Search and Research
Have you ever wondered why scientific investigation is called research instead of search? It seems likely that the reason is that findings must be able to be repeated. A finding from a single search may be accurate, but it must stand the test of research. A duplication of the experiment must achieve a duplication of the result. The flap over room-temperature fusion was a prime example of scientific doubt cast by failure to replicate a reported success.
In orthodontics, we have been hampered by a paucity of both search and research. There is little impetus for anyone to devote possibly 10 years to an original investigation of some aspect of the biology or physiology of orthodontics--let alone to confirm or deny a reported result. Indeed, in the history of science there have not been many individuals who have been willing or able to devote their lives to search and research.
Charles Darwin was one such individual. Darwin had an overwhelming interest in natural science, he had independent means, he had a supportive family, and he had a brilliant mind with a penchant for details and organization. While achieving prominence through the publication of several books on various scientific subjects, Darwin ruminated about what was to become the theory of evolution--natural selection through the survival of the fittest--for a period of more than 20 years before he was persuaded to publish. The persuasion came about because a young man named Alfred Russel Wallace achieved the same concept as Darwin through a flash of intuition in the midst of a bout with malarial fever, and published a precis of the idea.
It is amazing what these men were able to infer from their studies of flora and fauna. It was prior to the work of Gregor Mendel, the development of decent microscopes, the discovery of DNA, and the documentation of a whole host of biochemical principles--all of which are readily available to modern searchers and researchers. Still, the work of both Darwin and Wallace was search. It opened avenues of research for generations that followed and are yet to come.
Orthodontics seems to be limited mostly to search by the flash-of-intuition route, by part-time investigators or one-time investigators with little or no background in scientific method. There are not many professional researchers in orthodontics. There have not been many long-term projects, even in the matter of post-treatment stability, which would seem to be a natural even for the part-time investigator.
More than 20 years ago, in a column like this one (JCO, May 1971), I suggested a number of fruitful areas for research. They included:
Scientific investigation has touched little on these areas in 20 years, leaving them largely unresolved. The foremost achievements in orthodontics, from the point of view of the clinician and the patient, have largely resulted from technique innovations by countless individuals in clinical practice, and from attempts by countless others to duplicate the reported results.
There are some who denigrate reports of clinical experience as anecdotal and unscientific. But as long as we keep in mind that these are a part of search and research, and as long as we reserve judgment on them, they serve a useful purpose. Clinicians don't have the privilege of sacrificing their subjects or of putting them under a microscope or repeating the exact experiment.
By their very nature, clinical investigations cannot be held to the same rules as laboratory investigations. That doesn't make them invalid or useless. It is inappropriate to demand scientific certitude before sharing clinical experiences or to knock the this-is-what-I-did-and-this-is-what-happened school of search, or the that-looks-like-a-good-idea-I'll-try-it school of research.
In a clinical specialty we need both search and research. We need them at both the laboratory and clinic levels.