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Удаление здоровых зубов: "научность" медицинских протоколов, жреческие функции

https://www.quora.com/Do-all-people-need-tooth-extraction-before-they-get-braces-or-is-tooth-extraction-needed-in-some-cases-and-not-in-all-cases-In-what-cases-is-tooth-extraction-needed?fbclid=IwAR3DHNxweTz2120239Xoc8pNaRGBVBZjuCxBuUYWA6sSoU2-A71ocPPFSKc
Do all people need tooth extraction before they get braces, or is tooth extraction needed in some cases, and not in all cases? In what cases is tooth extraction needed?

Оригинал на английском ниже. Нового ничего нет, это все было написано в посте
Шарлатаны и полезные идиоты https://healthy-back.livejournal.com/436663.html (https://healthy-back.dreamwidth.org/424733.html), глава
Откуда всё это пошло, все эти алгоритмы и протоколы https://healthy-back.livejournal.com/438473.html (https://healthy-back.dreamwidth.org/426285.html)

Просто материал, так сказать, из другого источника

Нужно ли всем людям удалять зубы до установки брекетов, или необходимо удалять зубы в некоторых случаях, а не во всех? В каких случаях требуется удаление зубов?

Д-р К. Бадт, профессор (с 1999 года по настоящее время)

На этот вопрос нельзя дать краткий ответ. Вы использовали слово «нужно». Исторически сложилось так, что за первые 40 лет ортодонтии ни один пациент не «нуждался» в удалении. Идеальным для основателя ортодонтии доктора Эдварда Энгла (Dr. Edward Angle) было иметь полный широкий здоровый рот, включающий все 32 зуба. Для пациентов с сильной скученностью ортодонты использовали расширение нёба. Это изменилось в 1940 году, когда доктор Чарльз Твид (Charles Tweed) убедил коллег, что удаление будет означать меньший «рецидив» (возвращение зубов в исходное положение).

В то время ортодонты были возмущены предложением удалять здоровые зубы. Основные ортодонтические лидеры, такие как д-р Б Ф Дьюел (Dr. B F Dewel), впоследствии президент Американской ассоциации отодонтов, утверждали, что удаление зубов повредит росту челюстей и приведёт к поколениям американцев с уменьшенными улыбками и челюстями.

Тем не менее, мечтой ортодонтов было предотвращение рецидива, и удаление зубов было как дешевле, так и эффективнее с течением времени (по расчётам, на 4 месяца короче). Так что к 1960-м годам свыше 70% всех случаев в США «нуждались в удалениях».

Это изменилось в 1970-х годах по мере того, как эффект удалений Плоского лица стал популяризироваться в прессе и обсуждаться в ортодонтических журналах. Процент снизился до 50% пациентов, «нуждающихся» в удалениях.

Процент вновь изменился в 1990-х годах после того, как пациентка, которой удалили зубы, подала в суд на своего ортодонта в 1986 году за тяжёлое повреждение челюсти, которое она получила во время лечения. Она выиграла 1,3 миллиона долларов за то, что присяжные посчитали «уродованием её челюстей» из-за удаления зубов и уменьшения челюстей (Brimm vs Malloy). Это привело к большой тревоге и страху в ортодонтической индустрии, так как в результате могли последовать миллионы аналогичных исков, учитывая огромное количество пациентов, которым были удалены зубы. Они сделали два шага:

1) AAO заказал статьи ценой в полмиллиона долларов, чтобы получить «доказательства» того, что ортодонтия «не может» повредить челюсти, поскольку, как гласит аргумент, «зубы не имеют ничего общего с челюстями». Эти статьи были опубликованы в период 1992-1997 годов в специализированном журнале AJO-DO. Теперь все студенты-ортодонты должны читать эти статьи и потом говорить пациентам: «Высокое качество исследований [по заказу Американской ассоциации ортодонтов] доказало, что между зубами и челюстным суставом нет никакой корреляции».

2) количество удалений сразу же понизилась в США после судебного процесса, без слова объяснения общественности. Неожиданно только 25% случаев стали «нуждаться» в удалениях.

