Statement of the issue: Is there a link between the many perceived advances in orthodontic techniques/therapy and science in the past 20 years? The purpose of this paper is to take five topics and match the perceptions with the scientific evidence. The variety of appliances and the swings in treatment philosophy have been dramatic, including the swing from extraction to non-extraction therapy, the introduction of space-age wires, appliances that grow mandibles, the introduction and extraordinary growth of Invisalign, and reduced friction brackets to reduce treatment time, all with claims by manufacturers of better results than ever before. The focus is on faster treatment, reduced visits/appointments and superior results. Most of these ‘advancements’ represent what has been the ‘juggernaut of technology’.

Materials and methods: Five questions are posed, and an evidence-based approach is used to critically examine the literature in these selected topics.

Results: The evidence is lacking for some of the most commonly used systems and materials in orthodontic practice today.

Conclusion: More randomised clinical trials are needed in orthodontic practice to evaluate treatment outcomes.