A presentation on introduction to orthodontics

1. OrthodonticsOrthodontics
Please turn off cell phones.Please turn off cell phones.

2. Who Needs Orthodontic Treatment?Who Needs Orthodontic Treatment?
 Adults and children both seek orthodonticAdults and children both seek orthodontic
treatment for:treatment for:
Malocclusion (incorrect bite)Malocclusion (incorrect bite)
Tooth alignment (crooked teeth)Tooth alignment (crooked teeth)
Improvement of overall appearance, includingImprovement of overall appearance, including
gaps between teethgaps between teeth

3. Classification of OcclusionClassification of Occlusion
Class I Class II Class IIIClass 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 MalocclusionExamples of Malocclusion
 Overbite – The upper front teeth cover tooOverbite – The upper front teeth cover too
much (more than 30%) of the lower frontmuch (more than 30%) of the lower front
teeth. Also called a deep bite. This mayteeth. Also called a deep bite. This may
be seen in a Class I or II malocclusion.be seen in a Class I or II malocclusion.

5. Examples of MalocclusionExamples of Malocclusion
 Overjet – causes “buckteeth”. The upper front teeth areOverjet – causes “buckteeth”. The upper front teeth are
positioned too far forward (normal distance betweenpositioned too far forward (normal distance between
upper and lower front teeth is 1-3 mm). This is typical inupper and lower front teeth is 1-3 mm). This is typical in
Class II maloclussion.Class II maloclussion.

6. Examples of MalocclusionExamples of Malocclusion
 Underbite – causes a “bulldog”Underbite – causes a “bulldog”
appearance. The lower front teeth areappearance. The lower front teeth are
positioned in front of the upper front teeth.positioned in front of the upper front teeth.
This is seen in Cass III malocclusions.This is seen in Cass III malocclusions.

7. Examples of MalocclusionExamples of Malocclusion
 Crossbite – The upper teeth shouldCrossbite – The upper teeth should
overlap the lower teeth slightly when theoverlap the lower teeth slightly when the
jaws are closed. When this does notjaws are closed. When this does not
occur, it is called a crossbite. May occuroccur, it is called a crossbite. May occur
in any class of malocclusion.in any class of malocclusion.

8. Examples of MalocclusionExamples of Malocclusion
 Open bite – open space exists betweenOpen bite – open space exists between
upper and lower teeth when jaws areupper and lower teeth when jaws are
closed. Often caused by thumbsucking,closed. Often caused by thumbsucking,
seen in all classes of malocclusion.seen in all classes of malocclusion.

9. Examples of MalocclusionExamples of Malocclusion
 Midline shift – the center of the upper frontMidline shift – the center of the upper front
teeth is not aligned with the center of theteeth is not aligned with the center of the
lower front teeth. Can be seen in alllower front teeth. Can be seen in all
classes of malocclusion.classes of malocclusion.

10. What causes malocclusion?What causes malocclusion?
 Genetics - You may inherit a small mouthGenetics - You may inherit a small mouth
from mom and large teeth from dad.from mom and large teeth from dad.
 Tooth loss - If a tooth is lost from an injury,Tooth loss - If a tooth is lost from an injury,
cavities, or gum disease, the remainingcavities, or gum disease, the remaining
teeth may shift.teeth may shift.
 Bad habits such as thumbsucking canBad habits such as thumbsucking can
shift teeth or cause them to eruptshift teeth or cause them to erupt
improperly.improperly.
 Malnutrition – Nutritional deficits canMalnutrition – Nutritional deficits can
restrict the growth of jaws and teeth.restrict the growth of jaws and teeth.

11. When is the best time for ortho?When is the best time for ortho?
 The jaws of pre-teens and teens are still growing.The jaws of pre-teens and teens are still growing.
Therefore, it is easier to shift teeth at this stage.Therefore, it is easier to shift teeth at this stage.
 Sometime, two separate phases of braces are necessarySometime, two separate phases of braces are necessary
for treatment.for treatment.
 Phase I – when patients are 6 to 7 years old, to make room forPhase I – when patients are 6 to 7 years old, to make room for
the permanent teeth to erupt properlythe permanent teeth to erupt properly
 Phase II – at age 12 (or when permanent teeth have erupted) aPhase II – at age 12 (or when permanent teeth have erupted) a
second round of braces are applied to straighten teeth andsecond round of braces are applied to straighten teeth and
correct bite.correct bite.
•It is becoming more common for adults to seekIt is becoming more common for adults to seek
orthodontic treatment. Their treatment may take longer toorthodontic treatment. Their treatment may take longer to
complete.complete.

12. Space MaintainersSpace Maintainers
 When a primary, or deciduous, toothWhen a primary, or deciduous, tooth
(commonly called “baby” tooth) is lost too(commonly called “baby” tooth) is lost too
early, the space needs to be held openearly, the space needs to be held open
until the permanent tooth is ready to erupt.until the permanent tooth is ready to erupt.

