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Introduction to Orthodontics

Jonathan Chapple

Department of Orthodontics

Newcastle Dental Hospital

Jonathan ChappleDepartment of Orthodontics

Newcastle Dental Hospital

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3rd year BDS 15th December 2006

Good morning!

If you are 3rd year dental students attending a

lecture on Orthodontics

Then we are all in the right place.

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Objectives of this lecture

Orthodontics

What is orthodontics?

What do we do?

What will you get to do? Those who are interested..

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Orthodontics What is

Orthodontics? The branch of

dentistry concerned

with the treatment andprevention ofirregularities of theteeth and jaws

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Where does orthodontics sit?

Restorative DentistryProsthodontics

Conservative Dentistry

Periodontology

Oral Medicine and SurgeryOral and Maxilofacial Surgery

Oral Medicine

Oral Pathology

Child Dental HealthPaedodontics

Community Dental Services

Orthodontics

Clinical Dentistry

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What does orthodonticsdeal with?

Aesthetics

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Function

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Aesthetics

Function

Stability

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Orthodontics Prevention

Interceptive orthodontics

Advice on extraction of teeth to relieve crowdingor allow eruption of certain teeth

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Unerupted Teeth - incisors Impeded by

supernumerary

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Orthodontics Prevention

Interceptive orthodontics

Advice on extraction of teeth to relieve crowdingor allow eruption of certain teeth

Advice on extraction of certain teeth with poorprognosis to allow for spontaneous alignment.

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Extractions First molars

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Orthodontics Treatment

Skeletal discrepancy

Dento-alveolar disproportion(too little or toomuch space for all permanent teeth)

Also Missing teeth/small teeth

Trauma

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Treatment for Skeletal

Discrepancy Facial proportion

(vertical) Increase in overjet

(horizontal)

Increase in overbite

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Dento-alveolar Disproportion What does that mean?

Crowding

Spacing

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Treatment for Missing Teeth Where are they?

Impacted

Congenitally missing

Syndrome

Extracted for decay orperiodontal disease

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Treatment for TraumaTrauma may result in

loss to upper centralincisors

Treatments

Acute

Removal and spaceclosure

Space opening andprosthesis

Transplant

Implants

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Treatment methods Orthodontics only

Removable appliances Fixed appliances

Growth modification

Functional appliances

Headgear

Orthognathic surgery

combined approachwith MaxillofacialSurgery

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Treatment for skeletal discrepancy

Growing patient growth modification

Adult patient accept or surgery

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Growth modification Functional appliances

Twin blocks Medium opening

activators

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Skeletal disproportion

OJ Severe class II

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Skeletal disproportion

OJ Severe class II

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Growth Modification Headgear

Cervical

High pull

Reverse pull

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Orthognathic surgery Treatment for skeletal

discrepancy wherefunctional applianceshave failed or patient

wanting treatment is anadult

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Orthognathic Surgery Combined approach

with MaxillofacialSurgery

Approach where

orthodontics alone isinsufficient

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Orthognathic surgery Single jaw or

Bi-maxillary osteotomy

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So, after all that What do dental students get to do?

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Orthodontics - Appliances Removable appliance

Elssa.jpg

Elssa.jpg

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Orthodontics - Appliances Fixed appliances

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And of course Functional appliances

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What else is there? Move teeth which are

impacted Commonly maxillary

canine

Exposure by themaxillo-facial surgeons

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What else do we get involved in?

Osteogenic Distraction

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Orthodontic Treatment

Is it worth it?

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Orthodontics in the NHS

Service is provided by

General Dental Services

Specialist Practitioner

Community Dental Services

Hospital services

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GDS, Specialist Practice & CDS

Treats most patients

Mostly bread and butter orthodontics Efficient with high throughput

variable training; Combines GDP withinterest and practitioners with specialisttraining

CDS may treat medically compromised ormore difficult cases

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Hospital service

Consulation service for patients referred from

primary and secondary care Management of multidisiplinay patients (cleft,

restorative, orthognathic, paedodontic,medically compromised)

Treatment of complex orthodontic cases

Training of specialists/ GDP with interest

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Is orthodontics fun?

Its slooowwwwwwwww

And some people say its boring

It works and mostly, you get results

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If you want instant gratification -

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Or if you want more excitement

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Is orthodontics important?

It is to pass your final BDS examination

You may not provide any orthodontics ingeneral practice

But you need to know how it can benefit your

patients Advances in techniques and increased public

awareness Higher expectations

Improved outcomes

Increased multidisciplinary care

Do I want to be an

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Do I want to be an

orthodontist? Yes

If you like making nice smiles

If you like wire bending

Do I want to be an

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Do I want to be an

orthodontist? Yes

If you like doing puzzles

If you want to make loads of money (the top 10earning dentists in the UK are all orthodontists)

No

If you dont want to study for another 5 years

(minimum)

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Those who are interested..

Postgraduate qualification

BDS (Obviously) 2-3 years clinical experience, involving either

GPT, or VT and SHO in maxillofacial or dental hospital

MFDS, MFD Audit projects Publications

Apply for 3 year training programme M. Sc. M. Orth.

Further 2 years training to become a consultant

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Fi ll Th E d

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Finally - The End

Questions?

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