Decision-making Theory in Orthodontics

Orthodontic treatment is a successful and appropriate approach for improving and correcting the position of teeth which enhances the physical appearance and functional demands of patients. Orthodontic treatment can significantly alter a patient’s appearance and facial features. So, Treatment planning in orthodontics plays a vital role in outcomes. Orthodontic treatment can be divided into multiple steps and each step has its significance. Any flaw in treatment planning can affect the following phases and ultimately affect the final patient outcomes.

The decision-making in orthodontics depends upon multiple factors including patient clinical needs, patient preferences, operator choice, and patient compliance. The whole process is carried out in various steps.

The modern paradigm in orthodontics:

With time there is a shift in the health care outcome. Previously the treatment of disease was the focus of orthodontists but now the main goal is to enhance the patient’s quality of life. The quality of life includes multiple parameters like the patient’s social, psychological, and physical health. The new paradigm supports the previous concept that the patient’s ultimate motive for taking orthodontic help is to reduce their feeling of social handicap which affects their quality of life. Now the modern orthodontic decision has the following goals.

• Enhances the patient’s facial appearance and aesthetics with improvement in the patient’s social well-being and quality of life.
• Maintain the patient’s oral function and increase its adaptability.
• Gian the optimal occlusion of a patient with the proper occlusal contacts of teeth. However, there is no ideal occlusion that is optimal for all patients.
• Achieve a stable occlusion with the psychological well-being of the patient.

Problem-oriented approach in orthodontics:

A problem-oriented approach in orthodontics focuses on identifying and addressing specific issues or problems in a patient’s dental and facial structures. The first step in the decision-making process is to prioritize the patient problem list. The problem list is used as the diagnosis for the patient. The complete problem list can be constructed by interviewing the patient, clinical examination, and patient diagnostic records. The effective and appropriate use of a problem-oriented approach enhances the chances of successful orthodontic treatment and positive treatment outcomes. The orthodontic decision is based on multiple factors starting from the data collected by the patient and the diagnosis evolved after examination. Let’s give a brief review of related steps that might be helpful to make the most suitable orthodontist diagnosis.

Development of diagnostic database:

The first and most important step in orthodontic diagnosis is evaluating the patient’s needs and expectations. In the first interaction with the patient, the orthodontists can understand the patient’s chief concern. All these factors lead to the formation of a diagnostic database which is pivotal for future diagnosis and decision. All the relevant data can also be extracted through a questionnaire that can be filled out by patients or parents. In the first meeting, the orthodontist should not assume the patient’s chief concern without asking patien future expectations. In the same visit, the orthodontist can also determine whether the patient is a suitable candidate for orthodontics or not. There are various supportive aids that help in decision-making. One of the most recent advancements is the introduction of Artificial Intelligence for the diagnosis and treatment planning of orthodontic problems. Patient compliance is another factor that should be considered patient patient-first interactions. Like the very young patients might not be suitable for the removable appliances.

New concepts of decision-making:

Currently, Dr. Baxmann‘s developed a new system of ABCD for efficient and cost-effective decision-making elaborated in his book Lean Orthodontics®. The system has 100% success with 80% less effort. Dr. Baxmann‘s ABCD-System® is therefore also a decision-making aid that separates the important from the unimportant and filters out the unimportant according to the exclusion procedure. The system is based on the concept that the decision making should include multiple treatment modalities and final selection of treatment plan should base on patient clinical situation and chief concerns.

The ABCD system® is supported by artificial intelligence which is the fastest way that helps to think rationally. The artificial intelligence algorithms aid in reaching the final target point with accurate data and in possible shortest time possible. In the complexity theory of decision-making compression method was used with Dr. Baxmann’s ABCD-System®. This allows us to streamline the information entering the database system and organize it efficiently, for the conserve energy. As a result, we can reach our goals of cost-effective treatment planning more quickly and effortlessly.

The decision-making process can be time-consuming and complex but with the help of LeanOrthodontic® and new AI methods, it can be fast, cost-effective, and efficient. the orthodontist can engage the patient throughout the decision-making process but the final treatment plan should not be too much influenced by the patient’s choice and Judgment.

Citation:

1. Ackerman JL, Nguyen T, Proffit WR. The decision-making process in orthodontics. Graber LW, Vanarasdall RL, Vig KWL (edi). Current principles and techniques. 5th ed. St. Louis: Mosby. 2011 Jun 16:3-58.
2. Baxmann, M., & Gronau , K. (2024). Dr. Baxmann´s LEAN ORTHODONTICS® – The Ultimate Practice Book Series for excellent Orthodontics: Case Planning Volume 3. https://www.amazon.sg/Dr-Baxmann%C2%B4s-LEAN-ORTHODONTICS%C2%AE-Orthodontics/dp/3948361673