Это падение количество удалений было связано, по словам лидера В. Проффита (W. Proffit), с проблемами расстройств ВНЧС (как выделено в случае Brimm) и с эффектом сплюснутого профиля, который коррелировал с удалениями премоляров.

Сегодня «потребность» в удалениях варьируется от страны к стране, от ортодонта к ортодонту.

В Азии до 85% случаев «нуждаются» в удалениях. Согласно одному исследованию, китайцы предпочитают «плоский профиль», который развивается при экстракционной ортодонтии. В развивающихся районах Латинской Америки до 70% «нуждаются» в удалениях, потому что пациенты не могут позволить себе альтернативу (расширение нёба), быстрее и дешевле делать брекеты с удалениями. В Великобритании 65% пациентов «нуждаются» в удалении, потому что Национальная служба здравоохранения финансирует ортодонтическую помощь.

В Швейцарии, Австрии и Германии менее 10% пациентов ортодонтов «нуждаются» в удалениях.

В США сегодня процент пациентов, которые «нуждаются» в удалениях, варьируется от 85% (для традиционных ортодонтов, обученных методу Твида) до 0%.

Показатель 0% - от ортодонтов, которые видели повреждения сами у себя (у многих ортодонтов также были удаления с собственным лечением) или у своих пациентов.

В США есть сотни ортодонтов, которые не делают удалений даже в случаях сильной скученности. Также много тех, кто делает удаления менее чем в 3% своих случаев, только в редких случаях очень сильной скученности (редкое явление) или макродонтии.

Таким образом, чтобы ответить на ваш вопрос, «необходимость» удаления для ортодонтического лечения определяется культурой, географическим районом, экономическими ограничениями, а также собственными взглядами ортодонта на экстракционную «терапию», готовностью делать более длительное лечение и способностью предлагать альтернативы, такие как расширение нёба.

Спросите своего ортодонта: какой процент случаев вы делаете с удалениями? Затем можно определить, насколько «необходимы» ваши собственные удаления. За этим можно задать следующий вопрос, спросив: а что, если я откажусь от удалений? Внезапно может быть предложен новый план лечения без удалений.

Джеймс Стюарт, DDS, BS Dentistry & Microbiology, Университет Южной Калифорнии (1972)

Обычная практика удалений четырёх премоляров в ортодонтии часто называется «быстрой и грязной». Это быстрее, потому что зубная дуга не расширена для устранения первоначальной причины неправильной окклюзии. Она заканчивается нестабильной конфигурацией (постоянное и продолжительное время удержания зубов на месте).

Она создаёт проблемы, которые не могут быть исправлены позже.

Необходимость удаления зубов — редкий случай. Это лечение на всю жизнь. У тебя только один шанс. Сделай это правильно. Никаких удалений.

Том Брайт, практик в полиграфической промышленности (1994 - по настоящее время)

Мой личный стоматолог, решившая сохранить все мои зубы живыми и здоровыми, вздрогнула, когда я упомянул пользователей Quora, сообщающих о том, что их ортодонты удаляют премоляры и другие живые, здоровые зубы. «Я думала, что это вышло из моды 20 лет назад», — проворчала она.

Насколько я понимаю, государственные учреждения здравоохранения перестали одобрять большинство удалений живых, здоровых зубов ещё в 2006 году, включая планы по зубам мудрости и брекетам. Вот краткий судебный документ: http://www.lb7.uscourts.gov/documents/14-001203.pdf

https://www.facebook.com/groups/1270654792948954?multi_permalinks=4849606001720464&hoisted_section_header_type=recently_seen
Сьюзен Венделл (Susan Wendell):
https://en.wikipedia.org/wiki/Cognitive_authority
https://livepcwiki.ru/wiki/Cognitive_authority
Согласно Рие (2005), «Патрик Уилсон (1983) разработал теорию когнитивного авторитета из социальная эпистемология в своей книге «Знание из вторых рук: исследование когнитивного авторитета». Фундаментальная концепция когнитивного авторитета Вильсона состоит в том, что люди конструируют знания двумя разными способами: на основе собственного опыта или на основе того, что у них есть. узнал из вторых рук от других. То, что люди узнают из первых рук, зависит от запаса идей, которые они привносят в интерпретацию и понимание своих встреч с миром. Люди в первую очередь зависят от других в поисках идей, а также информации, выходящей за рамки прямого опыт. Большая часть того, что они думают о мире, - это то, что они приобрели из вторых рук. Уилсон (1983) утверждает, что все, что люди знают о мире за пределами узкого диапазона своей собственной жизни, - это то, что им говорили другие. не считайте все слухи равнозначными; только те, кто, как считается, «знают, о чем они говорят», становятся когнитивными авторитетами. Уилсон ввел термин когнитивный авторитет, чтобы объяснить вид авторитета, который влияет на мысли, которые люди сознательно признают правильными. Когнитивный авторитет отличается от административного авторитета или авторитета, выраженного в иерархической позиции". (Rieh, 2005).Википедия

