The article by Dr. Gordon Christensen in April JADA, "The Major Part of Dentistry You May Be Neglecting," reviews occlusal equilibration. On page 498, Dr. Christensen devotes almost a column to "postorthodontic occlusal equilibration." That segment of his article is incorrect.
Modern orthodontic fixed appliances are designed to place teeth into positions from which they can detail themselves via eruption (that is, "settling") into the most physiological and functional positions possible for the individual. After having treated over 23,000 patients with various orthodontic appliances, I can assure Dr. Christensen that the tooth positions on the day of the debanding will be different from those a day, a week, a month, a year and many years later.
In my opinion, as a practicing orthodontist with American Board of Orthodontics certification and many years of experience, any occlusal adjustment of the dentitions of newly debanded patients should be deferred for at least six months, if not for a year. It can take that long for final tooth positions to be somewhat stable. On the day of debanding, teeth are slightly mobile and shift readily into positions determined by the physiological forces on them. If one occlusally adjusted these teeth, interferences would likely develop in both working and non-working movements as the teeth moved into their final occlusal scheme. Thus, more harm than good would be accomplished. The above might explain why those of us who practice orthodontics do not adjust occlusions until long after the debanding date.
The one exception to the delayed timing of occlusal adjustment would be the adjustment of occlusal interferences in the periodontally involved patient. Of course, one should be adjusting the occlusion of those patients during treatment as well, to prevent adverse forces from creating excess mobility of the teeth, particularly the molars.
Dr. Christensen mentions "equilibration ... within hours of the removal of the orthodontic movement devices to avoid movement of the teeth caused by unavoidable occlusal prematurities." My cases do not have "unavoidable occlusal prematurities." If orthodontic care is provided correctly, the teeth should become leveled and aligned, the arches symmetrical and the teeth interdigitated into as ideal positions as possible.
As a general rule, I would caution against the occlusal adjustment of orthodontically treated teeth until they have had adequate time to settle.
