Ortho360 and the orthodontic- aesthetic interchange


Is an orthodontist an aesthetic dentist? This is one of many questions likely to arise at BOC where interdisciplinary treatment is a key theme and where several speakers include dental aesthetic concepts as part of their presentation.

The majority of UK orthodontists work to deliver a healthy occlusion. Certainly, that would be the priority for the treatment of the 200,000 young people who start NHS orthodontics annually in the UK. They qualify for treatment because they fall into one of the IOTN (Index of Orthodontic Treatment Need) categories and thus have a health-related need.

However, the rising demand among adults for straightening to improve their smile is perhaps changing the mindset. Not so long ago the “aesthetic” issue might have divided audiences at BOS events.  But today, all delegates at the British Orthodontic Conference will be receptive to their role in the aesthetic dimension

One of those who has led the way is the Alabama orthodontist Dr David Sarver. A Fellow of the American Academy of Esthetic Dentistry, an author and a lecturer with an international reputation, David is a keynote speaker at this year’s conference.

He may well describe the epiphany he experienced when he realised that he had been so focused on orthodontics that he was not thinking of the bigger picture, considerations such as:

     • the long-term future of the patient’s smile

     • the aesthetic opportunities afforded by new materials and techniques

     • his relationship with the general dentist and what this can bring to the outcome


This led him to rethink the way he worked and redirect communications at referring dentists, educating them about what he does but more importantly, learning from them about what they can bring to patient care.

David will argue that teeth should never be considered in isolation from the mouth or the face and always take account of the way the patient’s appearance will evolve. He also believes the “interdisciplinary” word, when used in the dental world, should always incorporate the general practitioner and his or her team, whose relationship with the patient should be respected.

Dr Raman Aulakh is a specialist orthodontist involved in training orthodontists internationally in clear aligner therapy.  He will undoubtedly touch on some similar topics as David Sarver. He will outline the challenges faced by orthodontists treating adult patients. The first challenge is that “orthodontics makes teeth straight not pretty”. Orthodontics alone cannot address the differential wear of incisors, tooth shape and size discrepancies. The second challenge is that “adult patients come with dental baggage”. Adults present with recessions, bone loss and heavily restored teeth. This can be very often associated with a degenerating process of the dentition. He will argue that these challenges can only be addressed if an interdisciplinary approach is adopted for all  adult patients.


Raman has adapted the Spear-Kokich model to encompass a systematic method based on aesthetics, occlusion, structure, and biology for facially generated treatment planning. He says his  presentation aims to give a “360 approach” to the assessment, treatment planning and implementation with adult orthodontics. He will also examine how to create a common understanding and clinical vision between all members of the interdisciplinary team.


To go back to the original question, is an orthodontist an aesthetic dentist? Come and join the discussion at BOC London 2018.