Preventive orthodontics 4

Definition:
The action taken to preserve the
integrity of what appears to be the normal
occlusion at a specific time.
(T.M.Graber)
www.indiandentalacademy.com

Alternatives to choose from:
1.Prevent any thing abnormal from occurring
2.Intercept any abnormal situation that is
developing
3.Correct an abnormality that has already
developed.

How is preventive
orthodontics different from
Interceptive orthodontics?
 Common procedures but
different timings
 Anticipation of problem
 Interceptive procedures are undertaken
when problems are already manifested

STEPS:
1. PARENT EDUCATION
2. CARIES CONTROL
3. CARE OF DECIDUOUS DENTITION
4. MAINTAINENCE OF QUADRANT WISE SHEDDING TIME
TABLE
5. CHECK UP FOR ORAL HABITS

7. PREVENTION OF DAMAGE TO OCCLUSION
-MILWUKEE BRACES
8. EXTRACTION OF SUPERNUMERARY TEETH
9. SPACE MAINTAINENCE
10. MANAGEMENT OF ABNORMAL FRENAL
ATTACHMENTS

Parental counseling
 Prenatal Counseling:
The importance of oral hygiene maintenance by
the mother.
Possible co -relationship between the mother’s
poor oral hygiene and premature births.
Transmitting the strings of caries inducing
bacteria to the baby
To have natural foods containing calcium and
phosphorus, as they would allow adequate
formation of deciduous tooth crowns

Postnatal Counseling:
 Six months to one – year of Age
Teething and the associated
irritation.
No sugar addition to bottle milk.
Brushing with the help of finger
brush during bathing.

Postnatal Counseling:
Two years of Age
Bottle - feeding should never be given
during the passage to sleep.
Clinical examination to assess any incipient
decay and eruption status of teeth
Three years of Age
Clinical examination --- generally the full
compliment of deciduous dentition should
have erupted

Caries control:
 Most common problem
 Diagnosis: Bite wing radiograph

Methods for caries prevention
Mechanical methods for plaque
control:
 Tooth brushing
 Flossing
 Inter dental brushes
 Chemical methods of plaque control:
 Chlorhexidine
 Dentifrices
 Fluorides

Recent methods:
 Pit and fissure sealants
 Ozone therapy
 Xylitol chewing gum
 Caries vaccines
 Tooth mousse

Pit & Fissure sealants:
It is primary level of prevention of caries
Seals deep pits and fissures
Age considerations:
3 to 4 years-deciduous dentition
6 to 7 years-permanent first molars
11 to 13 years-permanent second molars

Ozone therapy:
 On delivering Ozone
to a carious lesion it
reduces the number
of cariogenic bacteria
& thus arrests the
progression of the
lesion
 It also helps in
remineralisation .

Caries vaccine:
 Most recent advancement
 Vaccines produce antibodies against
cariogenic bacteria
 Still under experimentation

Tooth mousse- (CPP-ACP)
 Product derived from
milk casein
 Absorbed through
enamel surface
 The free calcium and
phosphate ions move
out of the CPP-ACP
and into the enamel
rods and form apatite
crystals

Care of decidous teeth:
 Importance: the decidous teeth are
excellent natural space maintainers until
the permanent teeth erupt into the oral
cavity

Maintenance of tooth shedding time
table:
 There should not be more than 3 months difference in
shedding of deciduous teeth and eruption of permanent
teeth in one quadrant as compared to others
 Delay in eruption is due to
Presence of retained deciduous teeth
Presence of unresorbed deciduous root fragments
Supernumerary teeth
Cysts
Ankylosis of permanent tooth

Space maintainers:
 Space maintenance can
be defined as the
provision of an appliance
(active or passive )which
is concerned only with the
control of space loss
without taking into
consideration measures to
supervise the
development of dentition

Space maintainers:
 Classification: Acc. To
Hitchcock
Removable or fixed or semi-fixed.
With bands or without bands.
Functional or non-functional.
Active or passive.
Certain combinations of the
above.

Band and loop appliance:
 EARLY LOSS OF
DECIDUOUS FIRST
MOLAR

TRANS PALATAL ARCH:
 UNILATERAL LOSS
OF SPACE

Lingual arch:
 BILATERAL LOSS
OF POSTERIOR
TEETH
 MILD MOVEMENT
OF ANTERIORS

Nance palatal arch:
 BILATERAL LOSS
OF DECIDUOUS
MOLARS
 HABIT BREAKING

DISTAL SHOE:
 PREMATURE LOSS
OF SECOND
PERMANENT
MOLAR

Oral habits check up :
 Thumb sucking
 Tongue thrusting
 Mouth breathing
 Nail biting
 Bruxism
 Lip biting
 Prevention is by:
Proper nursing
Physiologically designed nipple
Psychological counseling
Habit breaking appliance

Milwaukee brace:
 THIS IS USED IN TREATMENT OF
SCOLIOSIS

Management of abnormal frenal
attachments:
 Thick labial frenum prevents central incisors from
approximating leading to mid line diastema
 Presence of ankylogglosia or tongue tie
 Diagnosis: blanch test
 Treatment: frenotomy, frenectomy

Advantages:
 Obtain more stable results with less retention
problems
 Treatment is begun early enough that adequate
facial growth in horizontal/ vertical direction to fully
compensate for correction of over jet & overbite
 Single appliance can correct various problems
 Time saving
 Improves the esthetics

Disadvantages:
 Early and prompt diagnosis
 Poor cooperation of the child
 Misjudgment of the condition

Conclusion:
 So why to wait and complicate rather when
you can intrude and correct
 Thus a general dentist plays a major role in
preventive orthodontics
According to A.A.O & I.O.S, a child needs to have
his first Orthodontic consultation at the age of 7
years.

Preventive orthodontics 4

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