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Orthodontics lecture


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  • 1. Orthodontics Please turn off cell phones.
  • 2. 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. 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.
  • 4. 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.
  • 5. Examples of Malocclusion
    • Overjet – causes “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.
  • 6. Examples of Malocclusion
    • Underbite – causes a “bulldog” appearance. The lower front teeth are positioned in front of the upper front teeth. This is seen in Cass III malocclusions.
  • 7. Examples of Malocclusion
    • 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 occur in any class of malocclusion.
  • 8. Examples of Malocclusion
    • Open bite – open space exists between upper and lower teeth when jaws are closed. Often caused by thumbsucking, seen in all classes of malocclusion.
  • 9. Examples of Malocclusion
    • 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.
  • 10. What causes malocclusion?
    • Genetics - You may inherit a small mouth from mom and large teeth from dad.
    • Tooth loss - If a tooth is lost from an injury, cavities, or gum disease, the remaining teeth 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.
  • 11. 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 seek orthodontic treatment. Their treatment may take longer to complete.
  • 12. 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.
  • 13. 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
  • 14. Why does malocclusion need corrected?
    • An incorrect bite can have long-term effects including:
      • Interference with normal growth and development of jaws
      • Difficulty swallowing
      • Impaired chewing
      • Speech defects
      • Susceptibility to cavities and gum disease
      • Poor aesthetics
  • 15. 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
  • 16. 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 appliance Headgear
  • 17. How do braces work?
    • Treatment typically lasts 1 to 2 years. After braces are removed, retainers are used to hold the teeth in their new position.
    • Typically, retainers are worn 24 hours a day for the first six months and then worn only at night thereafter. Permanent retainers, bonded to the back side of front teeth, may also be used.
  • 18. 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 braces prematurely if the patients hygiene is poor.
  • 19. Home care for ortho patients
    • Brushing
      • Special orthodontic toothbrushes or battery toothbrushes may be useful.
      • Patients need to brush both above and below the brackets, paying special attention to the space between the gumline and the brackets.
  • 20. Home care for ortho patients
    • 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.
  • 21. Home care for ortho patients
    • A fluoride mouthwash, either over-the-counter or prescription, is usually recommended to help prevent tooth decay around the brackets and to reduce decalcification.
    • A oral irrigator such as a Waterpik, may be used to flush debris from the brackets.
  • 22. Home care for ortho patients.
  • 23. 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, ensuring great results when treatment is complete!