Children's dentists at odds in battle of the braces

Parents who take their children to the dentist because their teeth are crooked are not being warned that orthodontic treatment could permanently alter the shape of their faces. Research shows that three-quarters of patients, many of them children or teenagers, are not told that treatment could cause serious damage.

Parents who take their children to the dentist because their teeth are crooked are not being warned that orthodontic treatment could permanently alter the shape of their faces. Research shows that three-quarters of patients, many of them children or teenagers, are not told that treatment could cause serious damage.

Many suffer painful long-term damage to the skull, jaw pain and headaches as a result of orthodontic dentistry. In the worst cases, they suffer ringing in the ears, postural problems leading to muscle pain in the neck, shoulders and back, and extreme headaches.

On a Channel 4 Dispatches programme to be broadcast on 2 December, rebel orthodontists claim such problems are caused by the common practice of fixing braces accompanied by extractions. Of 700 families interviewed for the programme, more than half of those with children undergoing treatment had teeth removed when the the brace was fitted. Yet in southern California, where a dazzling smile is de rigueur, extractions take place in only 15 per cent of orthodontic treatments. There, many orthodontists fit removable, expanding braces combined with exercises to improve "oral posture".

Nigel Harradine, a spokesman for the British Orthodontic Society which defends traditional treatment, said the figure of 56 per cent was "slightly higher than desirable". He said the number of cases that should be treated with extractions should be between 20 and 40 per cent.

Dr John Mew, a critic of mainstream orthodontics, said the British methods can result in long-term damage to the skull. The face grows downwards and becomes longer and flatter, changing the angle of the jaw, sloping the forehead and making the nose look more prominent.

"I frequently see examples of faces which have been really badly spoiled. In my personal opinion, probably about 20 per cent of orthodontic patients are noticeably damaged and maybe another 30 per cent are slightly damaged," he said at his practice in Sussex. "If my views were accepted, orthodontics would have to change dramatically."

He believes the argument is most graphically illustrated by the case history of twin brothers, Quentin and Ben Creed, now 21. Quentin, the more serious case, was treated by Dr Mew, who expanded Quentin's jaw to make room for overcrowded teeth, while Ben was treated by a traditional orthodontist who extracted four teeth and then fixed braces.

Although identical before receiving treatment, they now look different. Ben Creed said: "Because of the extractions, the width of my mouth is smaller. In hindsight, I would have preferred to have gone with Dr Mew's method as it got much better results."

In another case a talented young ballet dancer had to abandon her dream of a stage career after she began to suffer debilitating headaches after orthodontic treatment at 13. Jo Edwards told the researchers: "I wanted to be asleep all the time so I didn't have to feel the pain."

After eight years, she was referred to dentist François Rossouw in Brentwood, Essex, another critic of traditional dental methods. When he asked her to open her mouth, Jo's mother noticed for the first time that instead of her jaw dropping down, it worked in an S shape and clicked.

Dr Rossouw said: "Orthodontic treatment had caused her jaw to grow in the wrong position and resulted in eight years of pain."

Dr Mew said people were not warned of the risks because dentists feared patients would be put off treatment. NHS rates also meant that dentists got paid less for the alternative treatment than the conventional brace. But Nigel Harradine, a consultant in Bristol, denied the risks were as great as Drs Mew and Rossouw claimed. "The vast body of orthodontists have every reason to believe they are basing their practice on the best available evidence," he said.