Когнитивный авторитет (Addelson 1983) медицины играет важную роль в искажении и замалчивании знаний инвалидов.

Медицинские работники были наделены полномочиями описывать и проверять опыт тела.

Если вы обращаетесь к врачам с симптомами, которые они не могут видеть напрямую или проверить независимо от того, что вы им говорите, такие как боль или слабость или онемение или головокружение или трудности концентрации, и если они не могут найти объективно наблюдаемую причину этих симптомов, вам, скорее всего, скажут, что с вами «всё нормально», как бы вы себя ни чувствовали.

Вам должно очень повезти с вашими врачами, иначе каким бы надёжным и ответственным вы ни считались до того, как начали жаловаться, что вы больны, ваш опыт будет признан недействительным. Другие люди являются властью на реальность вашего опыта жизни в вашем теле.

Когда вы очень больны, вы отчаянно нуждаетесь в медицинской проверке своего опыта не только по экономическим причинам (страховые требования, пенсии, социальное обеспечение и пособия по инвалидности все зависят от официального диагноза), но и по социальным и психологическим причинам. Людей с непризнанными заболеваниями часто бросают их друзья и семьи. Из-за того, что почти каждый принимает познавательный авторитет медицины, человек, чей телесный опыт кардинально отличается от медицинских описаний его/её состояния, признаётся недействительным как человек знающий и чувствующий.

Либо вы решаете скрыть свой опыт, либо вы социально изолированы со своим опытом, будучи помеченным психически больными "или нечестными". В обоих случаях вас затыкают.

Даже когда ваш опыт признаётся медициной, он часто повторно описывается способами, которые неточны с вашей точки зрения.


Dr. K. Badt, Professor (1999-present)
Answered September 3, 2021 · Author has 138 answers and 12.6K answer views
This question cannot be answered briefly. You used the word “need”. Historically, in the first 40 years of orthodontics no patient “needed” extraction. The ideal for the founder of orthodontics, Dr. Edward Angle, was to have a full wide healthy mouth including all 32 teeth. For patients who had severe crowding, orthodontists used palate expansion. This changed in 1940 when Dr. Charles Tweed convinced colleagues that extractions would mean there would be less “relapse”: i.e. teeth going back to their original position.

At the time, orthodontists were outraged at the proposition of extracting healthy teeth. Major orthodontic leaders such as Dr. B F Dewel, later President of the American Association of Othodontics, argued that extracting teeth will damage jaw growth and lead to generations of Americans with reduced smiles and jaws.

However, it was a dream for orthodontists to prevent relapse, and extracting teeth was both cheaper and more efficient time-wise (calculated to be 4 months shorter). So by the 1960s, over 70% of all US cases “needed extractions.”

This changed in the 1970s as the Flat Face effect of extractions began to be popularized in the press and discussed in orthodontic journals. The percentage went down to 50% of patients “need” extractions.

The percentage changed once more in the 1990s after an extraction patient sued her orthodontist in 1986 for the severe jaw damage she incurred during treatment. She won 1.3 million dollars for what the jury determined to be “mutilation of her jaws” due to extraction retraction (Brimm vs Malloy). This led to great anxiety and fear in the orthodontic specialty as millions of copy-cat lawsuits could result, given the huge number of patients who had been extracted. So they took two steps:

1) the AAO commissioned articles at the cost of half a million dollars to get “evidence” that orthodontics “can’t” damage jaws since, the argument went, “teeth have nothing to do with the jaws.” These articles were published between 1992–1997 in the trade journal AJO-DO. Now all orthodontic students today must read these articles and will later tell patients: “High quality research [commissioned by the American Association of Orthodontists] has proven that there is no correlation between teeth and the jaw joint.”

