Risks and benefits of orthodontic treatment Flashcards
benefits of orthodontics
improvement in
appearance
- dental
- facial
function
dental health
psychological benefits of orthodontic treatment
severe malocclusions affect facial attractiveness
- people with unattractive faces perceived unfavourably
correction may improve self esteem and psychological wellbeing
quality of life improvement
MOCDO acronym stands for
Missing teeth
Overjet
Crossbones
Displacement of contact point
Overbites
impacted teeth - potential consequences
can cause resorption
supernumerary teeth can prevent normal eruption
can be associated with cyst formation
overjet >6mm - potential consequence
risk of trauma to upper incisors increased
- worse with incompetent lips
Anterior crossbite - consequence
loss of periodontal support
tooth wear
posterior crossbite - consequence
significant displacement may lead to asymmetry
- must be corrected early
Crowding and caries link
crowded teeth are more difficult to clean and take longer
deep traumatic overbite - consequences
can cause gingival stripping
loss of periodontal support
Risks of orthodontic treatment
main ones
decalcification
root resorption
relapse
soft tissue trauma
others
recession
loss of periodontal support
enamel fracture and tooth wear
loss of vitality
allergy
poor/failed treatment
headgear injuries
how to prevent decalcification
good case selection
- motivated patient
- good OH pre treatment
- low caries risk
oral hygiene
diet advice
fluoride
Oral hygiene instruction for ortho patients should include:
before start and during
- toothbrushing - target areas
- interdental brushing
- brushing minimum twice per day
- target gingival margins and around each bracket
- disclosing tablets
diet advice for ortho patient
encourage a low cariogenic diet
sugar amount and frequency
- avoid snacks between meal
- avoid fizzy drinks etc
- sports drinks
- lollipops etc
sugar free gum
- stimulates salivary buffers
root resorption in orthodontics…
inevitable consequence of tooth movement
average approx 1mm over 2 years fixed appliances
can affect any teeth
- more commonly upper incisors then lower incisors then first molars
- mostly unnoticed
- severe in 1-5%
risk factors for orthodontic related root resorption
type of tooth movement
- prolonged, high force
- intrusion
- large movements
- torque (root movement)
root from
- blunt, pipette, already resorbed
previous trauma
nail biting?
define the term ‘relapse’ in relation to orthodontic treatment
the return of the features of the original malocclusion following correction
which teeth and cases are particularly prone to relapse following orthodontic treatment?
lower incisors
crowding
rotations
instancing laterals
how to manage relapse/potential relapse
case selection
- treat severe malocclusions, accept the mild
informed consent
retention
- lifelong
- can be fixed or removal
downsides of fixed retainers
prone to plaque and calculus build up
can break without patient noticing
requiers excellent OH
requires more care/long term maintenance
