Preventive orthodontics / dental implant courses

PreventivePreventive
orthodonticsorthodontics
(Part I)(Part I)
www.indiandentalacademy.comwww.indiandentalacademy.com

Contents:Contents:
 IntroductionIntroduction
 Orthodontics alternatives in occlusionOrthodontics alternatives in occlusion
maintenancemaintenance
 Parent educationParent education
 Care of deciduous dentitionCare of deciduous dentition
 Treatment for caries – a preventive orthodonticTreatment 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 ofRelation of oral habits to prevention of
malocclusionmalocclusion
 Role of second deciduous molar regionRole of second deciduous molar region
 Occlusal equilibration in the primary and mixedOcclusal 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 byPrevention by deformation of the dentition by
milwaukee brace treatmentmilwaukee brace treatment
 BibliographyBibliography

Introduction:Introduction:
 Dental neglect, in the primary dentition isDental neglect, in the primary dentition is
the principal cause of malocclusion in thethe principal cause of malocclusion in the
permanent dentition. Early, regular andpermanent dentition. Early, regular and
satisfactory dental care will help maintainsatisfactory dental care will help maintain
the primary teeth in healthy condition untilthe primary teeth in healthy condition until
the time for their normal exfoliation.the time for their normal exfoliation.
 The maintenance of arch length in theThe maintenance of arch length in the
primary dentition is essential for normalprimary dentition is essential for normal
occlusal relationship of the permanentocclusal relationship of the permanent
dentition.dentition.

 Preventive orthodonticsPreventive orthodontics
 Is defined as any form of treatment aimed atIs defined as any form of treatment aimed at
preventing the development of malocclusion bypreventing the development of malocclusion by
maintaining the integrity of an otherwise normallymaintaining the integrity of an otherwise normally
developing dentition. (Glossary of orthodonticdeveloping dentition. (Glossary of orthodontic
terms)terms)
 It is defined as the action taken to preserve theIt is defined as the action taken to preserve the
integrity of what appears to be normal occlusionintegrity of what appears to be normal occlusion
at a specific time. (shobha Tandon)at a specific time. (shobha Tandon)
 Preventive orthodontics, as a disciplinePreventive orthodontics, as a discipline
encompasses all the necessary steps to provideencompasses all the necessary steps to provide
proper transition of primary to permanentproper transition of primary to permanent
dentition without any problems into properdentition without any problems into proper
functional, esthetic and occlusal relationshipsfunctional, esthetic and occlusal relationships
helping in proper growth and development of thehelping in proper growth and development of the
jaws and face inturn.jaws and face inturn.www.indiandentalacademy.comwww.indiandentalacademy.com

 The dentition to start with is normal, it is the goalThe dentition to start with is normal, it is the goal
of the orthodontist to see that it stays that wayof 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, preventivewhich are “one shot” services, preventive
orthodontics, by its very nature, requires aorthodontics, 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, forconstant vigilance- a routine, a discipline, for
both the dentist and the patient.both the dentist and the patient.

Orthodontics alternatives inOrthodontics alternatives in
occlusionocclusion maintenancemaintenance::
 An Orthodontist has 3 optionsAn Orthodontist has 3 options
– Prevent anything abnormal from happeningPrevent anything abnormal from happening
– Intercept any abnormal situation that isIntercept any abnormal situation that is
developingdeveloping
– Correct an abnormality which has alreadyCorrect an abnormality which has already
developed.developed.

 An ideal orthodonticAn ideal orthodontic
service should devote.service should devote.
 10% - Observation and10% - Observation and
preventionprevention
 20% - Interceptive20% - Interceptive
procedures.procedures.
 25% - Partial corrective25% - Partial corrective
mechanotherapy and themechanotherapy 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 muchPreventive dentistry should ideally begin much
before the birth of the child.before the birth of the child.
 The expecting mother should be educated onThe expecting mother should be educated on
matters such as nutrition to provide an idealmatters such as nutrition to provide an ideal
environment for the developing fetus.environment for the developing fetus.
 Soon after the birth, the mother should beSoon 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 prolongedThe mother is also advised against the prolonged
use of pacifiers which can have a detrimentaluse of pacifiers which can have a detrimental
effect on the dentition.effect on the dentition.
 The parents should also be educated on the needThe parents should also be educated on the need
for maintaining good oral hygeine, should befor maintaining good oral hygeine, should be
taught he correct method of brushing the child’staught 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 thePreventive orthodontics includes care of the
deciduous dentition by way of prevention anddeciduous dentition by way of prevention and
timely restoration of caries teeth.timely restoration of caries teeth.
 The deciduous teeth are excellent natural spaceThe deciduous teeth are excellent natural space
maintainers until the developing permanent teethmaintainers 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 earlyThus all efforts should be taken to prevent early
loss of the deciduous teeth.loss of the deciduous teeth.
 Simple preventive procedures such as applicationSimple preventive procedures such as application
of topical fluoride and pit and fissure sealentsof topical fluoride and pit and fissure sealents
help in preventing caries.help in preventing caries.

