Occasionally I have patients ask about Damon brackets. Think about this, do you know the best knee replacement implant or pacemaker? Chances are you don’t, and if you needed to make that decision you’d ask someone knowledgeable that you trust. (Hopefully the orthopedic surgeon or cardiologist would be top on your list!) It’s the same with brackets. What Damon has done exceptionally well is marketed to consumers so they know to ask for Damon brackets. Which is fine, except I don’t believe they are the best brackets, and I don’t believe in the Damon system either. Here’s why:
- Damon touts light “biologic forces,” but this is not anything unique to the Damon system. Not exclusive to Damon, every modern orthodontist uses nickel titanium wires that exert light forces for tooth movement. The wires I use have been shown in studies to have lighter forces while at the same time maintaining the force to produce the desired movement.
- The slot on the Damon bracket (where the wire slides in) is oversized so the wire doesn’t fit precisely. Imagine a round wire in a square bracket slot. The fit isn’t tight. Pushing one tooth out slightly or raising or lowering one of the front teeth to create the most aesthetically pleasing smile is almost impossible without having full control of the wire. Now imagine how much easier and precise that movement would be with a square bracket and a square wire that fit perfectly together!
I also disagree with Damon on a philosophical level. Damon touts that any amount of crowding can be alleviated with light forces that expand the arch. As a result teeth are almost never extracted. I don’t recommend extracting teeth very often, but sometimes it is necessary to produce the best outcome. I like to think of it like this, there is tasteful plastic surgery and less tasteful surgery. Good plastic surgeons make things proportional and natural. Other surgeons encourage the mindset that bigger or tighter is better—imagine Joan River’s face. Most people don’t aspire to look that way. So it is with smiles. I can make a smile as wide and flared out as any Damon guy, but that doesn’t mean it is the healthiest or most aesthetic look. Two children of two different dentists have recently become patients after originally being treated with the Damon system in other offices. Although neither child was excited about having orthodontic treatment twice, their dentist fathers were unhappy with the flared front teeth and unnatural arch form.
My second issue with the Damon System is that the company sends sales representatives to provide an orthodontic manual and teach orthodontists the Damon system. Too often orthodontists allow the Damon manuals to supersede training from a research based residency program or continuing education courses.
In conclusion, can Damon brackets be used to create and aesthetic smile? Yes. The bracket and system just don’t fit my philosophy of individualized care and evidence based results.
Smile, Life is Good!