In this clinical narrative, Dr. William M. Hang recounts a troubling orthodontic case involving a young woman whose father, a single parent working for a movie studio, had previously taken her to an orthodontist in the San Fernando Valley. The prior treatment involved extraction of upper bicuspids and the use of a combination headgear—a standard of care at the time. The father, outraged by the outcome, picketed the orthodontist’s office and considered legal action. Dr. Hang offered pro‑bono treatment contingent on the patient traveling to Dallas for corrective surgery. The patient, now a married mother, suffers from chronic headaches, sleep apnea, TMJ clicking, and an open bite, all linked to the earlier orthodontic approach. Dr. Hang explains that further orthodontic manipulation (e.g., orthotics) could exacerbate the bite and airway issues, emphasizing the need for surgical correction and highlighting the long‑term airway and joint consequences of the original treatment.
Chapters
Traditional treatment for a young lady that looks like this, what are you gonna do? These are not my pictures, by the way. She was treated up in the San Fernando Valley by someone else before I came to California. And her father was a single dad trying to raise 3 kids, and he drove a limousine or something for one of the movie studios. I'm a little bit nervous. He hated what he had allowed to have happen. Because his daughter came to see me, she was looking like this. Now, she's had upper bicuspids out, and she wore a headgear. And this man has picketed the orthodontist's office. Wow. I'm not joking. Long before I ever came to town, he's telling me that I picketed this guy's office. I couldn't stand what happened. I saw her face do this, and it's not okay. I'm so guilty. And I told him to get— I had emails going back and forth and phone calls. I told him, you gotta get help, I'm sorry. Then he wanted to sue the orthodontist. I said, so what was done? Oh, she wore a headgear. What kind of headgear? One here and one here. I said, yeah, that's what you're taught to do, a combination headgear. Not a cervical headgear, but a combination headgear would be okay. And that's the standard of care. And this is exactly the outcome that you would expect. I then offered to treat this girl at no fee whatsoever. I did, I'll treat it for nothing, if you'll agree to go to Dallas, Texas, to have surgery with my surgeon. The girl was in her late teens, didn't wanna hear a thing about surgery, didn't wanna hear a thing about braces. She hated her father for bringing her to me. About 3 years ago, this was 1998, 8, I believe. About 3 years ago, the dad calls me up. Dr. Hang, remember me? Yeah, how you doing? Great, I thought about you. I saw somebody on TV and I thought about you. How are you and your family doing? We're doing just fine, blah blah blah. How's she doing? Well, she's living in— she's married and has a kid. Would you give me her contact information? I'd like to talk to her. So I called her up. Identified myself. She's got headaches all the time. She's in school. She has sleep apnea. She's got clicking jaw joints. Clicking joints are going down the tubes. It only is a matter of time when you go from this bite and then she's into one of your offices to treat the TMJ. And you know what you can do. Best case scenario for you treating this girl at this point. What are you gonna get out of it? She's starting out with an open bite. You put her in an orthotic, you're gonna make it worse. Then you're gonna rub the teeth, and what are you gonna do about her airway that isn't there? Mm-hmm.
