Need For Orthodontic Treatment Flashcards
In the CDH survey what % of 12 year olds were receiving orthodontic treatment at that time?
9%
In the CDH surgery what percentage of 15 year olds were receiving orthodontic treatment at that time?
21%
In the CDH surgery what % of 12 year olds were not in treatment but need treatment?
37%
In the CDH surgery what % of 15 year olds were not having treatment but need treatment?
20%
What is the overall prevalence of moderate to severe malocclusions in adolescents?
40-50%
What is the perceived need for orthodontic treatment?
Higher than the normative need Demand for treatment outweighs the resources available Social and cultural influences More socially acceptable to wear braces More adults seeking treatment
Is there a dental health gain with orthodontic treatment?
Dental health gain likely in severe cases
Straight teeth may be easier to clean than crooked ones but patient motivation and dental hygiene seems to be the overriding influencing factor in preventing gum disease
What does the WHO say the definition for health is?
Health is state of complete physical, mental and social well-being and not merely the absence of disease or infirmity
Is there a psychosocial gain for orthodontic treatment?
Teasing/bullying due to the appearance of teeth can happen regularly
School children can be particularly concerned when they are teased about the appearance of their teeth
What are the limitations of psychosocial gain?
Unrealistic to expect that correction of crooked teeth will radically change psychosocial make-up
Complex and subject to many influences, including the personality of the individual
What are examples where orthodontic treatment is at a benefit to oral health?
Deep bite causing soft tissue trauma
Difficulties eating
Crossbite with displacement
Crowding with gingival recession
Anterior crossbite with recession on lower incisors
Overjet and trauma
Unerupted and impaced teeth with risk to roots of adjacent teeth
What is the incidence of dental trauma in patients?
The risk of trauma doubles in patients with an overjet of greater than 3mm
The risk increases as the overjet increases
>9mm overjet increases the risk by 45% to upper incisors
35% of 9 year olds have evidence of trauma regardless of OJ
What are the risks of orthodontic treatment?
Decalcification
Root resorption
Relapse
What are the orthodontic indices?
Index of Orthodontic Treatment Need (IOTN)
Peer Assessment Rating
What does the IOTN consist of?
Dental health component
Aesthetic component
What does the dental health component of IOTN comprise of?
5 grades
- 1&2 not eligible for NHS treatment
- 3 borderline
- 4&5 eligible for NHS treatment
What does the aesthetic component of IOTN comprise of?
10 grades based on a scale of 10 colour photographs showing progressively poorer dental attractiveness
Patient has to be a 6 or above on the AC scale to be eligible for dental treatment
What are exceptions to the rule?
Severe malocclusion- no desire for treatment
Minor malocclusion- great desire for treatment
What are some complexities of treating the adult patient?
More complex assessment needed Different expectations to children More discreet orthodontic appliances Frequently more restored or missing teeth Tooth wear Periodontal problems Attachment loss Recession Absence of growth Higher prevalence of TMD Aesthetic demands Retention protocols
