Dental Problems

Potential Problems of Incipient Malocclusion during Deciduous Dentition

Pulpitis - Diagnosis and Treatment of PulpitisA child birth gives lot of excitement and happiness and along with some tension. It may be due to their growing habits. Development of teeth may also be a concern in some kids. There may be some potential problems of incipient malocclusion during deciduous dentition which are discussed below in this article. Let us examine them.

Potential Problems of Incipient Malocclusion during Deciduous Dentition

Deciduous dentition

  • The main value of observing kids during the deciduous dentition is to prevent and intercept malocclusion.
  • Serial examinations, cepjalograms, lateral jaw and intra oral radiographs and casts must be taken in order to record dentofacial maturation progress.
  • Diagnostic records should be obtained at the following intervals:
    1. Before the permanent mandibular incisors begin to erupt (age 5).
    2. After the permanent maxillary incisors begin to erupt (age 6.5)
    3. After the permanent maxillary lateral incisors begin to erupt (age 7.5 to 8)

Dental arches:

  • A kid’s primary dentition without spacing results in crowding of the permanent dentition in almost 40% cases.
  • Therefore, spacing is desirable in the primary dentition.
  • Although the presence of primate and developmental spacing does not ensure that the permanent dentition will erupt without crowding, these spaces usually alleviate some crowding.
  • Crowding or overlapped teeth in the primary dentition may occur, although it is rare.
  • True crowding in the primary dentition almost always guarantees a crowded permanent dentition.
  • Spacing in deciduous dentition -chances of crowding in permanent dentition
    1. Crowding -10 in 10
    2. No spaces -7 in 10
    3. Below 3 mm total spacing -5 in 10
    4. 3-6 mm -2 in 10
    5. Over 6 mm None
  • Crowding of isolated teeth, however, is sometimes indicative of a sucking habit. Lower anterior teeth can be tipped lingually into a crowded position as a result of constant pressure from a finger.

Transverse relationship:

  • One should look out for any midline discrepancies and posterior plane.
  • A large midline discrepancy is unusual in the early primary dentition, and one should be suspicious of a mandibular shift, which is often indicative of a posterior cross bite.
  • It is important to check that the mandible is in centric relationship because a bilateral cross bite will appear to be unilateral, if the mandible shifts laterally into maximum intercuspation.
  • The child shifts the jaw because the teeth do not fit well together and the bite is uncomfortable.
  • A true unilateral cross bite that is due to unilateral maxillary constriction in the primary dentition is rare but can occur.
  • Maxillary constrictions in primary dentition may be due to an active thumb sucking habit, although there are many cases in which the origin of the cross bite is undertermined.
  • In a small number of cases, the mandibular shift is due to an interference caused by the primary canines (selective removal of enamel in both arches eliminated the interference and the lateral shift into cross bite).
  • Anterior cross bite may occur due to over retained primary teeth.
  • A cross bite in the primary dentition usually will be present in the permanent dentition, and if corrected in primary dentition it may not reappear in the permanent dentition.
  • Untreated functional posterior cross bite gradually brings about a compensatory structural change of the mandible and sometimes of the condyle.

Vertical dimension:

  • Overbite:

    It is approximately 2 mm in the primary dentition. Anterior open bite is usually indicative of a sucking habit in this age group.

    If the patient and the parent deny the existence of a sucking habit, further investigation into the cause of the open bite is needed.

    Skeletal malocclusion condylar fracture and degenerative disease such as juvenile rheumatoid arthritis may account for the open bite and should be investigated.

  • Overjet:

    Excessive overjet in the primary dentition is usually due to a non-nutritive sucking habit or to a skeletal mismatch between upper and lower jaws.

Delay of eruption:

  • Kids with delayed dental eruption may either have a very slow but normal sequence of eruption or some isolated eruption problem.
  • To distinguish the eruption sequence of the child, it is compared with the normal sequence of eruption and the eruption pattern on the right side is compared with that on the left.
  • If the sequence seems appropriate, dental development is slow (probably).
  • If the patient’s eruption pattern deviated from the normal sequence and there are differences between the contralateral sides of the mouth, further investigation is warranted to determine whether the teeth are missing or are impeded from erupting.
  • If a tooth is missing (often maxillary lateral incisors) or prevented from erupting, it could be an indication of the development of an incipient malocclusion.
  • A missing primary molar could lead to discrepancies in arch length at a later date (i.e., during eruption of the permanent Ist molar). Similarly with an impacted primary tooth.

Habits:

  • Thumb and finger sucking, pacifier habits, lip habits, tongue thrust, mouth breathing, nail biting, bruxism and self-mutilation are some habits that can be seen during the primary dentition period.
  • Thumb sucking (4 -6 hours per day) can cause the following problems:
    1. Anterior open bite
    2. Facial movement of the upper incisor and lingual movement of the lower incisors
    3. Maxillary constriction
  • Changes that occur during the primary dentition are okay so long as the habit extinguishes itself prior to eruption of the permanent teeth.

The above article discusses about the

potential problems of incipient malocclusion during deciduous dentition.

Thus, parents must take care of their kids and consult their dentist as soon as possible as the first tooth emerges.

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