preventive orthodontics /endodontic courses

Preventive Preventive orthodonticsorthodontics

(Part I)(Part I)INDIAN DENTAL ACADEMYINDIAN DENTAL ACADEMY

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Contents:Contents:

IntroductionIntroduction Orthodontics alternatives in occlusion Orthodontics alternatives in occlusion

maintenancemaintenance Parent educationParent education Care of deciduous dentitionCare of deciduous dentition Treatment for caries – a preventive orthodontic Treatment for caries – a preventive orthodontic

procedureprocedure Eruption cycle of permanent teethEruption cycle of permanent teeth Critical period of tooth exchangeCritical period of tooth exchange


Relation of oral habits to prevention of Relation of oral habits to prevention of malocclusionmalocclusion

Role of second deciduous molar regionRole of second deciduous molar region Occlusal equilibration in the primary and mixed Occlusal equilibration in the primary and mixed

dentitionsdentitions - disking- disking - labial frenum- labial frenum Management of ankylosed toothManagement of ankylosed tooth Aberrant resorption patternAberrant resorption pattern Prevention by deformation of the dentition by Prevention by deformation of the dentition by

milwaukee brace treatmentmilwaukee brace treatment

Bibliography Bibliography


Introduction:Introduction:

Dental neglect, in the primary dentition is Dental neglect, in the primary dentition is the principal cause of malocclusion in the the principal cause of malocclusion in the permanent dentition. Early, regular and permanent dentition. Early, regular and satisfactory dental care will help maintain satisfactory dental care will help maintain the primary teeth in healthy condition until the primary teeth in healthy condition until the time for their normal exfoliation.the time for their normal exfoliation.

The maintenance of arch length in the The maintenance of arch length in the primary dentition is essential for normal primary dentition is essential for normal occlusal relationship of the permanent occlusal relationship of the permanent dentition. dentition.


Preventive orthodonticsPreventive orthodontics

Is defined as any form of treatment aimed at Is defined as any form of treatment aimed at preventing the development of malocclusion by preventing the development of malocclusion by maintaining the integrity of an otherwise normally maintaining the integrity of an otherwise normally developing dentition. (Glossary of orthodontic developing dentition. (Glossary of orthodontic terms)terms)

It is defined as the action taken to preserve the It is defined as the action taken to preserve the integrity of what appears to be normal occlusion integrity of what appears to be normal occlusion at a specific time. (shobha Tandon) at a specific time. (shobha Tandon)

Preventive orthodontics, as a discipline Preventive orthodontics, as a discipline encompasses all the necessary steps to provide encompasses all the necessary steps to provide proper transition of primary to permanent proper transition of primary to permanent dentition without any problems into proper dentition without any problems into proper functional, esthetic and occlusal relationships functional, esthetic and occlusal relationships helping in proper growth and development of the helping in proper growth and development of the jaws and face inturn. jaws and face inturn.


The dentition to start with is normal, it is the goal The dentition to start with is normal, it is the goal of the orthodontist to see that it stays that way of the orthodontist to see that it stays that way and entails nipping of the problems in the bud. and entails nipping of the problems in the bud.

Unlike certain phases of restorative dentistry, Unlike certain phases of restorative dentistry, which are “one shot” services, preventive which are “one shot” services, preventive orthodontics, by its very nature, requires a orthodontics, by its very nature, requires a continuing, long-range approach. continuing, long-range approach.

Preventive orthodontics means a dynamic, ever-Preventive orthodontics means a dynamic, ever-constant vigilance- a routine, a discipline, for constant vigilance- a routine, a discipline, for both the dentist and the patient.both the dentist and the patient.


Orthodontics alternatives in Orthodontics alternatives in occlusion occlusion maintenancemaintenance::

An Orthodontist has 3 optionsAn Orthodontist has 3 options

– Prevent anything abnormal from happeningPrevent anything abnormal from happening– Intercept any abnormal situation that is Intercept any abnormal situation that is

developing developing – Correct an abnormality which has already Correct an abnormality which has already

developed.developed.


An ideal orthodontic An ideal orthodontic service should devote.service should devote.

10% - Observation and 10% - Observation and preventionprevention

20% - Interceptive 20% - Interceptive procedures.procedures.

25% - Partial corrective 25% - Partial corrective mechanotherapy and the mechanotherapy and the balance of full treatment.balance of full treatment.

45% - Full corrective, 45% - Full corrective, mechanotherapy cases.mechanotherapy cases.


Parent education:Parent education: Preventive dentistry should ideally begin much Preventive dentistry should ideally begin much

before the birth of the child. before the birth of the child. The expecting mother should be educated on The expecting mother should be educated on

matters such as nutrition to provide an ideal matters such as nutrition to provide an ideal environment for the developing fetus. environment for the developing fetus.

Soon after the birth, the mother should be Soon after the birth, the mother should be educated on proper nursing and care of the child.educated on proper nursing and care of the child.

The mother is also advised against the prolonged The mother is also advised against the prolonged use of pacifiers which can have a detrimental use of pacifiers which can have a detrimental effect on the dentition. effect on the dentition.

The parents should also be educated on the need The parents should also be educated on the need for maintaining good oral hygeine, should be for maintaining good oral hygeine, should be taught he correct method of brushing the child’s taught he correct method of brushing the child’s teeth.teeth. www.indiandentalacademy.comwww.indiandentalacademy.com

Care of deciduous dentition:Care of deciduous dentition:

Preventive orthodontics includes care of the Preventive orthodontics includes care of the deciduous dentition by way of prevention and deciduous dentition by way of prevention and timely restoration of caries teeth. timely restoration of caries teeth.

