Trumpeting the power of braces

02 February 2018
Volume 31 · Issue 6

Lubo Rnic, a teenager from Bristol, has won the first place prize in the British Orthodontic Society's Against the Odds award.

Lubo Rnic badly wanted to play the trumpet when he was in primary school. Though try as he might, he was the only child in his class who couldn’t produce a single sound. Seven years later, Lubo not only plays the trumpet, in March he will be playing in a school concert.

The 17-year-old owes this achievement to the skill of an orthodontist and the initiative of a speech and language therapist. Peter Thomas is the Bristol orthodontist who carried out Lubo’s life-changing orthodontic treatment and Sarah Barnett is the speech and language therapist who had a hunch that braces could help Lubo. And she was right.

The story began when Sarah suggested to Lubo’s parents, Mihailo and Olya, th9at orthodontics might improve his speech, saliva control and eating skills - helping achieve less messy biting and chewing. Lubo has some disabilities, including dyspraxia and autism. His weak muscle tone and protruding teeth meant he couldn’t close his lips.

Sarah said, “Not being able to close his lips affected his speech, and he had difficulties with eating and drinking. If you can’t close your lips, it’s difficult to keep your food in your mouth when you’re chewing. Also, you need to be able to close your lips for swallowing. Adults need to swallow their saliva around 2000-3000 times per day. Lubo couldn’t close his lips, so couldn’t control his drooling. I wasn’t certain orthodontics would help but I hoped it would.”

The devoted parents looked around for the right person to provide the treatment, fearing that they would be turned down. But Peter Thomas of Bristol Orthodontics was willing, “I knew I could do the treatment but the question was whether Lubo would cope with the braces. I started out with trepidation.”

Mrs Rnic said, “We were apprehensive, but Dr Thomas immediately put us at our ease. He explained everything and showed us pictures and said there was a tiny chance that orthodontics would help with speech and saliva control.”

Lubo would have to wear a functional brace, which is designed to bring his lower teeth forward. Then he would have to wear fixed braces combined with elastic bands which would hook together his upper and lower teeth to improve the bite. Finally, throughout treatment, he would have to have his teeth cleaned by his parents at least twice a day, every day. But Lubo did not waver.

Now the amazing story of Lubo’s teeth-straightening has won him first prize in the British Orthodontic Society’s Against the Odds award. Not only was it a challenging treatment but Lubo had to be highly cooperative over the course of the two and a half years of treatment. He began with the functional brace for nine months and then wore fixed braces for 18 months. Only a few weeks into treatment, his saliva control improved and gradually he found he could close his lips. By the end of treatment, when he was given a trumpet, he found he could play!

Mrs Rnic said, “The proudest and most emotional moment was when his braces were taken out and, even with his limited language, he remarked, ‘Now finally I can smile properly in photographs.’

“We can’t begin to count the number of benefits that the treatment has brought Lubo. It’s exceptional for us that now, because he has a perfect bite, he can play the trumpet. But he is the hero in all of this. We helped him, but he was the one who did it.”

This praise is echoed by Peter Thomas, “Lubo was a delight to treat. He always came in with a smile and he never complained that his braces were awkward or difficult. Off the back of Lubo’s treatment I would like to see research into the impact of orthodontics on lip seal and muscle tone. Orthodontics is about so much more than teeth-straightening.”

BOS research director Professor Philip Benson is supportive of research into the impact of orthodontics on speech. He commented, “There is a reasonable amount of evidence that specific speech problems are associated with certain occlusal anomalies; however, I think there is little research showing that orthodontic treatment improves speech and this might be something to look at in future studies.”

Sarah added, “The progress made by Lubo is really, really remarkable. He always gives of his best in therapy sessions and is such a joy to work with. His parents and his sister have been instrumental. Their love for him and their celebration of who he is and their desire to make his life easier really helped.”

She added that she was now in discussion with Peter Thomas about other patients of hers with speech and language difficulties who could possibly benefit from orthodontics. “So often we work in silos, but referrals to other professionals was stressed during my training and I was convinced that with Lubo it was worth exploring orthodontics. It’s pleasing to have been vindicated.”

The runner-up in the competition was Roshannah Cox from Dunfermline, Fife who was treated by Colin Chambers while Archie Kidd from Darlington was awarded a special commendation for his witty and engaging entry. He was treated by Jonathan Hunter. The judges were Professor Tim Newton, professor of Psychology as applied to dentistry at King’s Dental Institute and Stephen Hancocks, editor of the British Dental Journal.

Anshu Sood, chair of the BOS Orthodontic Specialists Group, said, “We are delighted that orthodontics can have such a big impact on so many people and especially both the winners of the Against the Odds Competition. The power of a functional bite and a confident smile cannot be underestimated. We are very pleased with the number of entries the competition continues to receive and the difference that orthodontics continues to make to so many people.”