loss, drifting teeth, tipped molars, posterior bite collapse, anterior flaring, and occlusal trauma are just some of the difficult clinical problems we constantly face. When clinical situations like these arise, we must be equipped with alternatives in therapy to maintain a healthy, intact masticatory system. By integrating appliance therapy into your armamentarium, you can gain the versatility you need to meet these challenges.

In the past, the term “appliance therapy” only referred to the use of simple orthodontic appliances like a space maintainer or a Hawley retainer. Today, this term encompasses a wide variety of appliances which are used through every phase of a patient’s treatment. Whether you are placing implants, performing periodontal surgery, or simply doing interceptive orthodontics, you will need to use appliances to help control and direct your patient's treatment.

Last year, The Manual of Appliance Therapy for Adults and Children was introduced to help you integrate the use of appliances into your practice. In this Practice Building Bulletin, I would like to share with you some clinical cases that demonstrate many of the innovative ways that appliances are being used.

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