orthodonticslecture-100823205437-phpapp01

7/30/2019 orthodonticslecture-100823205437-phpapp01

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Orthodontics

Please turn off cell phones.


2/23

Who Needs Orthodontic Treatment?

Adults and children both seek orthodontic

treatment for:

Malocclusion (incorrect bite)

Tooth alignment (crooked teeth)

Improvement of overall appearance, including

gaps between teeth


3/23

Classification of Occlusion

Class I Class II Class III

Upper and Lower

molars align

properly, but teeth

are crooked. 72%

of ortho cases.

Upper molars are

positioned too far

forward (anterior)

compared to the

lower molars. 22%

of ortho cases.

The upper first

molar is

positioned behind

the lower first

molar. 6% of

ortho cases.


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Examples of Malocclusion

Overbite The upper front teeth cover too

much (more than 30%) of the lower front

teeth. Also called a deep bite. This may

be seen in a Class I or II malocclusion.


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Overjetcauses buckteeth. The upper front teeth are

positioned too far forward (normal distance between

upper and lower front teeth is 1-3 mm). This is typical in

Class II maloclussion.


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Underbitecauses a bulldog appearance.

The lower front teeth are positioned in front

of the upper front teeth. This is seen in

Cass III malocclusions.


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Crossbite The upper teeth should

overlap the lower teeth slightly when the

jaws are closed. When this does not

occur, it is called a crossbite. May occurin any class of malocclusion.


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Open bite open space exists between

upper and lower teeth when jaws are

closed. Often caused by thumbsucking,

seen in all classes of malocclusion.


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Midline shift the center of the upper front

teeth is not aligned with the center of the

lower front teeth. Can be seen in all

classes of malocclusion.


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What causes malocclusion?

Genetics - You may inherit a small mouthfrom mom and large teeth from dad.

Tooth loss - If a tooth is lost from an injury,

cavities, or gum disease, the remainingteeth may shift.

Bad habits such as thumbsucking can shift

teeth or cause them to erupt improperly. Malnutrition Nutritional deficits can

restrict the growth of jaws and teeth.


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When is the best time for ortho?

The jaws of pre-teens and teens are still growing.

Therefore, it is easier to shift teeth at this stage.

Sometime, two separate phases of braces are necessary

for treatment. Phase I when patients are 6 to 7 years old, to make room for

the permanent teeth to erupt properly

Phase II at age 12 (or when permanent teeth have erupted) a

second round of braces are applied to straighten teeth and

correct bite.

It is becoming more common for adults to seekorthodontic treatment. Their treatment may take longer to

complete.


12/23

Space Maintainers

When a primary, or deciduous, tooth

(commonly called baby tooth) is lost too

early, the space needs to be held open

until the permanent tooth is ready to erupt.
http://www.dental-videos.com/xrays/spotlight/impacted/impacted1.htm


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Space Maintainers

A space maintainer is an appliance made

of metal or plastic and may be removable

or cemented onto neighboring teeth.

Removable space maintainer

Band and loop maintainer Lower lingual holding arch
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Why does malocclusion need

corrected?

An incorrect bite can have long-termeffects including:

Interference with normal growth and

development of jaws Difficulty swallowing

Impaired chewing

Speech defects

Susceptibility to cavities and gum disease

Poor aesthetics


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How do braces work?

Teeth can be GRADUALLY moved into proper position by

applying pressure in certain directions using bands,

wires, and elastics. A series of clear trays, such as

Invisalign, may also be used.

standard

braces

lingual

braces

Clear

braces

virtually

invisible

Invisalign trays
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How do braces work? Removeable appliances may also be used such as:

Palatal expander to widen the arch Jaw repositioning appliance, or splint, to retrain the

jaw to close properly

Headgear- involves a strap that wraps around the

head and attaches to a wire or face bow in the front.used to slow the growth of the upper jaw and move

front teeth towards the back.

palatal expander

Jaw repositioning

applianceHeadgear
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How do braces work?

Treatment typically lasts 1 to 2 years. Afterbraces are removed, retainers are used to holdthe teeth in their new position.

Typically, retainers are worn 24 hours a day for

the first six months and then worn only at nightthereafter. Permanent retainers, bonded to theback side of front teeth, may also be used.


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Home care for ortho patients

Braces collect food and plaque very easily.

Often, ortho patients are children or teenagers

who do not have optimum brushing and flossing

habits.

If braces are not kept clean, tooth decay and

gum inflammation easily occur.

Orthodontists may decide to remove bracesprematurely if the patients hygiene is poor.


19/23


Brushing Special orthodontic toothbrushes or battery

toothbrushes may be useful.

Patients need to brush both above and below thebrackets, paying special attention to the space

between the gumline and the brackets.
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20/23


Flossing

Flossing around braces is time consuming.

Superfloss (strands of floss with stiff ends) or floss

threaders are used to floss beneath the wires.

Interdental brushes can be used between the wire

and the tooth, between brackets.
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A fluoride mouthwash, either over-the-counter orprescription, is usually recommended to helpprevent tooth decay around the brackets and toreduce decalcification.

A oral irrigator such as a Waterpik, may be usedto flush debris from the brackets.
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Home care for ortho patients.
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Dental Check-ups

An orthodontic patient needs to visit his or

her general dentist at least every 6 months

for a cleaning and check-up to monitor the

health of the teeth and gums, ensuringgreat results when treatment is complete!
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