prevention in orthodontics Flashcards
what are the 5 risks of orthodontic treatment?
- DEMINERALISATION (down)
- ROOT RESORPTION (round)
- PULP DAMAGE(past)
- PERIO(peters)
- SOFT TISSUE(shop)
Down Round Past Peters Shop
what is the aetiology of demineralisation in pts with orthodontic appliances?
- poor OH
- attack by acidic by-products of plaque
- plaque
- sugar
- susceptible tooth surface
- time
what must patients consent to with regards to demineralisation before tx?
they must be warned of the possibility of demineralisation, its part of the consent process
what is the management of demineralisation of pts with ortho appliances?
- 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
what prevention can be done to insure demineralisation does not happen on pts with ortho appliances?
- OHI
- diet
- Flouride MW throughout tx
- use GI cement on bands due to fluoride release
what teeth are most commonly affected by root resorption in orthodontic appliances?
incisors
what are 3 risk factors of root resorption with ortho appliances?
1) pts with resorption pre-tx
2) previous trauma
3) root filled teeth
what prevention can be done to reduce root resorption in ortho appliances?
- make sure you have a good history
- radiographs
- use light forces during tx
- minimise tx length
- take radiographs during tx if pt at risk
what are some risk factors of pulp damage with ortho?
- previous trauma
- trauma during tx
- care when using rotary instruments
pulpal pain is likely to last around how long after appliance has been fitted/adjusted?
2-7 days
discussion of the risk of periapical abscess is important in what patients?
patients that have a heavily restored mouth
why might there be increased gingival inflammation during ortho tx?
reduced access for cleaning
poor gingival halth before tx means what?
that the patient is unsuitable for treatment
psuedo-pocketing due to inflammation may give what?
a false impression of attachment loss
what medical conditions may patients be more at risk of perio from?
- poorly controlled diabetics
- epileptics whose anticonvulsants cause gingival overgrowth
what is the management of gingivitis/perio problems during ortho?
- OHI
- obtain good perio health before starting any tx
- maintain good OH( 3/12 s&p)
what type of soft tissue damage can occur during ortho tx?
- traumatic ulceration
- friction against components of appliance
- archwire ends/ligatures not tucked out of the way
- clumsy instrumentation
what might chlorhexidine mouthwash may be effective at what during ortho?
relieving the discomfort of oral ulceration
what are some other risk factors of orthodontic treatment?
- allergic reactions
- burns
- TMJ dysfunction
- prolonged tx
- relapse
what 2 safety features are incorporated into headgears to prevent injury?
1) prevents displacement of the facebow
2) prevents recoil of the headgear
why is there poor succes with orthodontic implants?
as there is no osseo-integration
what are 2 common allergens with orthodontics?
- latex
- nickel
