The paradigm shift in contemporary orthodontics: why waiting to treat malocclusion is no longer a scientifically defensible position

This is an authorial synthesis article, reflecting my personal opinion and critical interpretation as the sole author, built upon and supported by the body of literature cited throughout the text. It is not a systematic review, nor a meta-analysis, nor a primary research report. It is an integrative essay that articulates evidence streams from evolutionary anthropology, sleep medicine, functional orthodontics, nutrition, neurophysiology, and the Ibero-American tradition of jaw functional orthopedics, with the aim of offering a coherent reading of the historical moment the profession is going through. The article argues that the dominant orthodontic “wait-and-see” doctrine is no longer scientifically sustainable, and that the contemporary literature – from Kevin Boyd’s evolutionary anthropology and the Mews’ orthotropics to Christian Guilleminault’s sleep medicine, the 2024 Chinese Expert Consensus on pediatric orthodontics, and Paul Henny's recent philosophical-structural critique – converges on the need for timely, interdisciplinary, airway- and function-centered care. The article also seeks to position the Ibero-American tradition of neuro-occlusal rehabilitation (Pedro Planas) and jaw functional orthopedics (Wilma Alexandre Simões) as the historical and conceptual bedrock of much of what the Anglophone literature is now rediscovering, and to articulate the recently proposed neurostomatological framework as the unifying biological foundation of the new paradigm.