Making a pragmatic choice depends on assessing factors honestly and realistically, not basing them on an ivory tower view of the world. When helping a patient choose between orthodontic and restorative treatments, there can be factors at play beyond the purely medical.
Time and money
Time is arguably the most precious resource any of us have. The old saying goes that ‘time is money’, but time is also opportunity. Orthodontic treatment can take multiple years depending on the case, followed by ongoing usage of a retainer. Repeated appointments are required to ensure things are progressing as they should be, taking up valuable time that both practitioner and patient likely can little afford. Restorative approaches can often be completed in a single session, requiring minimal time on their part.
Compliance and risks
We must acknowledge human nature – compliance is a significant issue among patients during and after orthodontic treatment. During treatment, many orthodontic patients struggle with their oral hygiene. This can make patients more vulnerable to decalcification and caries – even five years after completing treatment, patients who have undergone orthodontic treatment have a significantly higher incidence of enamel opacities than those who have not.
Troublingly, a great many patients fail to wear their retainers, risking all the hard-won progress made. A study found that within the first year, more than a quarter of patients failed to wear their retainers for the required amount of time. After a year this drops even further, with less than half of patients wearing their retainer to an adequate degree. Other patients frequently damage their appliances, whether by accident or carelessness, extending treatment time and necessitating additional appointments.
A great restoration can have a transformative effect on patients, not just restoring their smile, but improving it too. BRILLIANT COMPONEER™ is a new composite enamel shell from COLTENE that enables you to perform outstanding restorations chair-side.
Some members of the public may be concerned about restorative treatments like veneers, having seen or read horror stories in the media and could be unaware that minimally invasive treatment options exist. BRILLIANT COMPONEER™ are a minimally invasive, cost effective treatment that can be completed in just one session – with no laboratory support required whatsoever. No impressions need to be taken to offer highly customised, beautiful teeth. Offering great aesthetics with its high gloss retention and polishability, curtesy of proven submicron filler technology – this is a high-quality solution that gives excellent results.
When it comes to choosing between treatment options, particularly when the primary motive is aesthetics, looking pragmatically at the specifics of the case and the nature of the patient are crucial to achieving an optimal result.
 Meeran N. Iatrogenic possibilities of orthodontic treatment and modalities of prevention. Journal of Orthodontic Science. 2013; 2(3): 73-86.
 Abeskharon A., Fischer M., Burnheimer J. Compliance with retainer wear in the first year: an analysis of 320 cases. Journal of the World Federation of Orthodontics. 2018; 7(1): 13-16. https://doi.org/10.1016/j.ejwf.2018.01.005 May 20, 2019.
 Seeliger J., Machoy M., Koprowski R., Safranow K., Gedrange T., Woźniak K. Enamel thickness before and after orthodontic treatment analysed in optical coherence tomography. BioMed Research International. 2017; 2017: 8390575. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5294353/ May 20, 2019.More about Coltene here