 Eruption cycle of permanentEruption cycle of permanent
dentition:dentition:
 During the eruption cycle of a tooth, as the rootDuring the eruption cycle of a tooth, as the root
elongates, the crown of the permanent toothelongates, the crown of the permanent tooth
approximates the deciduous root. There isapproximates the deciduous root. There is
growth of bone, cementum, dentin, pulpalgrowth of bone, cementum, dentin, pulpal
mesenchyme and periodontal membranemesenchyme and periodontal membrane
tissues, all moving in an orderly fashion.tissues, all moving in an orderly fashion.
 The progress of this extravaganza of natureThe progress of this extravaganza of nature
should be observed by the dentist to maintainshould be observed by the dentist to maintain
the time-table of development in casethe time-table of development in case
something goes wrong.something goes wrong.

Critical period of toothCritical period of tooth
exchangeexchange::
 A constant Vigilance is essential during the criticalA constant Vigilance is essential during the critical
period of tooth exchange.period of tooth exchange.
 Leighton, in an excellent study including birthLeighton, in an excellent study including birth
notes of a large group of children, found thatnotes of a large group of children, found that
there are a number of observations that may bethere are a number of observations that may be
made early, concerning tooth position alignmentmade early, concerning tooth position alignment
and from which predictions may be made. Byand from which predictions may be made. By
fostering study along these lines, truly preventivefostering study along these lines, truly preventive
dentistry may be achieved, eliminatingdentistry may be achieved, eliminating
unnecessary and inappropriate treatment.unnecessary and inappropriate treatment.

– Dentists must be on the lookout for anythingDentists must be on the lookout for anything
that might stand in the way of development ofthat might stand in the way of development of
normal occlusion.normal occlusion.
Abnormal resorption patternsAbnormal resorption patterns
Retained deciduous root fragmentsRetained deciduous root fragments
Supernumerary teethSupernumerary teeth
Ankylosis of deciduous toothAnkylosis of deciduous tooth
Soft tissue barrierSoft tissue barrier
overhanging restoration in a deciduous toothoverhanging restoration in a deciduous tooth

 Aberrant resorptive pattern:Aberrant resorptive pattern:
1.1. Abnormalities of resorption are associatedAbnormalities of resorption are associated
more frequently with space deficiencymore frequently with space deficiency
problems.problems.
2.2. Deciduous canines and second deciduousDeciduous canines and second deciduous
molars are particularly prone to aberrantmolars are particularly prone to aberrant
resorption patterns.resorption patterns.
3.3. In an ideal sequence, right and left secondIn an ideal sequence, right and left second
deciduous incisors should be loose and lost atdeciduous incisors should be loose and lost at
about the same time, deciduous lateralabout the same time, deciduous lateral
incisors should be loose and lost at about theincisors should be loose and lost at about the
same time, all canines should be loose andsame time, all canines should be loose and
lost within a short period, etc.lost within a short period, etc.

 Role of Second Deciduous MolarRole of Second Deciduous Molar
region:region:
 The second deciduous molar region is particularlyThe second deciduous molar region is particularly
a critical area. Because the second deciduousa 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 mayabnormal resorption and prolonged retention may
have a far-reaching effect.have a far-reaching effect.
 Erupting canines may be forced buccally orErupting canines may be forced buccally or
lingually or may actually be prevented fromlingually or may actually be prevented from
erupting at all because of the additional archerupting 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 andT.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; 4thW 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; 8thDentistry for the child and adolescent; 8th
edition; Elsevier publicationedition; Elsevier publication
4.4. Shobha Tandon; Text book of Pedodontics; 1stShobha 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 4thth
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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