Dental Problems

Early Orthodontic Intervention -Overview

tooth-5Early orthodontic interventions is a highly controversial issue by the pediatric dentist generated by a section of specialists. Although, a comprehensive treatment might be required at the later stage, the need for the early orthodontic intervention cannot be denied. The problem could be prevented from occurrence in the first place or its complexity could be reduced to an extent such that the further procedures are simplified. Clinical experiences of various Pedodontists shows that emphasis must be placed on the guidance of growth, early interception of developing malocclusion and elimination of the first symptom. In this article, there is a brief overview of early orthodontic intervention. Let us examine them.

Early orthodontic intervention

An overview of early orthodontic intervention includes benefits of early diagnosis treatment, difficulties in early treatment, conditions that need early intervention -in primary dentition, contra-indications to early intervention and in mixed dentition period.

Benefits of early diagnosis treatment:

  • a. The possibility of achieving better results.
  • b. Some forms of treatment can only be done at an early age.
  • c. Early treatment of serious deleterious habits is easier than treatment after years of habit reinforcements.
  • d. Psychological advantage to early treatment in some children.

Difficulties in early treatment

Before starting treatment, however, one must evaluate the drawbacks such as:

  1. Misperceptions exist about the goals of early treatment.
  2. Improper early treatment can be harmful.
  3. Diphasic treatment may lengthen the chronological treatment time.
  4. Early diagnosis and treatment planning are more tentative during active growth and tricky to predict whereas when growth diminishes the factors of malocclusion are clearly seen.

Conditions that need early intervention:

In primary dentition:

  • a. Anterior and posterior cross bite.
  • b. Cases in which teeth have been lost due to caries and loss of space may result.
  • c. Unduly retained primary incisors which interfere with formal eruption of permanent incisors.
  • d. Malpositioned teeth which interfere with normal occlusal function or induce faulty pattern of mandible closure.
  • e. All habits or malfunctions which may distort growth.

Contra-indications to early intervention

  • a. There is no assurance that treatment results will be sustained.
  • b. A better result can be achieved with less effort at another time.
  • c. Social immaturity of the child makes treatment impracticable.
  • d. Patient unwilling to co-operate for treatment.

In mixed dentition period:

The mixed dentition period is the time of the greatest opportunity for occlusal guidance and interception of malocclusion. At this time, the dentist has the greatest challenges and finest opportunities for efficient orthodontic treatment. Following conditions may need a thorough evaluation with an early intervention.

  • a. Loss of primary teeth endangering available space in the arch.
  • b. Closure of space due to premature loss of deciduous teeth. The lost space in the arch must be regained.
  • c. Malpositions of teeth that interfere with normal development of occlusal function, faulty pattern of eruption, mandibular closure or endanger the health of teeth.
  • d. Supernumerary teeth that may cause malocclusions.
  • e. Cross bites of permanent teeth.
  • f. Malocclusions resulting from deleterious habits.
  • g. Oligodontia -if closure of space is preferable to prosthesis.
  • h. Localized spacing between the maxillary central incisors for which orthodontic treatment is indicated.
  • i. Neutro occlusion with extreme labio version of maxillary teeth.
  • j. Class II (disto occlusion) cases of functional type.
  • k. Class I (disto occlusion) of dental type.
  • l. Class I (disto occlusion) cases of skeletal cases.
  • m. Space supervision problems.
  • n. All malocclusions accompanied by extremely large teeth. If serial extraction is to be undertaken, treatment must be instituted in mixed dentition.
  • o. Gross inadequacies of disharmonies of apical bases.

These problems can be either completely eliminated by the preventive measures or can be corrected in their inception before they cause irreparable damage.

The above article gives an overview about the early orthodontic intervention.

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