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Dr. Kamran Davami
If the growing patient in our office has the normal growth patterns and facial bones are within the normal limits evaluating the spaces for each primary or permanent teeth, eliminating the premature contact, respiration and sleep quality are in the field of preventive orthodontics.
If the growing patient in our office has the normal growth patterns and facial bones are within the normal limits evaluating the spaces for each primary or permanent teeth, eliminating the premature contact, respiration and sleep quality are in the field of preventive orthodontics.
In some cases in lower arch absence of second premolars is seen. In such cases several treatment plan are possible.
Each primary tooth is responsible for the following permanent tooth space and if lost space maintain is necessary.
In most of the cases sleep apnea is related to maxillary constriction and should be treated by an orthodontist as soon as possible.
Growing patients with normal skeletal facial bones with some space deficiency for the teeth are the best candidates for preventive orthodontics.
If the crowding is less than 3-4 mm it usually relieve by the time but more than 4 mm needs preventive orthodontics.
In most of the patients referring to Orthodontic clinic, the amount of growth, direction and relation of the upper and lower jaws are within the normal limits; in such cases the orthodontist is just responsible for eruption guidance and eliminating the interfering factors.
Preventive Orthodontics is a field of dentistry responsible for guiding the permanent dentition to grow in normal situation. The best method for getting the proper alignment in mixed dentition is increasing the dental arch length to let the dentition grow naturally.
The first step in preventive orthodontics is conservative stripping of the primary dentition to open the space for permanent teeth eruption. This method usually is a perfect solution for eruption guidance of the second premolar but not very effective for canines.
Maxillary constriction with the symptoms of obstructive sleep apnea should be treated as soon as possible by a fixed palatal expander. The appliance is fixed to the upper teeth. It usually needs 6 months to treat the constriction and there is no pain experience for the patients.
Schwarts appliance is a removable plate for the lower arch. In case of mandibular crowding the appliance is used to expand the lower dentition. It is just responsible for more room for the lower arch dentition and let the nature for eruption the teeth.
In growing patient, in case of occlusion, if the patient deviates the lower arch to right, left or forward, the possibility of any premature contact should be considered. Any premature contact may result in very bad deviation of the jaws during growth and should be treated as soon as possible.
As the mouth is a dynamic environment and several kinds of forces in different directions are present in the mouth, in case of premature loss of primary dentition, space maintaining by fixed or removable appliances is necessary.
Usually the first visit for the children should be at the age of 6, after the eruption of first permanent teeth, but most of the orthodontic appliances should be started at the age of 8 after the eruption of upper front teeth.
Most of the preventive orthodontic treatments are simple, easy, cheap and short time. So it is beneficial to start the treatment by preventive orthodontics,
Maxillary constriction, should be treated before the age of 14-15. In older cases the results are questionable.
Space maintainer, fixed or removable, by preserving the primary space may stops the future crowding.
Expanders, in upper and lower arch by increasing the length of dental arch may help the nature for eruption guidance.
Due to all above, preventive orthodontics is easier and cheaper than adult orthodontics and should be considered.