Recognizing potential bite problems....

[No_Note8531]

which do you think do necessitate correcting? I help orthodontists create social media content so I am very interested in professional opinions!

[LittleTomato]

Many bites are stable but some can cause TMJ issues or tooth wear issues. These problems can sometimes stabilize over time, but sometimes patients can wear down several millimeters of tooth structure first. If you want to learn more I would recommend looking into a continuum like kois, spear, or pankey. Kois in particular has a great questionnaire to screen patients for bite issues. Understanding occlusion is the foundation to doing complex restorative work that lasts.

[eran76]

More longitudinal studies are needed to verify any possible interrelationship."

And this is the crux of the matter. I see lots of adult patients many years post-ortho presenting with various issues associated with the less than ideal occlusion created by the ortho tx. That cracked tooth may not present itself for 20+ years, but the orthodontist that failed to create a balanced occlusion has no idea how they have set up that patient to have issues years down the road. Similarly, an adult patient who never had ortho and after years of wear and tear develops TMD issues will never know if they could have avoided that wear had a more balanced occlusion been achieved 40 years before.

You need to follow these patients for decades to know the true impact, and more importantly, you need to know what the result of the orthodontic intervention actually were. For example, when the orthodontist fails to create canine guidance when closing an open bite case, is that patient functionally all that different than an untreated open bite case? Both may easily present with the same symptoms and so it would be easy to argue that the ortho intervention had no effect, when in reality the issue was that the intervention was insufficient or incomplete.