Orthodontics and Vibration Technology

Vibration device orthodontic treatment

The aim of vibration technology in orthodontics is to speed up tooth movement and ultimately reduce treatment time. As long as there are no undesirable side effects this would be a very positive development! This explains why I’ve been asked if I use the technology.

As I see it, the use of vibration technology in orthodontics presents the following pros and cons:

Vibration device used in orthodontics

Demonstration of wearing dental vibration device.

Pros:

  • Potentially shorter treatment time
  • Potentially reduced risk of the typical orthodontic side effects as a result of reduced treatment time

Cons:

  • Significant additional expense for patient
  • Time required by patient in using the vibration device
  • Potential unmet expectations for shorter treatment time
  • Potential yet-to-be-discovered side effects

Over the course of my career in orthodontics I have seen a number of potentially promising and heavily-marketed products fall short of expectations so I feel a duty to evaluate the research on a product or technology before incorporating it into treatment of patients, for the following reasons:

  • Patients may make a treatment decision based upon the promise of a technology and then later regret the decision if expectations are not met
  • If shorter treatment time is not met as promised, the choices are to either extend treatment beyond what was expected or to compromise results in order to meet time expectations

I don’t find either of those scenarios to be pleasant, and I doubt that patients would either. Although I’ve heard a lot of positive discussion and testimony regarding the technology (which is referred to as anecdotal evidence, akin to hearsay), if the technology is effective then research should conclusively show that it is.

 

What about the research on vibration technology in orthodontics?

First a word on research. Not all research is created equal. There are all kinds of design and bias issues that can call results and conclusions into doubt. Studies must be of sufficient size, proper design, and independent of commercial interests. In addition, it’s best to have a high level of agreement between multiple, well conducted studies. Finally, while animal studies can shed light upon concepts, it takes studies with human subjects to verify effectiveness when it comes to actual treatment.

So, what have we learned from the research? In looking at the Scientific Evidence page of a commercial vibration device manufacturer’s website we see various published studies involving rodents, and mainly addressing sutures (growth centers of the skull), rather than actual movement of teeth. At the time of this blog post, there were no studies of human tooth movement referenced.

In my search of the scientific literature I found a few recent studies on the effects of vibration technology on human tooth movement but not necessarily focused on whether it reduces total orthodontic treatment time–which is what we really want to know, right? In the pro-vibration camp, Pavlin et al. found an accelerated rate of tooth movement, but the researchers received funding from the company that is producing the device (potential funding bias). In addition, Bowman found an accelerated rate of bite leveling but not of teeth aligning, or straightening. On the other hand, Woodhouse et al. showed no enhancement of the rate of tooth movement or reduction of time to achieve final alignment, and Miles et al. found no clinical advantage in initial alignment time nor reduction in treatment discomfort. In short, the research is not conclusive.

***UPDATE:

A recently published clinical trial study determined that vibration technology does not significantly shorten treatment time. Here is a review of the study, with a opinion regarding the current state of evidence on the topic of vibration technology in orthodontics.

Where I stand on the issue of vibration technology in orthodontics

Of course every orthodontist wants to offer the most safe, comfortable, convenient, cosmetically-acceptable, predictable, and quick treatment possible. We also have a duty to our patients to filter through the universe of techniques, treatment philosophies, and technologies; and properly-conducted scientific research is an indispensable tool in this quest. My hope is that future research conclusively demonstrates that vibration technology safely reduces treatment time in orthodontics. Until then I choose not to actively offer nor market the technology. As there have been no findings of harm from the device, I am not opposed to a patient using the technology as long as they understand that I make no promises and I do not endorse it.