Early interceptive orthodontics
There are currently a number of innovative systems on the market that allow general dental practitioners to include orthodontic procedures in their treatment lists. At a time when more and more people are becoming conscious of the state of their teeth, these developments have been timely.
Patients want affordable and effective systems that don’t intrude much on their lifestyles, and can treat a wide range of malocclusions. Among the benefits of the most cutting-edge systems is the fact that the dentist does not need to send a valuable patient away on referral. You can effectively
continue to develop a strong relationship with the patient, and retain control of their
treatment, with the continuous support of orthodontic experts.
Orthodontic treatment is preferable to ‘smile solutions’ because it has a focus on achieving a natural smile. This is done by taking the entire skull into account, looking at the relationships between dentition and physiological disorders and formative issues. In diagnosis, it can also pick out temporo-mandibular joint disorders, a key benefit over alternative treatments that focus entirely on the teeth, with less regard to the fact that every tooth movement affects occlusal function. By taking the entire skull into account, orthodontics delivers superior results the
natural way, with a good profile and in support of better patient wellbeing in general.
The British Dental Health Foundation recommends that ‘orthodontic treatment is generally best carried out in children, while the American Association of Orthodontists has long argued that a child’s first orthodontic appointment should take place at the age of seven. However, not all of the new systems for GDPs allow the treatment of child patients.
So, why is it important to select a system that caters for children? Well, the case to be made for early interceptive orthodontics is a strong one. Firstly, the diagnostic process will identify any abnormal development in the teeth and jaw structures. This will help provide child patients with a firm foundation upon which to develop excellent oral and dental hygiene, since straight and even teeth are easier to clean, with less hard-to-reach gaps where debris might become fixed, or abscesses develop. Also, the child patient can overcome any developmental issues.
In the early life of the infant, jaw functions develop around the positions of the mandible and tongue in relation to maintaining a clear airway. As teeth appear, this dictates tongue position and the infant begins to exert more conscious control over jaw movements and learns to chew. Developmental issues that adversely affect jaw function include nasal obstruction, which can lead to a repositioned mandible, leading in turn to an underdeveloped maxilla.
Orthodontic experts have seen how breast-feeding can play a part in healthy development of the maxilla. It has also been noted that, since the mandible adapts to the maxilla, some class 2 malocclusions have been caused by a lack of suction when feeding. This might be down to the child, as an infant, lying on his or her back when given the bottle, so no suction was required.
So, early interceptive orthodontics can stop degeneration before it gets any worse, and repair any problems, too. It is best to treat the patient in youth, because of difficulties and compromises of late treatment, as identified by Dr Darrick Nordstrom:
• ‘Significantly reduced potential for midface anterior
development due to impacted sinuses and near completion of tongue growth without the functional oral matrix’
• ‘The development of the basal bone of the mandible is near mature and narrow, limiting the potential for arch development, or correction of the angle and corpus length’
• ‘The learned, deviate swallow habit has matured; lip size and position are now fixed, and have become a part of the persona’
• ‘Slow, chronic remodelling has occurred around the TMJ [tempero-mandibular joint] and mandible to accommodate the internal derangement (if present)’
• ‘The patient is rarely willing to be involved in the extensive extra treatment required (including changing sleep posture).’
To sum up, when developmental problems have not been caught in the child and have been allowed to develop into adolescence or adulthood, the orthodontist’s job is hampered by several factors. One of these factors is that the treatment is likely to intrude upon the patient’s lifestyle. Older patients are more self-conscious, and since they may have become familiar with the various discomforts and abnormalities that early interceptive orthodontics might have dealt with, will be more adverse to change.
When you begin to offer orthodontic treatment, you will be amazed at the boost to your patient base. Once you have been given adequate support and guidance from specialists, you will then be able to offer treatment to your patients’ children, too. This may give you a loyal patient for life, and cement your place in the local community as a comprehensive provider of multidisciplinary dentistry.
1. www.dentalhealth.org.uk/faqs/leaflet detail.php?LeafletID=29
2. www.tmjfacialpain.com/orthodon tics.htm