13. Space MaintainersSpace Maintainers
 A space maintainer is an appliance madeA space maintainer is an appliance made
of metal or plastic and may be removableof metal or plastic and may be removable
or cemented onto neighboring teeth.or cemented onto neighboring teeth.
Removable space maintainer Band and loop maintainer Lower lingual holding arch

14. Why does malocclusion needWhy does malocclusion need
corrected?corrected?
 An incorrect bite can have long-termAn incorrect bite can have long-term
effects including:effects including:
Interference with normal growth andInterference with normal growth and
development of jawsdevelopment of jaws
Difficulty swallowingDifficulty swallowing
Impaired chewingImpaired chewing
Speech defectsSpeech defects
Susceptibility to cavities and gum diseaseSusceptibility to cavities and gum disease
Poor aestheticsPoor aesthetics

15. How do braces work?How do braces work?
Teeth can be GRADUALLY moved into proper position byTeeth can be GRADUALLY moved into proper position by
applying pressure in certain directions using bands,applying pressure in certain directions using bands,
wires, and elastics. A series of clear trays, such aswires, and elastics. A series of clear trays, such as
Invisalign, may also be used.Invisalign, may also be used.
standard
braces
lingual
braces
“Clear”
braces
virtually
invisible
Invisalign trays

16. How do braces work?How do braces work?
 Removeable appliances may also be used such as:Removeable appliances may also be used such as:
 Palatal expander to widen the archPalatal expander to widen the arch
 Jaw repositioning appliance, or splint, to retrain theJaw repositioning appliance, or splint, to retrain the
jaw to close properlyjaw to close properly
 Headgear- involves a strap that wraps around theHeadgear- involves a strap that wraps around the
head and attaches to a wire or face bow in the front.head and attaches to a wire or face bow in the front.
used to slow the growth of the upper jaw and moveused to slow the growth of the upper jaw and move
front teeth towards the back.front teeth towards the back.
palatal expander Jaw repositioning
appliance
Headgear

17. How do braces work?How do braces work?
 Treatment typically lasts 1 to 2 years. AfterTreatment typically lasts 1 to 2 years. After
braces are removed, retainers are used to holdbraces are removed, retainers are used to hold
the teeth in their new position.the teeth in their new position.
 Typically, retainers are worn 24 hours a day forTypically, retainers are worn 24 hours a day for
the first six months and then worn only at nightthe first six months and then worn only at night
thereafter. Permanent retainers, bonded to thethereafter. Permanent retainers, bonded to the
back side of front teeth, may also be used.back side of front teeth, may also be used.

18. Home care for ortho patientsHome care for ortho patients
 Braces collect food and plaque very easily.Braces collect food and plaque very easily.
 Often, ortho patients are children or teenagersOften, ortho patients are children or teenagers
who do not have optimum brushing and flossingwho do not have optimum brushing and flossing
habits.habits.
 If braces are not kept clean, tooth decay andIf braces are not kept clean, tooth decay and
gum inflammation easily occur.gum inflammation easily occur.
 Orthodontists may decide to remove bracesOrthodontists may decide to remove braces
prematurely if the patients hygiene is poor.prematurely if the patients hygiene is poor.

19. Home care for ortho patientsHome care for ortho patients
 BrushingBrushing
 Special orthodontic toothbrushes or batterySpecial orthodontic toothbrushes or battery
toothbrushes may be useful.toothbrushes may be useful.
 Patients need to brush both above and below thePatients need to brush both above and below the
brackets, paying special attention to the spacebrackets, paying special attention to the space
between the gumline and the brackets.between the gumline and the brackets.

20. Home care for ortho patientsHome care for ortho patients
 FlossingFlossing
 Flossing around braces is time consuming.Flossing around braces is time consuming.
Superfloss (strands of floss with stiff ends) or flossSuperfloss (strands of floss with stiff ends) or floss
threaders are used to floss beneath the wires.threaders are used to floss beneath the wires.
 Interdental brushes can be used between the wireInterdental brushes can be used between the wire
and the tooth, between brackets.and the tooth, between brackets.

21. Home care for ortho patientsHome care for ortho patients
• A fluoride mouthwash, either over-the-counter orA fluoride mouthwash, either over-the-counter or
prescription, is usually recommended to helpprescription, is usually recommended to help
prevent tooth decay around the brackets and toprevent tooth decay around the brackets and to
reduce decalcification.reduce decalcification.
• A oral irrigator such as a Waterpik, may be usedA oral irrigator such as a Waterpik, may be used
to flush debris from the brackets.to flush debris from the brackets.

22. Home care for ortho patients.Home care for ortho patients.

23. Dental Check-upsDental Check-ups
 An orthodontic patient needs to visit his orAn orthodontic patient needs to visit his or
her general dentist at least every 6 monthsher general dentist at least every 6 months
for a cleaning and check-up to monitor thefor a cleaning and check-up to monitor the
health of the teeth and gums, ensuringhealth of the teeth and gums, ensuring
great results when treatment is complete!great results when treatment is complete!