EDITOR’S WELCOME Greg Cannizzo, DDS, CDE, JAOS Editor 3617 Municipal Drive, McHenry, IL 60050 Phone: (815) 344-2282 • Fax: (815) 344-5815 • Email: drgrc@joltmail.com ASSOCIATION STAFF Nate Porter AOS Executive Director American Orthodontic Society 1785 TX-26 Suite 200 Grapevine, TX 76051 E-mail: support@orthodontics.com Adam Griswold AGpO Executive Director Academy of Gp Orthodontics 509 E. Boydston St. Rockwall, TX 75087-3956 (800) 634-2027 E-mail: agriswold@academygportho.com Now Is Not the Time for Detractors The January issue of the J ournal of Clinical Orthodon-tics included a Q&A on “Managing Erroneous Care.” In the article, a roundtable of orthodontists discussed “questionable practices by non-orthodontic specialists” and commented on care provided by non-specialists, making several generalized claims without citing supporting evidence. The editor asserted that “practi-tioners overprescribe frenectomies and myofunctional appliances,” dismissing the modalities as “costly with little benefit.” Such statements represent a concerning lapse in professional curiosity. To disregard the intersection of bone biology, respiratory health, and anthropology is to view the oral cavity in isolation, divorced from the broader human system. Moreover, to do so without refer-encing the existing body of literature (see the detailed references at the conclusion of this editorial, including the work of researchers like Guilleminault, Yoon, and Corruc-cini) suggests a closed-loop perspective that risks becom-ing resistant to new data. As the field evolves, so too must our willingness to engage with emerging evidence and adapt our approaches to solving clinical problems. This situation recalls the classic parable of the hedgehog and the fox. The hedgehog is a specialist. It knows one thing and knows it well—in this case, how to find the sweetest acorns in the high oak forest. The hedgehog ignores alternative food sources, focusing solely on its niche expertise. The fox, by contrast, is a generalist. While not exceptional in any single domain, it possesses a broad range of skills—fishing, foraging, digging, and climbing—allowing it to adapt to varied conditions. When a severe drought strikes and the oak forest fails to produce acorns, the hedgehog continues to rely on its singular strategy, growing weak as its environment changes. The fox, however, adapts. It seeks out new food sources, shifting from river hunting to foraging in shaded marshes. In a changing environment, adaptabil-ity—not specialization alone—ensures survival. The roundtable participants correctly emphasized that the key to orthodontic excellence lies in accurate diagnosis, comprehensive treatment planning, a sound understanding of growth and biomechanics, and the execution of appropriate mechanics. On this point, there is full agreement. The principles are foundational and central to the standards of care taught by organiza-tions like the American Orthodontic Society and Academy of General Practice Orthodontics in their comprehensive training programs. In many respects, our organizations extend beyond traditional expectations. Our credentialing pathways emphasize advanced diagnostic skills, clinical judgment, and a commitment to ongoing continuing education. In this issue, Dr. Leonard Carapezza highlights the enduring relevance of the standard of care established by the late Dr. Lawrence F. Andrews through his Six Keys to Occlusion and a mutually protective functional occlusion. These standards of care, given to dentistry by Andrews, are an integral part of what we teach and follow in our credentialing process. When asked about pediatric dentists providing orthodontic treatment, the panel acknowledged that “treatment quality depends on the clinician’s understanding—not on whether they are a pediatric or general practitioner.” This perspective underscores an important point. High-quality care is rooted in education, experience, and clinical judgment. The training provided by our organizations—combined with structured advancement, ongoing continuing education, and scholarly discourse through this jour-nal—ensures that our clinicians are well-equipped to deliver evidence-based, patient-centered care. When we stop being curious about the root cause of skeletal collapse, we stop being healers and start being mechanics for a failing system. I choose to follow the data—wherever it leads—combined with the excellent standard of care our organizations teach and follow. References 1. The "Software" of Breathing (OMT) • Guilleminault, C., et al. “Critical role of myofascial reeducation in pediatric sleep-disordered breathing.” Sleep Medicine , 2013, Jun, 14(6): 518–25. o The Data: Myofunctional therapy reduced the apnea-hypopnea index (AHI) by 50% in adults and 62% in children. o The Reality: The tongue and pharyngeal muscles are the "software" that maintains the airway. Moving the "hardware" (teeth) without addressing the "software" is why traditional retention so often fails. 2. The Mechanical Release (Frenectomy) • Yoon, A., et al. “Toward a functional definition of ankyloglossia: validating current grading scales for lingual frenulum length and tongue mobility in 1052 subjects.” Sleep Breath , 2017, Sep, 21(3): 767–775. o The Data: Restricted lingual frenulums are statistically correlated with maxillary hypoplasia (narrow palates). o The Reality: A tongue tie is a physical tether that prevents the tongue from serving as the body’s natural orthodontic expander. Release is not "over-prescribing," but rather restoring biological potential. 3. The Historical Control (Anthropology) • Price, W.A. Nutrition and physical degeneration: A comparison of primitive and modern diets and their effects. New York, NY, 1939: P.B. Hoeber, Inc. • Corruccini, R.S. “Anthropological aspects of orofacial and occlusal variations and anomalies.” In Advances in dental anthropology, 1991, M.A. Kelley and C.S. Larsen (eds.), New York, NY, Wiley-Liss: 295–323 o The Data: Pre-industrial skulls consistently show wide arches and zero crowding. The "nickel standard" of spacing in primary teeth was the biological norm for millennia. o The Reality: Crowding is a modern "mismatch disease." Bioblocs and Myo Munchies act as mechanical signals to mimic the hard-chewing forces our ancestors used to develop robust faces. EDITORIAL STAFF Greg Cannizzo, DDS ............. AGpO/AOS Editor Shea Gibbs ............................... AOS/AGpO Managing Editor Email: shea@gibbscom.com EDITORIAL REVIEW BOARD Robert Allen, DDS.................................AGpO Ron Austin, DDS...................................AGpO Kauser Bari, DDS ...................................AGpO Jeff Dahm, DDS........................................AOS Fred Der, DDS .......................................AGpO Elsa Echeverri, DDS..................................AOS Drew Ellenwood, DDS ..........................AGpO Debra Ettle-Resnick, DDS.........................AOS Clark Hunstad, DDS.................................AOS Scott Earp, DDS.....................................AGpO Bernadino Elizondo, DDS ........................AOS Andrey Horton, DDS................................AOS Thomas Jacobsen, DDS.........................AGpO Gregory T. Jeneary, DDS ..........................AOS Amanda Larsh, DMD ............................AGpO Brian Machart, DDS..............................AGpO Kyle McCrea, DDS ................................AGpO Sherman Menser, DDS..........................AGpO Danielle Meirick-Immerman, DDS ..........AOS Nemeen El Gammal, DDS ....................AGpO Milton Ntragatakis, DDS.......................AGpO Humberto Nunez-Gil, DMD .................AGpO Jana Oister, DDS.......................................AOS Ann Mary Orr, DDS .................................AOS Jennifer Rand, DDS...............................AGpO Allen Rotberg, DDS ..................................AOS Raphael Santore, DDS...........................AGpO Gary Schulman, DDS ...............................AOS Coty Shores, DDS..................................AGpO Kimberly Suter, DDS ................................AOS Susan Tiede, DDS .....................................AOS Walter Tippen, DDS ..............................AGpO Brian Vierthaler, DDS...............................AOS Bradford R. Williams, DDS ......................AOS 4 Spring 2026 JAOS
Journal of the American Orthodontic Society Spring 2026: Page 4
