Orthotown April 2020 - 24

message board
Fenrisúlfr
Member Since: 02/25/09
Post: 9 of 29

Myofunctional therapy is a scam because the proponents make ludicrous claims without
scientific evidence to prove its efficacy as it pertains to open bite closure and orthodontic relapse.
As an example of their level of scientific rigor, here's a critique of their holy grail: the MFT
Open-Bite paper.
Smithpeter J, Covell D Jr. Relapse of anterior open bites treated with orthodontic appliances with and
without orofacial myofunctional therapy. Am J Orthod Dentofacial Orthop. 2010 May;137(5):605-14. 1.
"There was no data presented on the similarity or homogeneity of pretreatment skeletal or
dental characteristics between the experimental and control groups, including cephalometric
measurements etc. How similar were the two groups? We don't know.
"The lack of random allocation to experimental or control group and lack of blinding leads
to a significant amount of selection bias. Out of the 27 subjects in the experimental group, 23
had no previous orthodontic treatment, whereas all 49 patients in the control group had relapse
following orthodontic treatment. This is therefore a comparison between 4 patients who had
post-ortho relapse vs. 49 in the control group. Not exactly an apples-to-apples comparison, and
a totally inadequate sample size to reach the conclusions of the study.
"Did the subjects in the control group have AOBs before orthodontic treatment or only after?
In other words, was the AOB iatrogenic? We don't know. As an additional example of cognitive
and observer bias, the control group was referred to MFT after relapse of orthodontic treatment,
whereas the experimental group was referred to MFT before or during orthodontic treatment.
This leads to a couple of confounders:
(a) There is no reason to believe that a similar degree of relapse would have occurred in the
experimental group relative to the control group, especially since there was no attempt to
match the groups at baseline.
(b) It is impossible to delineate the supposed effects of MFT from the effects of orthodontic
treatment alone. Also, this exposes an a priori underlying and unfounded bias (ironically
one that this study purported to address) that MFT would "prevent" AOB relapse.
"Reduction of excessive incisor protrusion can close the bite. Since we don't have any measurements, that remains unknown. No mention of the nature of orthodontic treatment provided
or mechanics used. Certain types of tooth movement (incisor extrusion with vertical elastics) is
more prone to relapse. In this particular study, the degree of frequency of vertical elastic usage
is unknown." ■
2/12/2020

NyceBiteR
Member Since: 10/21/08
Post: 10 of 29

I would posit that just because it hasn't been well studied yet doesn't mean it's a scam. Do
you have a well-designed study that provides evidence that it's useless?
Now, should someone-as a doctor with a fiduciary responsibility to patients to practice based
on evidence-recommend something to patients without evidence? Perhaps no, perhaps yes, as
long as the patient is aware that there is no good scientific evidence to establish its efficacy and
risks are minimal, as certainly is the case with myofunctional therapy. ■
2/12/2020

Fenrisúlfr
Member Since: 02/25/09
Post: 11 of 29

No. It doesn't work that way. I don't have to prove them wrong; they have to prove them right.
In other words, the burden is on them to prove that it is useful, not on me to prove it is useless.
Especially since the cost of this therapy can run up to $3,000.
Hitchens's Razor applies. This is a scam. Pure and simple. If you have proof of its efficacy,
please provide it. ■

2/12/2020

APRIL 2020 // orthotown.com

OT0420_MB1_Open-Bite_AG.indd 24

3/26/20 12:38 PM

http://www.orthotown.com

Orthotown April 2020

Table of Contents for the Digital Edition of Orthotown April 2020