Collaboration between different dental specialists while managing complex cases is key to a good outcome.
A false yet unfortunately common consideration for orthodontic treatment is that one should “wait for all permanent teeth or permanent canines to erupt before referring a patient for orthodontic treatment”. However, orthodontic treatment is not just placing braces to align teeth! Certain conditions warrant early intervention to reduce the complexity of the treatment. In fact, early intervention often facilitates non-invasive and non-extraction treatment.
While orthodontic treatment can be initiated at any age, young and old, it is always prudent to get even “normal” growth and development screened clinically. It is recommended to consult an orthodontist as early as the eruption of the first permanent teeth in the oral cavity; usually around the age of 7 years. A patient may even be referred before any permanent teeth have erupted if an abnormality is detected prior. So, a patient should be referred as soon as any abnormality is anticipated or observed. Preventive treatment is always preferred to interceptive and corrective treatment.
Treatment timing
Dentofacial complex
As a dentist, you have the opportunity to screen not just dental but also facial imbalances and musculoskeletal abnormalities. For instance, simple situations such as a single tooth crossbite if left untreated can lead to abnormal jaw relations. Your patients rely on your expertise and guidance.
Leveraging an opinion from an orthodontist will elevate your practice, as this field goes beyond aesthetic teeth alignment into establishing complete dentofacial harmony. A team of dental surgeons, with an orthodontist, can regulate stomatognathic functions, promote normal growth and development, and intercept habits before they become a challenge.
Screen your patients for the following and champion a healthier smile:
01
Naso-oral or mouth breathing
02
Tongue abnormalities - Thrust, low lying posture, large size, tongue tie
03
Frenal attachments - Thick and low frenal attachment, midline diastema
04
Airway impairment - enlarged adenoids or other morphological abnormalities such as the deviated nasal septum, mandibular retroposition, maxillary constriction, and allergies
05
Facial imbalance
06
Abnormal, non-nutritive habits beyond normal age - thumb or digit sucking, lip biting, and lip sucking
Clinical scenarios
in adults
Individuals who could not access early dental intervention due to some reason often seek treatment when the situation is already complicated. This warrants an interdisciplinary approach and orthodontics plays a crucial role.
Ortho-restorative: Extraction spaces or missing teeth gaps that have not been rehabilitated in a timely manner create a variety of challenges for optimal restoration at a later stage
Extruded opposing tooth/teeth
Collapsed or drifted adjacent teeth leading to inadequate space for restoration
Alveolar bone loss
Orthodontics can provide adequate vertical and mesio-distal clearance with healthy bone support to maximize restorative treatment options and outcomes.
Ortho-periodontics: Abnormally positioned teeth are accompanied by compromised periodontal conditions. In addition, compromised periodontium may cause pathological movement of teeth. Careful orthodontic movement can control these situations and improve long-term prognosis, plus enhance bone regeneration.