Public health aspects of orthodontics - PowerPoint Presentation

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Public health aspects of orthodontics

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INTRODUCTION

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Definition-

Orthodontics includes the study of the growth and development of the jaws and face particularly; and the body generally, as influencing the position of the teeth; the study of the action and reaction of internal and external influences of the development, and the prevention and correction of arrested and perverted development.

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Malocclusion is a complex morphological and functional phenomenon manifested in a disharmony of two or more features of jaws, teeth and soft tissue.

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PROBLEMS ASSOCIATED WITH MALOCCLUSION

Poor facial appearance

Risk of caries

Predisposition to periodontal diseasesPsychological disturbances

Risk of trauma

Abnormalities of function

TMJ problems

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Aetiology of malocclusion

MOYER'S CLASSIFICATION:

Heredity: a) Neuromuscular system

b) Bone c) Teeth and d) Soft parts

2

) Developmental defects of unknown origin

3)

Trauma

a) Prenatal trauma and birth injuries

b) Postnatal trauma

4) Physical agent

a) Premature extraction of primary teeth

b) Nature of food

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5) Habits

a) Thumb sucking and finger sucking

b) Tongue thrusting

c) Lip sucking and lip biting

d) Posture

e) Nail biting

6) Diseases:

a) Systemic diseases

b) Endocrine disorders

c) Local diseases

a)

Nasophalyngeal

diseases and disturbed respiratory function

b) Gingival and periodontal disease

c) Tumors

d) Caries

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Dental base abnormalities

1)Anterio-posterior

malrelationship 2) vertical malrelationship

3) Lateral

malrelationship

4) Disproportion of size between teeth and basal bone

5) Congenital abnormalities

B) Pre-eruption abnormalities

1) Abnormalities in position of developing tooth germ

2) Supernumerary teeth and teeth abnormal in form

3) Prolonged retention of deciduous teeth

4) Large labial frenum

5) Traumatic injury

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C) Post-Eruption Abnormalities

1)Muscular

a) Achieve muscle force b) Rest position of musculature

c) Sucking habit d) Abnormalities in path of closure 2) Premature loss of deciduous teeth

3) Extraction of permanent teeth

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EPIDEMIOLOGICAL TRIAD

AGENT

ENVIRONMENT

HOST

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HOST FACTORS :

Race & Ethnic Group:

Dental characteristics like facial features also show racial influences

In a homogeneous racial grouping the incidence of malocclusion seems relatively low. But where there has been a mixture of racial stratus the incidence of Jaw size

descripancies

and occlusal disharmonies is significantly greater

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2.Sex:

There is no predilection except for lower anterior crowding common in males.3.Age:

Incidence of normal occlusion in deciduous dentition is about 60%

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Heredity:

Heredity plays a significant role in determining the following characteristics namely

1)Tooth size

2) Width and length of the arch

3) Height of the palate

4) Crowding and spacing of teeth

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The heredity plays a part in the following conditions;

1)Congenital deformities cleft lip and palate

2) Facial asymmetries

3)

Macrognathia

and

micrognathia

4)

Macrodontia

and

Microdontia

5)

Oligodontia

and

anodontia

6) Tooth shape variation

7) Frenum,

diastemas

8) Deep over bite

9) Crowding and rotations of teeth

10) Mandibular

retrusion

11) Mandibular

prognathism

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CONGENITAL:

1) Cleft lip and palate

2) Cerebral palsy 3) Torticollis

4)

Cleidocranial

dysostosis

5) Congenital Syphilis

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Predisposing Metabolic, Climate and Disease:

a) Endocrine Imbalance:

b) Metabolic disturbances and infectious disease:

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INTRAORAL VARIATION

a) Anomalies in Number of Teeth

b) Abnormalities of tooth size:c) Anomalies of tooth shape d) Abnormal labial frenum :

e) Premature loss of deciduous teeth:

f) Prolonged retention:

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g) Delayed eruption of permanent teeth

Causes:1) Congenital absence of permanent tooth

2) Presence of supernumerary tooth 3) Deciduous roots

4) Premature loss of deciduous tooth 5) Mucosal barrier

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h) Abnormal eruptive path :

i) Ankylosis:

j) Habits: 1) Thumb sucking

2) Finger sucking 3) Tongue thrusting

4) Lip biting

5) Nail biting

6) Cheek biting

7) Pencil or foreign object sucking

8) Lip sucking

9) Mouth breathing

10) Clenching

11) Bruxism

12) Occupational habits

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Agent Factors:

