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Completely novel user-centered orthodontic appliance design: A paradigm shift
Journal of the World Federation of Orthodontists 5 (2016) 79
Contents lists available at ScienceDirect
Journal of the World Federation of Orthodontists journal homepage: www.jwfo.org
Editorial
Completely novel user-centered orthodontic appliance design: A paradigm shift
In 2001, a product was launched that would forever revolutionize the music industry. Under the slogan “1000 songs in your pocket”, the iPod was introduced into the market, setting new paradigms in product design. Steve Jobs unveiled the obvious to the general public: All products and services should be user-centered. His authorized biography brought to light an intriguing story. Very often - during the iPod’s development e one of Apple’s engineers brought up new possible features which were usually fantastic, but too complex for ordinary users. Jobs used to vigorously reject such initiatives. Even then he already knew that a conventional user would spend no more than 20 minutes reading a product manual, and he was obsessed with the idea that the new player should be intuitive and user-friendly. Besides, he wanted it to be controlled by a single hand, while rendering it comfortable, convenient and pleasant to use. User-centered product design can be challenging. The fundamental difference from other product design philosophies is that user-centered design attempts to optimize the product towards the ways in which users can, want, or need to use the product, rather than force users to change their behavior to accommodate the product. This concept is relatively new e just a few decades old -, and has also been extended to health sciences, such as orthodontics. One of the major disadvantages of fixed orthodontic appliances, be they lingual or conventional, is that they were developed in an age when clinicians wanted patients to undergo treatment with the sole purpose of correcting a given malocclusion. Limited attention was devoted to the patient’s quality of life. It was therefore a time when doctors dictated treatments. Orthodontists naturally enhanced appliance design aiming at improving patients’ quality of life. Less traumatic bracket shapes and aesthetic brackets are examples of such commitment. However, most experienced orthodontists have very likely answered the following typical question posed by a patient that has just received
2212-4438/$ e see front matter Ó 2016 World Federation of Orthodontists. http://dx.doi.org/10.1016/j.ejwf.2016.11.002
braces: “how come you orthodontists haven’t yet developed a more comfortable appliance?” There are indeed more comfortable appliances: aligners. Nonetheless, they have several mechanical limitations that impair orthodontists’ ability to achieve high scores of treatment excellence, and this is why orthodontists tend to have mixed feelings about their use. On the other hand, aligners are user-centered, and this tends to be very attractive to the population. Our specialty stands at a crossroads. On the right-hand side, we have the choice of fixed appliances: an over-a-century-old road that has been repaved time and again. It may be winding and rough, but it leads to the blue mountains of excellence that one can descry on the horizon. On the left-hand side, we have the aligners’ road. It is smooth and new, appealing for its freshness, but it ends far before reaching excellence, in the muddy terrain of acceptable results. Unfortunately, no one can simultaneously ride both roads. It might be the right moment to blaze the trail of a whole new road. It might be time for our specialty to rethink orthodontic appliances, using technology and patient-centered design to achieve excellence while maintaining good quality of life during treatment. This endeavor would require a complete reshaping of what we use nowadays. Probably a start from scratch. Doing so would not necessarily give rise to a seismic shift in orthodontics. The pillars of our art and science do not rest upon brackets, wires, or plastic. They are deeply seated in biological concepts, proper diagnosis, and high quality education. Furthermore, the basic goal of any given health science is to improve the standards of care. Therefore, we must always seek improvement in our methods. This editorial raises a challenge. Passionate orthodontists, I challenge you to completely change the way I treat my patients. Within a decade, I will want a brand-new road to ride on. Jorge Faber, Editor-in-chief
Contents lists available at ScienceDirect
Journal of the World Federation of Orthodontists journal homepage: www.jwfo.org
Editorial
Completely novel user-centered orthodontic appliance design: A paradigm shift
In 2001, a product was launched that would forever revolutionize the music industry. Under the slogan “1000 songs in your pocket”, the iPod was introduced into the market, setting new paradigms in product design. Steve Jobs unveiled the obvious to the general public: All products and services should be user-centered. His authorized biography brought to light an intriguing story. Very often - during the iPod’s development e one of Apple’s engineers brought up new possible features which were usually fantastic, but too complex for ordinary users. Jobs used to vigorously reject such initiatives. Even then he already knew that a conventional user would spend no more than 20 minutes reading a product manual, and he was obsessed with the idea that the new player should be intuitive and user-friendly. Besides, he wanted it to be controlled by a single hand, while rendering it comfortable, convenient and pleasant to use. User-centered product design can be challenging. The fundamental difference from other product design philosophies is that user-centered design attempts to optimize the product towards the ways in which users can, want, or need to use the product, rather than force users to change their behavior to accommodate the product. This concept is relatively new e just a few decades old -, and has also been extended to health sciences, such as orthodontics. One of the major disadvantages of fixed orthodontic appliances, be they lingual or conventional, is that they were developed in an age when clinicians wanted patients to undergo treatment with the sole purpose of correcting a given malocclusion. Limited attention was devoted to the patient’s quality of life. It was therefore a time when doctors dictated treatments. Orthodontists naturally enhanced appliance design aiming at improving patients’ quality of life. Less traumatic bracket shapes and aesthetic brackets are examples of such commitment. However, most experienced orthodontists have very likely answered the following typical question posed by a patient that has just received
2212-4438/$ e see front matter Ó 2016 World Federation of Orthodontists. http://dx.doi.org/10.1016/j.ejwf.2016.11.002
braces: “how come you orthodontists haven’t yet developed a more comfortable appliance?” There are indeed more comfortable appliances: aligners. Nonetheless, they have several mechanical limitations that impair orthodontists’ ability to achieve high scores of treatment excellence, and this is why orthodontists tend to have mixed feelings about their use. On the other hand, aligners are user-centered, and this tends to be very attractive to the population. Our specialty stands at a crossroads. On the right-hand side, we have the choice of fixed appliances: an over-a-century-old road that has been repaved time and again. It may be winding and rough, but it leads to the blue mountains of excellence that one can descry on the horizon. On the left-hand side, we have the aligners’ road. It is smooth and new, appealing for its freshness, but it ends far before reaching excellence, in the muddy terrain of acceptable results. Unfortunately, no one can simultaneously ride both roads. It might be the right moment to blaze the trail of a whole new road. It might be time for our specialty to rethink orthodontic appliances, using technology and patient-centered design to achieve excellence while maintaining good quality of life during treatment. This endeavor would require a complete reshaping of what we use nowadays. Probably a start from scratch. Doing so would not necessarily give rise to a seismic shift in orthodontics. The pillars of our art and science do not rest upon brackets, wires, or plastic. They are deeply seated in biological concepts, proper diagnosis, and high quality education. Furthermore, the basic goal of any given health science is to improve the standards of care. Therefore, we must always seek improvement in our methods. This editorial raises a challenge. Passionate orthodontists, I challenge you to completely change the way I treat my patients. Within a decade, I will want a brand-new road to ride on. Jorge Faber, Editor-in-chief