MS2 - Self-correcting anomalies

Question 1

What are 3 self-correcting anomalies that a child may have during the Pre-Dental period

Answer 1

• Retrognathic mandible
• AOB
• Infantile swallowing

Question 2

A parent presents to you worried that her 4 month old child’s chin looks too receded and thinks the child will need braces in the future. Upon examination, the child has a retrognathic mandible.
What do you tell the parent? (cause, reason for this feature, age of correction and how)

Answer 2

-Retrognathic mandible -> Mx gum pad protrude approx. 5mm to the mandibular gum pad
-Due to differential growth of the Maxilla and mandible -> mandible undergoes the largest amount of growth postnatally rather than prenatally
- Self corrects at 6-7 months by downward and forward growth of the mandible

Question 3

Parent presents her 3 month old child who’s anterior gum pads do not touch when the child closes its mouth. What do you tell the parent? (Cause, reason, age of correction and how)

Answer 3

• Anterior Open Bite - Gum pads contact only at molar region
• helps with suckling
• Self corrects 6-7 months old by eruption of primary incisors

Question 4

Parent presents to you as their infant slightly sticks their tongue out while breastfeeding and some milk dribbles down their chin. What do you tell the parent? (Cause, age of correction and how)

Answer 4

• Infantile swallowing
  –>AOB, tongue placed between nipple and lower gum pad for suckling - it is guided and controlled
  -Self corrects and onsets to mature swallowing with the eruption of teeth and as the child begins to eat solid food (approx. 1st year)

Question 5

What self-correcting anomalies may a child present with during the primary dentition period? What ages would

Answer 5

• Deep bite
• Spacing
• Flush terminal plane
• Edge-to-edge bite

6m-2.5/3.5y

Question 6

Parent brings their 2y/o in worried about an anterior deep bite and wondering if the child will need orthodontic tx. what do you tell the parent? (causes, age of correction and how)

Answer 6

• it is not abnormal and the child does not require orthodontic treatment at this stage.
  -cause: primary incisors more upright than permanent incisors AND infra-occlusion of primary molars
  -Correction:
• Eruption of primary molars (Increase VD)
• forward and downward growth of mandible
• attrition of incisal edges)

Question 7

Parent is worried about the spacing in their child’s teeth. the child is 2 y/o. what do you tell the parent?

Answer 7

spacing in primary teeth is normal and actually desirable, as the permanent teeth will use these spaces to erupt (as the overall widths of permanent teeth are greater than the primaries)

Question 8

4 y/o child has flush terminal plane. Is this an anomaly/malocclusion?

Answer 8

No, FTP is Corrected by mesial forces of erupting 1st permanent molar

Question 9

child with primary dentition presents with an edge-to-edge bite and parent is concerned. what do you tell the parent? (cause, how it’ll correct)

Answer 9

It’s normal to see this during the ages of primary dentition
Cause:
* Attrition of primary incisors
* by downward and forward growth of mandible
Self-corrects by:
* Eruption of permanent incisors (which have more labial inclination)

Question 10

What self-correcting anomalies may a child int he mixed dentition stage present with? (6-12/13 years)

Answer 10

• Deep bite
• Crowding in anterior mandible
• *Ugly Duckling stage
• End-on relationship

Question 11

Child in the mixed dentition stage (aged approx. 6-7) presents with anterior deep bite which the parent is concerned about. what do oyu inform the parent? (cause, how is it self corrected?

Answer 11

-it apears as a deep bite due to large permanent incisors.
- should self correct by by complete eruption of permanent molars (inceading VD)

Question 12

Child in early mixed dentition presents with lower incisor crowding which the parent is concerned about. what do you tell the parent? (cause, how it’ll correct)

Answer 12

Its not abnormal to see in the early mixed dentition stage
Cause
* disproportion between tooth size and arch length
Self corrects by:
* Increased inter-canine width
* tongue pressure - causes forward migration of lower incisors

Question 13

Parent presents concerned about their child’s unaesthetic appearance of teeth. Child’s age is 10. What do you tell the parent? (cause, age of correction and how it’ll correct)

Answer 13

Ugly duckling stage (a.k.a. Broadbent phenomenon)
-seen at age 8-11
Cause:
* Eruption of permanent canine exerting pressure on lateral incisor, which then puts pressure on permanent incisor.
Self-corrected by:
* Complete eruption of maxillary permanent canine -> pressure is transferred from roots to coronal area
* no ortho required, unless abnormal impaction of canine is seen radiographically

Question 14

Pt in mixed dentition presents with this presentation. what is it called, and should you be concerned if you see this in mixed dentition? (cause, how it’ll correct)

Answer 14

End-on relationship
-buccal cusp tip of upper 6 in line with the buccal cusp of lower 6
Cause:
-> happens soon after flush terminal plane in primary molars is replaced by permanent dentition
Self corrected by:
* mesial eruptive forced of permanent molars
* late shift
* differential jaw growth

Question 15

Patient presents with OJ and OB in early permanent dentition. Can this be self-corrected without ortho?

Answer 15

it can be self-corrected by:
* eruption of all permanent molars
* differential growth of the mandible