2) the rate of extraction immediately lowered in the US after the lawsuit, without a word of explanation to the public. Suddenly only 25% of cases “needed” extractions. This drop in extraction rate was due, according to leader W. Proffit, to the TMD jaw issues (as highlighted by the Brimm Case) and to the flattened profile effect that correlated with premolar extractions.

Today the “need” for extractions varies from country to country, and orthodontist to orthodontist.

In Asia, up to 85% of cases “need” extractions. According to one study, the Chinese prefer the “flat profile” that develops from extraction orthodontics. In developing areas of Latin America, up to 70% “need” extractions because the patients can’t afford the alternative (palate expansion) and it is faster and cheaper to do braces with extractions. In the UK, 65% of patients “need” extractions because the National Health Service funds orthodontic care.

In Switzerland, Austria and Germany, less than 10% of orthodontic patients “need” extractions.

In the US, today the percentage of patients who “need” extractions varies from 85% (for traditional orthodontists trained in the Tweed method) to 0%.

The 0% figure is from orthodontists who have seen the damage in themselves (many orthodontists have also had extractions with their own treatment) or in their patients.

There are hundreds of orthodontists in the USA who do no extractions even in cases of severe crowding. There are also many who do extractions in less than 3% of their cases, only in rare cases of very severe crowding (a rare occurrence) or macrodontia.

So to answer your question, the “need” for extractions for orthodontic treatment is determined by culture, geographic area, economic constraints, and the orthodontist’s own perspective of extraction ‘therapy’, willingness to do a longer treatment and capacity to offer alternatives such as palate expansion.

Ask your orthodontist: what percentage of cases do you do with extractions? You can then determine how “necessary’ your own extractions are. You can follow up by saying: what if I refuse extractions? Suddenly a new extraction-less treatment plan may be proposed.

James Stewart, DDS, BS Dentistry & Microbiology, University of Southern California (1972)
Answered September 4, 2021 · Author has 8.7K answers and 3.2M answer views
No. The common practice of four premolar extractions in orthodontics is often referred to as “fast and dirty”. It is quicker because the dental arch is not expanded to remove the original cause of malocclusions. It ends with an unstable configuration (permanent and extended time for retainers to keep teeth in place).

It creates problems that cannot be corrected later.

It is the rare case that requires extraction of teeth. This is a treatment for life. You only get one chance. Do it right. No extractions.

Tom Bright, Sole Practitioner at Printing Industry (1994-present)
Answered September 3, 2021 · Author has 3.3K answers and 960.2K answer views
My personal general dentist—dedicated to keeping all my teeth alive and healthy—flinched when I mentioned Quorans reporting their orthos extracting premolars and other living, healthy teeth. “I thought that was out of style 20 years ago,” she grumbled.

It’s my understanding government health agencies stopped approving most extractions of living, healthy teeth back in 2006, including wisdom teeth and braces programs. Here’s a short court paper:

http://www.lb7.uscourts.gov/documents/14-001203.pdf

https://www.facebook.com/groups/1270654792948954?multi_permalinks=4849606001720464&hoisted_section_header_type=recently_seen
By Susan Wendell:
The cognitive authority (Addelson 1983) of medicine plays an important role in distorting and silencing the knowledge of the disabled. Medical professionals have been given the power to describe and validate everyone’s ex-perience of the body. If you go to doctors with symptoms they cannot observe directly or verify independently of what you tell them, such as pain or weak- ness or numbness or dizziness or difficulty concentrating, and if they cannot find an objectively observable cause of those symptoms, you are likely to be told that there is “nothing wrong with you,” no matter how you feel. Unless you are very lucky in your doctors, no matter how trustworthy and responsi-ble you were considered to be before you started saying you were ill, your ex-perience will be invalidated. l3 Other people are the authorities on the reality of your experience of your body.

