DIAGNOSIS AND EARLY FACIAL DEVELOPMENT

Question 1

what do we mean by interceptive orthodontics?

Answer 1

this is taken to mean any treatment procedure which eliminates or reduces the severity of a developing malocclusion.

Question 2

what is an ectopic canine

Answer 2

a canine which is following the abnormal path of eruption in the maxilla

Question 3

what do we mean by craniofacial disharmony?

Answer 3

the relations between the upper and lower jaws are not appropriate! there is a DISHARMONY between them

Question 4

what are the aims of orthodontic treatment (7)

Answer 4

DENTAL HEALTH
- risk vs benefit
AESTHETICS
- improve the smile
- improve the tooth position
PSYCHOLOGICAL WELLBEING
- improve self esteem

Question 5

what is the role of PRIMARY CARE (GDP/Therapist) in ortho diagnosis and assessment? (3)

Answer 5

• the primary role of therapists in ortho is not MONITOR dental development and highlight any variations from the expected.
• GDPs and therapists are the gatekeepers of ortho treatment
• it is crucial that gdps/therapists can identify the patients occlusal problem and refer appropriately where required (outwith our remit)

Question 6

what are we listening for from the patient when carrying out a PRIMIARY CARE examination?

Answer 6

• PATIENTS CONCERNS eg squint teeth, gummy smile
• FAMILY CONCERNS not as important as pts
• SOCIAL CONCERNS eg bullying trauma
• TEETH eg any missing? where? teeth of poor prognosis etc
• SOFT TISSUES eg lip trap - trauma risk, gingival recesson/stripping

Question 7

what are we LOOKING for in a patient when carrying out a PRIMARY CARE EXAMINATION?

Answer 7

FACIAL BONES
- what is the jaw relationship
- are the jaws symmetrical
- TMJ
- ENSURE THE PATIENT IS DENTALLY FIT WITH GOOD OH!

Question 8

what ocurrs in an orthodontic examination ? (NOT PRIMARY CARE EXAMINATION)

Answer 8

• listen to the patient
• assess the patients facial skeleton
• assess the pts gingival health BPE
• assess the pts OH
• assess the teeth: number, prognosis, position

Question 9

what may a patients MH influence on orthodontics? (5)

Answer 9

• treatment choice eg epilepsy and removable appliances
• gingivae eg medications related to gingival overgrowth
• co operation eg autism etc
• infection risk eg diabetes
• candida risk eg asthmatic patients

Question 10

how can we measure/examinate the pts skeletal pattern

Answer 10

• pt should be upright in natural head position (if pt is posturing use the FRANKFORT-MANDIBULAR PLANE)
• pt should be at rest (teeth together in position of maximum intercuspation)
• skeletal pattern should be measured in 3 planes (antero-posterior, vertical, transverse)

Question 11

what 3 planes do we measure on a pt for assessing the skeletal pattern?

Answer 11

ANTERO-POSTERIOR
VERTICAL
TRANSVERSE

Question 12

how do we measure ANTEROPOSTERIOR aspect

Answer 12

• view the patient from the side
• look at the relative position of the maxilla and the mandible
• PALPATE - soft tissue A point and soft tissue B point.

Question 13

what are the 3 skeletal patterns and describe each classification

Answer 13

• CLASS 1 - mandible is 2-3mm posterior to maxilla
• CLASS 2 - mandible is retruded relative to the maxilla (overjet)
• CLASS 3 - mandible is protruded relative to the maxilla (underbite)

Question 14

what can a DPT be used to see for ortho reasons

Answer 14

• overall dental assessment
• missing teeth
• root morphology

Question 15

what can a lateral ceph be used to see for ortho reasons

Answer 15

• indicated for skeletal discrepancies or where anterior or posterior movement of the incisors is required.

Question 16

what can an upper anterior occlusal radiograph be used for to see for ortho reasons

Answer 16

to investigate the position of an unerupted canine

Question 17

what can a CBCT scan be used for, for ortho reasons

Answer 17

• 3D assessment of dentition
• used for impacted teeth in the UK

Question 18

what do we mean by diagnosis in orthodontics

Answer 18

• this is the culmination of all the information you have to hand
• we use a tool called IOTN - so does the patient qualify for treatment on NHS.

Question 19

what does IOTN stand for/whats its purpose?

Answer 19

-the index of ortho treatment needed
-the purpose of this measuring tool is to determine the impact of a malocclusion on an individuals dental health and psychosocial well-being.

Question 20

What two elements comprises IOTN

Answer 20

• Dental Health Component DHC
• Aesthetic component
• DHC SCORES OF 4/5 WILL RECIEVE TX ON THE NHS CURRENTLY

Question 21

describe the grades in DHC

Answer 21

grades 1 - no need
grade 2 - little need
grade 3 - moderate need
grade 4 - great need
grade 5 - very great need

Question 22

what is MOCDO in DHC

Answer 22

• an acronym to identify the single worse feature
  M - missing tooth
  O - overjet
  C - crossbites
  D - displacement of contact points
  O - overbites