Interceptive Orthodontics: A milestone in dentistry.
By Dr Jacob John
A healthy mouth and beautiful teeth can be a great asset. Our teeth have such an important role to play in our lives. They help us chew and digest food, they help us to talk and speak clearly and they also give our face its shape. A smile also has other day-to-day benefits. It can give us greater confidence, as well as influence our social lives, careers and relationships. Because of this, it only makes sense to give our oral health the best care possible. When a person's teeth or jaws do not fit together properly, orthodontic treatment may be necessary to correct the problem. If left untreated, these orthodontic problems, often referred to as malocclusions, can cause speech difficulty, premature wear of the teeth and protective enamel, and even increase the chance of injury to the teeth and jaw joints. Most of the Orthodontic treatment like braces, invisaligner and removable appliance can be done at any age, but there are treatments that can be done for children whose teeth and jaws are still growing which will intercept with the complicated problems that will come up in future. Interceptive Orthodontics basically refers to measures undertaken to prevent a potential malocclusion (irregular teeth & malpositioned jaw) from progressing into a more severe one. Interceptive treatment procedures are carried out when the signs and symptoms of a malocclusion have appeared and thus eliminate the causative factor and prevent the developing dental, skeletal and functional abnormalities. Age and time of interceptive orthodontic treatment Interceptive orthodontic treatment starts as early as 6 to 12 years of age which provides sufficient benefits, especially when jaw irregularities are present. Early age orthodontic treatment with appliances will influence the growth and development of jaw/bones, which is not possible to do at an older age. It is effective only while the body is growing that's why it begins early and is not recommended for adult. Various interceptive orthodontic treatment procedures are: Correction of developing Crossbite (reverse bite of the opposing teeth) can be done using maxillary arch expansion appliance. Untreated Crossbite can cause narrow (constricted) upper arch & deviated oversized lower jaw. Management of developing skeletal and jaw abnormalities Correcting forwardly placed or large size lower jaw (excess mandible) by using chin cup and reverse pull facemask treatment to maintain ideal relation, if done at right period, can avoid complicated orthognathic surgery. For the correction of under developed/ backward placed lower jaw (small size mandible) by using myofunctional appliance to accelerate or stimulate the lower jaw growth to achieve a normal profile. For the correction of prominent gums (large & forwardly placed upper jaw) by using headgear and face bow for restricting excess upper jaw growth. Interception of Abnormal Habits: This will ensure that this harmful oral habit does not become fixed and its adverse effects do not affect the normal growth and development of the patient's profile. Oral habits such as thumb sucking, mouth breathing and tongue thrusting tend to cause dental malocclusion by imbalance in the forces acting on the teeth and if left untreated over a longer period of time will lead to abnormal positioning of the upper and lower jaw. Tongue thrusting habit is the habit of pushing the tongue front between the upper and lower teeth and this should be intercepted by using fixed removable tongue crib .If not treated will lead to front teeth open bite and forwardly placed upper teeth with generalised spacing. Mouth breathing habit is caused by nasal obstruction like enlarged adenoids or tonsils or allergic conditions which can lead to large size prominent gums and teeth, small lower jaw and open bite. This can be controlled by using flexible oral screen. The appliance allows for the child to shift from oral breathing pattern. Thumb sucking habit is considered as placement of thumb or one or more fingers into the mouth if it persists after 4 years of age should be intercepted using blue grass appliances to avoid the adverse effect like protruded front teeth, narrow upper arch. Importance of interceptive orthodontics: Many progressive treatment are now available for patients 7 to 11 years of age, which provide sufficient benefits especially when jaw irregularities and harmful oral habits are present. Newer, softer and effective appliances made by CAD/CAM technologies have been introduced in recent times which is immensely accepted by the patient. Treatment started at appropriate time can have a positive impact on facial growth and tooth development. Interceptive Orthodontics is not just a pretty smile. It adds to one's functional and ability to maintain healthy teeth throughout their lives. The author will be visiting Aster Medical Centre from September 6--13. * Professor Dr Jacob John is working as a Consultant Specialist Orthodontist at Aster Medical Centre
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