When you are very ill, you desperately need medical validation of your experience, not only for economic reasons (insurance claims, pensions, welfare and disability benefits all depend upon official diagnosis), but also for social and psychological reasons. People with unrecognized illnesses are often abandoned by their friends and families. l4 Because almost everyone accepts the cognitive authority of medicine, the person whose bodily experience is radically different from medical descriptions of herhis condition is invalidated as a knower. Either you decide to hide your experience, or you are socially iso lated with it by being labelled mentally ill” or dishonest. In both cases you are silenced.

Even when your experience is recognized by medicine, it is often re-described in ways that are inaccurate from your standpoint.

https://docs.google.com/document/d/1xS9WBJlx_bB5WG_EaW9v6NhxHriUTWPV/edit?fbclid=IwAR3Sq5bQmeO_D2pNqTAeuf_X4rLhxECzKJ-Xf274a8k87B_woiaDRtVUGoo
The Science of Orthodontics? Kevin O'Brien's Blog Post "A Brilliant Summary of Orthodontics and Obstructive Sleep Apnea"

I have always wondered how it was possible after the 1986 court verdict of Brimm vs Malloy determining that premolar extraction/retraction orthodontics can cause severe TMD damage that the orthodontic profession could continue to extract and retract healthy teeth and claim that there is no relationship between extractions and the jaw joint. I knew, of course, that the American Association of Orthodontics had commissioned a series of "high quality" articles in response to this verdict: articles which predictably provided evidence that there is no relationship with the jaw joint and teeth. I knew that no medical doctors were involved in these studies, let alone TMD experts, and that all were written by orthodontists who at that time (1992) had had no training in jaws or TMD issues in dental school—and still today have scanty training in the area. I also knew that one of these commissioned articles is today required reading for the American board examinations of new orthodontists, and that the Brimm case is taught in orthodontic schools as a case of misfired justice. I had read the AJO-DO editorial that argued that orthodontics is above the law, and that no state court verdict about the consequences of extracted teeth should stop the extraction of teeth, as surely orthodontists know more than juries.

But I was baffled why so few in the field—and no overviewing body—thought to question such a trumped up determination. It was astonishing for me that in a 2018 interview with the director of the orthodontic program at Columbia University, I was told that "TMD is a myth" and besides "there is no relationship between the jaw joint and teeth." I was similarly taken aback when a well-reputed orthodontist stated in an email that "high quality" evidence (i.e. the commissioned literature) "has proven that there is no connection between the jaws and the teeth."

My shock derives not merely from the fact that biology dictates that the jaws in a child grow only as far as the position of the teeth - and if teeth are forcibly retracted, then basal bone growth will per force be stunted. The basal bone cannot grow further than the alveolar ridge: the maxillary process which holds the teeth.

No, my bafflement is how can it be that orthodontists nearly unanimously hold that the "extraction and TMD debate was finished" in 1992—even though research articles before and after 1992 provide evidence that TMD indeed can result from extraction/retraction orthodontics. Moreover, how could they continue to "believe" that the connection with TMD and extraction orthodontics is unquestionably a myth after a dozen internet forums have cropped up devoted to "extraction victims" with TMD, at least twenty complaints (that I am aware of) reported to the GDC in the UK from patients who have encountered TMD, and one lawsuit in Germany from an extraction case who had TMD, and a 2020 survey of 803 extraction-treated patients, representing 58 countries, in which 53% reported TMD?

It is not that orthodontists should "believe" the opposite: that TMD is caused by extraction orthodontics.

My question is why are they not open to questioning: why do they accept knowledge on the basis of "belief"?

The answer dawned on me when I stumbled upon the recent AAO organized study of the newest reported consequence of premolar extraction retraction orthodontics: Obstructive Sleep Apnea.

Granted this possible consequence is so severe that the orthodontic specialty, charged with producing an iatrogenic condition, in potentially up to 60% of patients treated with extraction orthodontics, would be prone to wish it were not true. One cannot blame the AAO for responding to this charge by commissioning a task force with the aim to prove this charge is not true.

But wishing to come up with a certain outcome and scientific inquiry are two different processes.

