Age-appropriate orthodontic treatment options: A joint responsibility for orthodontists and pediatric dentists

Orthodontists and pediatric dentists often have shared responsibilities of treatment for the same patient, at the same time. As such, it is fair to assume that clinicians in both specialties will be called upon to detect, treat, or monitor abnormalities that impact function and/or esthetics of their mutual patients. The opportunity to directly treat the maturing young patient during all developmental stages and/or triage or monitor treatment rendered by other clinicians places an extraordinary burden upon practitioners of both the specialties. Consequently, a more profound communication should exist between the orthodontist and pediatric dentist. This may be especially true while patients are transitioning from the mixed dentition to the permanent dentition, a time interval often accompanied by notable dental, skeletal, emotional, neuro-musucular, and intellectual maturation. Too often, important concepts and insights remain buried within scientific disciplines as a result of either compartmentalized pedagogy or even worse inexplicable territorial boundaries delineated by the respective specialties themselves. Neither of these contributes to optimal individual patient care. For parents, a more consistent, shared knowledge base between pediatric dentists and orthodontists will contribute to the synergy and the common good. This can only result in less confusion and more satisfying results. And, that is precisely the goal of this 2-part issue of Seminars in Orthodontics devoted to exploring the available options presented in age-appropriate orthodontic treatment.

As co-editors of this issue of Seminars in Orthodontics, we are pleased and honored. Our intention is for this 2-part issue to help continue an important dialogue between the orthodontic and pediatric dental specialties. Sharing time-honored concepts of dentofacial growth and development as well as applying the interpretations of recent evidence-based and/or evidence-bolstered investigations characterize many of the articles within this issue. In part 1, Jay Bowman presents compelling reasons to re-examine the role of extraction therapy in modern orthodontic practice. Peter Buschang’s presentation of the development of mandibular incisor malalignment reviews critical evidence serving to “debunk” commonly held myths and misunderstandings about dental crowding. Bell and Sonis offer clinical possibilities as well as limitations of nonextraction protocols during the transitional dentition. This will be of keen interest to orthodontic and pediatric dental clinicians observing and/or treating patients during the mixed dentition. Tsourakis and Johnston present fresh data, shedding important light on the contributions of skeletal growth and tooth movement in the development of Class II malocclusions. Lastly, Moskowitz and Garcia revisit conservative measures to redirect the pre-eruptive paths of ectopically developing maxillary permanent canines, thereby avoiding future impactions of these teeth.

Both of us trust the interdisciplinary Festschrift offered in Seminars in Orthodontics will be useful for clinicians and academics in the orthodontic and pediatric dental specialties. We thank the former Editor-in-Chief, Dr. P. Lionel Sadowsky, and the publisher of Seminars in Orthodontics for their recognition of the need for their focus on these topics.