Adverse effects of orthodontics: a report of 2 cases

Adverse effects are results beyond the expected good outcomes of treatment. Like any other field in dentistry and medicine, orthodontics is not immune to such effects. The probability of adverse results in orthodontics increases when important rules and facts are ignored. To illustrate this, treatment and its adverse effects in 2 patients are discussed. In 1 young adult female, a palatally impacted maxillary canine was being moved into its place in the arch when it became ankylosed. Despite the cessation of movement, the orthodontist continued to apply mechanical forces to the canine for an additional 16.5 years. The effect of this extremely prolonged treatment period on the rest of the dentition was devastating. In another case, a 12-year 10-month-old boy with a mild Class II, Division 1 malocclusion, developed alopecia areata 4 months after the onset of orthodontic treatment. Four months later, he had lost all of his hair (alopecia totalis). The etiology of this condition was determined to be psychological stress and anxiety evoked by the orthodontic treatment. In both cases, the orthodontists failed to recognize existing problems or chose to ignore them. It was concluded that these adverse effects of orthodontic treatment could have been avoided if the orthodontists would have paid closer attention to the tissue response to mechanotherapy, as well as to the patient's attitude toward treatment. The latter conclusion is particularly noticeable when treating children and teenagers, who can reject being forced by their parents to undergo orthodontic treatment.