The 14 member AAO task force on sleep apnea - which consisted of 13 orthodontists and dentists, one neurologist and not a single sleep doctor —came up with a white paper, the findings of which were announced in 2019 at the AAO annual conference. In this report, they determined - among many other determinations—that:

1) Children "with transverse maxillary expansion deficiency" should be considered to be prone to pediatric OSA since (as stated in another part of the paper) craniofacial deformities have been associated with OSA, and a narrow palate is one such deformity.

2) Extraction/retraction orthodontics reduces the intermolar width [hence reduces the width of the hard palate: the width of the palate is equal to the IMW].

3) Extraction/retraction orthodontics reduces the upper airway.

They then added these three points together--and reached the conclusion that extraction/retraction has no causal influence on OSA, and hence orthodontists should not re-examine their policy on orthodontic extractions.

One sleight of hand operating here (necessary to arrive at this illogical connecting of dots) was that while in one section, the authors confirm that the airway is reduced by extraction/retraction, in the next they assert that airway size actually is not a factor in OSA and indeed breathing is a matter of "airway muscle". Hence they conclude that if the patient has good airway muscles, they can “compensate” for an airway reduced in size by orthodontic retraction.

To quote the White Paper statement:
"In discussing orthodontic treatment changes in the dimensions of the upper airway [which the authors confirmed can happen due to extraction orthodontics], it also is helpful to understand that an initial small or subsequently reduced size does not necessarily result in a change in airway function. Reflecting the higher significance of neuromuscular control on airway function during sleep, it has been demonstrated that a narrow airway does not result in OSA, but rather it is an inability for a patient’s airway muscles to compensate adequately that leads to obstruction and sleep-disordered breathing." (emphasis mine)
In plain words: we may narrow the airway with extraction orthodontics but if obstructive sleep apnea results it is because "of the inability of the patient's airway muscles to compensate" for the reduction we caused.

Note that to date, even following this report, it is not required that orthodontists disclose to patients that extractions can narrow the airway and they may need to “compensate” for the narrowed airway for the duration of their lives. Nor does the AAO report address the fact that airway tissue and muscles become lax as a patient ages, and this compensation may not work.

There is another important sleight of hand in this article. This was the authors’ decision to slip the point that extraction-retraction results in a reduced intermolar width (i.e. a narrowed palate) in an earlier section of what is a very long paper, so the fact about extractions narrowing the palate—well established in orthodontic research--may be forgotten by the time the reader gets to the later point that narrow palate width is a factor in OSA. Hence a careless reader may not notice the glaring contradiction that the writers argue on the one hand that orthodontists should take great care not to further narrow a narrow palate—because a narrow palate can cause sleep apnea (indeed the authors advise that orthodontists do diagnostic exams on pre-existing signs and symptoms, such as a narrow palate, to protect themselves from legal repercussions after the orthodontic treatment if sleep apnea ensues) –and then, illogically, advise them to not worry about doing extractions as these cannot cause sleep apnea— after admitting that extractions can narrow the palate.

But this slippery white paper was not what opened my eyes to how a profession can follow false information without question.

What opened my eyes to this was a 2019 report written by an orthodontist in attendance at the AAO conference for the alleged purpose of transmitting this information to "colleagues worldwide not able to attend" so they could have this "important information" at hand.

The blog was posted as a "summary" (i.e. as a factual representation) of this conference on a prominent orthodontist's website: Dr. Kevin O'Brien.

O'Brien introduces this "brilliant summary" of the AAO's so-termed "unbiased" findings with joy:

In light of all of the information (and misinformation) that has appeared in the dental community in recent years, the AAO commissioned a task force in 2017 to examine obstructive sleep apnea and the role that orthodontists play (or don’t play) in the prevention, diagnosis, and treatment of this serious medical condition. After two years of work, this group of unbiased experts drafted a 20-page “white paper” (that will be published as an upcoming AJODO article)….. There is no evidence linking orthodontic procedures (headgear, extractions, or so-called “backwards pulling mechanics,” etc.) to the development of OSA.

