Traditionally orthodontists have been taught that the size and shape of the jaws is inherited and most orthodontic treatment is based on this belief. Clearly if the teeth are too large for the jaws some teeth would need to be extracted but there is a shortage of good evidence to explain why the jaws sometimes fail to grow or that extracting teeth is of long-term benefit. In fact there is some evidence to suggest that removingteeth increases the tendency there for crowding.
Many orthodontists consider crowded teeth are caused by interbreeding between humans with different sized jaws. Biologists do not support this view, and even if a 100 kg Great Dane were crossed with a 1kg Chihuahua the offspring would be unlikely to have malocclusion. There is evidence to suggest that the size of the teeth and jaws is inherited, but little to suggest that disproportionate growth is.
Some orthodontists believe that evolution has caused jaws to become smaller over the last few thousand years (Walpoff 1975). Certainly crowding has got worse, but this has been mostly within the last 400 years (More 1968), which is far too short a period for an evolutionary change. Also an evolutionary change would have to start in one area and spread, but irregular teeth are found all over the world, wherever people take their standard of living above a certain level.
Some of the best scientists in the world have been very critical of the current state of orthodontic evidence. Here are some of the comments about orthodontics from world scientific heavyweights “orthodontics is behind homeopathy and on a par with scientology” (Sackett 1985), “Treatment is based on trial and error” (Johnston 1990), “students are taught technical skills rather than scientific thinking” (Richards 2000), “Sadly it is hard to see this situation change unless the inadequacy of current knowledge is acknowledged” (Shaw 2000), “Most treatment correct the symptoms, not the cause”. (Frankel 2001).
Lars Bondemark in Sweden has recently pointed out that orthodontists have done little researchon the influence of orthodontic treatment on the appearance of the face. Most orthodontists are fully aware of this risk but have been very reluctant to research or compare the effect of traditional treatment with Orthotropics which is specially designed to improve the face. This may be because existing research has shown that the cases treated with orthotropics look much better.
Despite the overwhelming evidence, most orthodontic treatment is still carried out on the basis that disproportionate jaws are inherited and that little can be done to change them. Based on this belief and in contradiction to the evidence the teeth are moved into line mechanically usually coupled with the extraction of either four or eight permanent teeth. If the jaws are in the wrong position orthodontists may recommend that they are cut and corrected surgically. Many thousands of children and young adults have this surgery each year although a substantial proportion of those who have been told that surgery is the "only answer" have subsequently been corrected with Orthotropics. Despite this, surgeons are refusing to tell their patients that there might be an alternative.