1)Bacteria (

streptococcus mutans and lactobacillus acidophilus

): Carious teeth2) Tissue invading organisms: actinomycetem comitans

,

Mycoplamsa

and Spirochetes : loss of teeth

3) Dietary Problems: Slow growth

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ENVIRONMENT FACTORS :

Pre-Natal:

German measles and medications taken during pregnancy may cause congenital deformities including malocclusion

2) Postnatal Including Birth Injuries:

e.g., Forceps delivery

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PREVALANCE OF MALOCCLUSION

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PREVENTIVE ORTHODONTICS

Parent education

Caries control

Care of deciduous dentitionManagement of

ankylosed

teeth

Maintenance of quadrant wise tooth shedding time table

Checkup for oral habits

Occlusal

equilibriation

Extraction of supernumerary teeth

Space maintenance

Management of deeply locked first permanent molar

Management of abnormal

frenal

attachments

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Education of the parent

The expecting mother should be educated on matters such as nutrition to provide an ideal environment for the developing foetus.

Soon after the birth, the mother should be educated on proper nursing & care of the child.

The mother should be advised on physiologic nipple than conventional nipple because physiologic nipple are designed to permit suckling of the milk which more or less resembles the normal functional activity as in breast feeding.

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Care of Deciduous Dentition

Preventive orthodontics include care of the deciduous dentition by way of prevention and timely restoration of the carious teeth. The deciduous teeth are excellent natural space maintainers until the developing permanent teeth are ready to erupt into the oral cavity.

Simple preventive procedures such as application of topical fluoride & pit and fissures sealant help in preventing caries.

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Extraction of supernumerary teeth

Presence of supernumerary and supplemental teeth can interfere with the eruption of nearby normal teeth. They can deflect adjacent teeth to erupt in abnormal positions. Presence of an

unerupted mesiodens

prevents the two maxillary central incisors from approximating each other. Thus supernumerary teeth should be identified and extracted before they cause displacement of other teeth.

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Maintenance of tooth shedding time table

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Oral habits check up and patients parent education

Habits such as finger and thumb sucking, nail biting, tongue thrusting and lip biting should be identified .

Prevention starts with proper nursing and use of physiologically designed nursing nipple and pacifier to enhance normal function and deglutition activity.

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Space maintenance

Premature loss of deciduous teeth can cause drifting of the adjacent teeth into the space. It can result in abnormal axial inclination of teeth, spacing between teeth & shift in the dental midline.

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INERCEPTIVE ORTHODONTICS

Serial extraction

Correction of developing cross bite

Control of abnormal habitsSpace regaining

Diastema

closure

Muscle exercises

Interception of skeletal

malrelation

Removal of soft tissue or bony barrier to eruption of teeth

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Interceptive orthodontics

It is defined as that phase of science and art of orthodontics employed to recognize and eliminate potential irregularities and

malpositions of the developing dento

facial irregularities.

It is defined as that phase of science and art of orthodontics employed to recognize and eliminate potential irregularities and

malpositions

of the developing

dento

facial irregularities.

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Space regaining

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Interception of habits

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Muscle exercises

The dental tissue are blanketed from all direction by muscles. Normal occlusion development depend upon the presence of normal oro-facial muscle function.Exercise for the

Masseter muscles an exercise to strengthen the Masseter muscle involving the clenching of teeth by the patient while counting to ten.

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Exercise for the lips-

stretching of the upper lip to maintain lip seal is an important therapeutic measure in patient having short hypotonic lips.

Patient is asked to stretch the upper lip towards the chin.

Holding & pumping of water back and forth behind the lips.

Massaging of the lips.

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CONCLUSION

Malocclusion is a complex morphological and functional phenomenon manifested in a disharmony of two or more features of jaws, teeth and soft tissue. Subjective perception of malocclusion varies among the individuals based upon the severity of condition, impact on esthetic and oral functional, socioeconomic status etc.

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SMILE IMPROVES THE FACE VALUE

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A smile is a curve that sets everything straight. 

Always remember to be happy because you never know who's falling in love with your smile