O'Brien celebrates the supposed fact that this "unbiased" panel of "sleep apnea experts" (which, O'Brien's assertion notwithstanding, did not include one sleep apnea expert) determined that sleep apnea is a matter of "obesity" and "soft tissue" alone, and has nothing to do with cranial-facial structure, i.e. anything that could possibly be influenced by orthodontics, such as palate shape, arch width or jaw position: a claim that is so conspicuously false that it inspired one reader in the UK to muse: "While the AAO can be obtuse, they cannot be that stupid!" Palate size and mandible position are well-established to be prime considerations in OSA diagnostics and treatment.

This reader of O'Brien's blog (a dentist) was in such disbelief at this "stupid" claim that he dug up the white paper that the AAO member's "report" was supposedly a transmission of—and realized that no, the AAO panel was actually not that stupid. The report makes the opposite claim as the reporter, and actually repeats several times that childhood craniofacial structures can cause OSA and even recommends orthodontic procedures such as rapid maxillary expansion (RME) for those patients who have cranial structural deformities, such as a narrow palate.

In fact, the AAO conference member "emissary" of the white paper, Dr Greg Jorgensen—who happens, Kevin O'Brien notes, to serve on the Council of AAO Communication—miscommunicated a number of other significant AAO findings as well, which the reader listed to me, with bullet points.

The reader in question—who chose to go by his alias James White, so as not to have professional backlash—wrote Dr. Kevin O'Brien and asked him to remove his post at once as a misrepresentation of information and a breach of professional ethics, given that O'Brien's blog is read by orthodontists worldwide, and this misrepresentation of facts can influence policy and patient treatment.

Dr. Kevin O' Brien refused to take down the blog. The reader has since registered a complaint with the GDC.

The comments responding to O'Brien's blog suggest that the majority of the orthodontists reading this blog were convinced by this "unbiased" report of the "unbiased" AAO commissioned study and believed, as O'Brien claimed, that it was true representation of the facts.
Indeed, a number joined in O'Brien's jubilation.

Now I understand the blindsiding of well-meaning orthodontists worldwide after the Brimm Case scandal.

The orthodontic specialty does not appear to run according to the criteria of science.
As an academic, the first thing we are trained to do is to put acquired knowledge in question. Science is based on the principle that the hypothesis we hold to be true is not true. A scientist does not do an experiment to prove s/he is right. That is not science. A scientist does an experiment to prove that the null hypothesis is not supported.

"This is what differentiates science from religion," imparted Dr. Kevin O'Regan, physicist and former director of the CNRS perception laboratory in Paris. "Religions want to hold onto their truths and find evidence all around them that they are right. Scientists look for evidence that they are wrong, so they can advance the field of knowledge. That is why science changes radically in its precepts in a matter of decades."

If this is the definition of science, one understands that orthodontics is a religion.
The reason why orthodontists do not question the conclusions of this "very important” AAO study, reported in faulty telephone tag on a popular blog—or bother to go check the original research or read it—or bother to question the research design of an AAO funded research on OSA without any sleep specialists on board---is because that is something a scientist would do.

Not a disciple of a priesthood.

As an academic, I have attended many academic conferences (and just two orthodontic conferences). An academic conference is typified by one quality: argument. The Q and A s after a conference paper are often characterized by objection. The author must be prepared to be attacked on every point: their logic, their sources, their conclusions, their biases.
And then they all go out to lunch.

Debate and objection are indeed the norm of an academic conference. It continues well after the conference, as writers change their arguments, do new research, take into account collegial criticism and go back to the drawing board.

This is the way we too develop knowledge.

At no conference have I ever heard unilateral cheering. Indeed, if a conference paper does not get an attack from the audience, it means the paper was not interesting and fell on deaf ears.

There was little criticism of this summary of the AAO white paper on sleep apnea, and no questioning (apart from a few notable exceptions).

Instead there was—if O'Brien's blog comments are an indication—a majority acceptance of the summary report as "fact".

Indeed, given that only one commentator posted an objection to this O'Brien's blog for its egregious misrepresentation of the original source, there also appears to be a lack of interest from the community to even read the "important” White Paper on this "very important issue of sleep apnea."

Why bother when an AAO clergy member can explain this paper to the flock, in his own twisting words, on an internet blog?

Religion versus science?

I now understand why the basic principles of orthodontics have not evolved in 80 years.
Tags: Культура
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