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Editorial

The Death of the Orthodontic Bracket

Well buddy when I die throw my body in the back
And drive me to the junkyard in my Cadillac
- Cadillac Ranch.  Bruce Springsteen.  1980

What’s up guys?   On today’s episode of the Bulletin we are going to talk cars, braces and how they are dying a slow and painful death.”  (Cue the snazzy intro music!).

Ahh.  The pandemic.  So much time.  So little to do.  Looking back over the year, I should have made infinitely better use of it all.  Maybe write my first novel, find the cure for orthodontic relapse or at least clean up the house.  Such good intentions, so little traction.  Instead, enter the iPad and YouTube; the world’s biggest time-sink known to all.

What to watch?  Cats making faces while doing stupid tricks? Sounds good.  Babies seemingly making political speeches?  Never! (Well, maybe just a clip or two; so cute!)  No, I prefer to waste my quality time scrolling decrepit sailboats, obscure Film Noir and rusty old abandoned automobiles.

Permit me to dwell on my current vice, good old-fashioned car porn, an addiction born out of necessity.  Living in Toronto, where a single car garage goes for 750 thousand (that’s three-quarters of a million) dollars, while carving out a meager existence on essentially a fixed income (thanks University of Toronto), a cool exotic sports car is not in the cards for me.  Hence, my descent into automotive voyeurism, along with the acquisition of an embarrassingly large Hot Wheels collection for an over-grown middle-aged, man-child like me.

Which brings me back to YouTube and one Doug DeMuro, an internet icon who reviews cars, old and new, by pointing out the unique and quirky features of each specimen in his own unique and quirky way. The reviews blend into each other after a while.  Last night, whilst cleaning up after the latest of my infamous, low-sodium high-quality suppers of frozen burritos, cheap salsa and Lays Cheddar Jalapeno potato chips, I half-listened to his latest review of the 2021 BMW M3 sedan.  Other than the scathing assessment of the hideous front end and the associated stratospheric price tag, the review was standard fare.  But Dougie said something during this diatribe that made me think obscurely about my life, my loves and the practice of orthodontia.  

‘Buy this car if you want a car with modern technology, an internal combustion engine and a manual six speed transmission. This is last of the line’.  

The gasoline engine is at the top of its game.  Entry level cars routinely get 40 miles per gallon (7.06 litres per 100 kilometeres) or more. Emissions are lower than ever and while one cannot categorize any new car as cheap, the price point is such that most working folk could take the plunge if they were so inclined.  The petroleum-powered pram is as good as it going to get.  And its headed straight into the history books.

What was said about this BMW reminded me of the good old-fashioned orthodontic bracket.  Just like the Bimmer, it’s also at the top of its game.  Brackets were invented around the same time as the horseless carriage.   They evolved from clunky soldered masses affixed to cast iron harnesses into sleek bondable attachments that move teeth like nobody’s business.  While not inexpensive, it is not the price of brackets the public is talking about when they express concern over the cost of orthodontic treatment.

Nevertheless, folks didn’t like the ligature ties.  No problem; the dawn of coloured elastomerics was upon us. Folks didn’t like the coloured elastomerics.  No problem.  We got rid of those and perfected the nickel titanium self-ligating spring clip.  Still, folks didn’t like the look of the metal. No problem. We can them out of ceramic, gold, or glass; whatever works for ‘ya.  It doesn’t really matter, the fix is in. Make them out of Silly Putty; it still will never be enough.

Today’s orthodontic bracket is a high-performing machine and its future is on shaky ground.   People just don’t like them, especially when the alternative that has been so effectively marketed through every conceivable avenue imaginable. You can bet that every orthodontic bracket sees in its rearview mirror a clear aligner with its headlamps focused in on high.  Disruptors have become the norm.  It’s time to pull over and face facts;

The bonded stainless-steel bracket is the fully loaded manual transmission gasoline-powered car of the orthodontic profession.   What we are using now is the end of the line.

Call me a masochist, but I could go one step further.   It’s no secret the electric powered self-driving car will be the favoured mode of transportation in the near future.  Elon Musk is a billionaire many times over for good reason.  Tesla is valued at the level it is not because of the number of cars it produces today but for its potential to meet the demands of tomorrow.  Are Direct-to-Consumer aligners the self-driving car of the orthodontic profession?  Maybe.  Hopefully not.  We are all aware of the inherent risks of unmonitored care.   What could be riskier than driving down the road, plugged into your iPhone with nobody at the wheel?  But still, billions are being poured into both.  

I never thought I’d live to see the end of the conventional automobile. One look at the soaring prices of cars from my youth leads me to believe that I am not alone.   I am certain, however, that I will be around to see the demise of the venerable orthodontic bracket.   That time is roaring up all too fast.

We’d best keep our eyes on the road.    

Jimmy P
Sent from my iPhone 
(just to prove a point!)
 
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