The deciduous teeth are excellent natural space The deciduous teeth are excellent natural space maintainers until the developing permanent teeth maintainers until the developing permanent teeth are ready to errupt into the oral cavity. are ready to errupt into the oral cavity.

Thus all efforts should be taken to prevent early Thus all efforts should be taken to prevent early loss of the deciduous teeth. loss of the deciduous teeth.

Simple preventive procedures such as application Simple preventive procedures such as application of topical fluoride and pit and fissure sealents of topical fluoride and pit and fissure sealents help in preventing caries.help in preventing caries.


Eruption cycle of permanent Eruption cycle of permanent dentition:dentition:

During the eruption cycle of a tooth, as the root During the eruption cycle of a tooth, as the root elongates, the crown of the permanent tooth elongates, the crown of the permanent tooth approximates the deciduous root. There is approximates the deciduous root. There is growth of bone, cementum, dentin, pulpal growth of bone, cementum, dentin, pulpal mesenchyme and periodontal membrane mesenchyme and periodontal membrane tissues, all moving in an orderly fashion. tissues, all moving in an orderly fashion.

The progress of this extravaganza of nature The progress of this extravaganza of nature should be observed by the dentist to maintain should be observed by the dentist to maintain the time-table of development in case the time-table of development in case something goes wrong. something goes wrong.


Critical period of tooth Critical period of tooth exchangeexchange::

A constant Vigilance is essential during the critical A constant Vigilance is essential during the critical period of tooth exchange.period of tooth exchange.

Leighton, in an excellent study including birth Leighton, in an excellent study including birth notes of a large group of children, found that notes of a large group of children, found that there are a number of observations that may be there are a number of observations that may be made early, concerning tooth position alignment made early, concerning tooth position alignment and from which predictions may be made. By and from which predictions may be made. By fostering study along these lines, truly preventive fostering study along these lines, truly preventive dentistry may be achieved, eliminating dentistry may be achieved, eliminating unnecessary and inappropriate treatment. unnecessary and inappropriate treatment.


– Dentists must be on the lookout for anything Dentists must be on the lookout for anything that might stand in the way of development of that might stand in the way of development of normal occlusion.normal occlusion.

Abnormal resorption patternsAbnormal resorption patternsRetained deciduous root fragmentsRetained deciduous root fragmentsSupernumerary teethSupernumerary teethAnkylosis of deciduous tooth Ankylosis of deciduous tooth Soft tissue barrierSoft tissue barrieroverhanging restoration in a deciduous tooth overhanging restoration in a deciduous tooth


Aberrant resorptive pattern:Aberrant resorptive pattern:

1.1. Abnormalities of resorption are associated Abnormalities of resorption are associated more frequently with space deficiency more frequently with space deficiency problems.problems.

2.2. Deciduous canines and second deciduous Deciduous canines and second deciduous molars are particularly prone to aberrant molars are particularly prone to aberrant resorption patterns.resorption patterns.

3.3. In an ideal sequence, right and left second In an ideal sequence, right and left second deciduous incisors should be loose and lost at deciduous incisors should be loose and lost at about the same time, deciduous lateral about the same time, deciduous lateral incisors should be loose and lost at about the incisors should be loose and lost at about the same time, all canines should be loose and same time, all canines should be loose and lost within a short period, etc.lost within a short period, etc.


Role of Second Deciduous Molar Role of Second Deciduous Molar region:region:

The second deciduous molar region is particularly The second deciduous molar region is particularly a critical area. Because the second deciduous a critical area. Because the second deciduous molar is usually larger than its successor, molar is usually larger than its successor, abnormal resorption and prolonged retention may abnormal resorption and prolonged retention may have a far-reaching effect.have a far-reaching effect.

Erupting canines may be forced buccally or Erupting canines may be forced buccally or lingually or may actually be prevented from lingually or may actually be prevented from erupting at all because of the additional arch erupting at all because of the additional arch length taken up by the retained deciduous molar.length taken up by the retained deciduous molar.


BIBLIOGRAPHY:BIBLIOGRAPHY:

1.1. T.M.Graber; orthodontics principles and T.M.Graber; orthodontics principles and practice; 3rd edition; W.B. Saunders co.practice; 3rd edition; W.B. Saunders co.

2.2. W R. Proffit, Contemporary Orthodontics; 4th W R. Proffit, Contemporary Orthodontics; 4th Edition, Mosby publication, 2007.Edition, Mosby publication, 2007.

3.3. Ralph Mc Donald, David Avery & Jeffery Dean; Ralph Mc Donald, David Avery & Jeffery Dean; Dentistry for the child and adolescent; 8th Dentistry for the child and adolescent; 8th edition; Elsevier publicationedition; Elsevier publication

4.4. Shobha Tandon; Text book of Pedodontics; 1st Shobha Tandon; Text book of Pedodontics; 1st edition; paras publication. edition; paras publication.

5.5. Robert E Moyers: Handbook of orthodontics 4Robert E Moyers: Handbook of orthodontics 4 thth editionedition

6.6. Soben Peter: textbook of community dentistry; Soben Peter: textbook of community dentistry; 11stst edition. edition. www.indiandentalacademy.comwww.indiandentalacademy.com

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