prevention in orthodontics

Question 1

what are the 5 risks of orthodontic treatment?

Answer 1

1. DEMINERALISATION (down)
2. ROOT RESORPTION (round)
3. PULP DAMAGE(past)
4. PERIO(peters)
5. SOFT TISSUE(shop)

Down Round Past Peters Shop

Question 2

what is the aetiology of demineralisation in pts with orthodontic appliances?

Answer 2

• poor OH
• attack by acidic by-products of plaque
• plaque
• sugar
• susceptible tooth surface
• time

Question 3

what must patients consent to with regards to demineralisation before tx?

Answer 3

they must be warned of the possibility of demineralisation, its part of the consent process

Question 4

what is the management of demineralisation of pts with ortho appliances?

Answer 4

• prevention
• monitor OH
• discontinue tx if demineralisation is detected and pt not willing to improve OH
• if WSL found on debond, apply F varnish.
• microabrasion may sometimes be used

Question 5

what prevention can be done to insure demineralisation does not happen on pts with ortho appliances?

Answer 5

• OHI
• diet
• Flouride MW throughout tx
• use GI cement on bands due to fluoride release

Question 6

what teeth are most commonly affected by root resorption in orthodontic appliances?

Answer 6

incisors

Question 7

what are 3 risk factors of root resorption with ortho appliances?

Answer 7

1) pts with resorption pre-tx
2) previous trauma
3) root filled teeth

Question 8

what prevention can be done to reduce root resorption in ortho appliances?

Answer 8

• make sure you have a good history
• radiographs
• use light forces during tx
• minimise tx length
• take radiographs during tx if pt at risk

Question 9

what are some risk factors of pulp damage with ortho?

Answer 9

• previous trauma
• trauma during tx
• care when using rotary instruments

Question 10

pulpal pain is likely to last around how long after appliance has been fitted/adjusted?

Answer 10

2-7 days

Question 11

discussion of the risk of periapical abscess is important in what patients?

Answer 11

patients that have a heavily restored mouth

Question 12

why might there be increased gingival inflammation during ortho tx?

Answer 12

reduced access for cleaning

Question 13

poor gingival halth before tx means what?

Answer 13

that the patient is unsuitable for treatment

Question 14

psuedo-pocketing due to inflammation may give what?

Answer 14

a false impression of attachment loss

Question 15

what medical conditions may patients be more at risk of perio from?

Answer 15

• poorly controlled diabetics

- epileptics whose anticonvulsants cause gingival overgrowth

Question 16

what is the management of gingivitis/perio problems during ortho?

Answer 16

• OHI
• obtain good perio health before starting any tx
• maintain good OH( 3/12 s&p)

Question 17

what type of soft tissue damage can occur during ortho tx?

Answer 17

• traumatic ulceration
• friction against components of appliance
• archwire ends/ligatures not tucked out of the way
• clumsy instrumentation

Question 18

what might chlorhexidine mouthwash may be effective at what during ortho?

Answer 18

relieving the discomfort of oral ulceration

Question 19

what are some other risk factors of orthodontic treatment?

Answer 19

• allergic reactions
• burns
• TMJ dysfunction
• prolonged tx
• relapse

Question 20

what 2 safety features are incorporated into headgears to prevent injury?

Answer 20

1) prevents displacement of the facebow

2) prevents recoil of the headgear

Question 21

why is there poor succes with orthodontic implants?

Answer 21

as there is no osseo-integration

Question 22

what are 2 common allergens with orthodontics?

Answer 22

• latex

- nickel