ORTHODONTICS

From the Clinic Manual

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GRADE SHEETS

CLINIC FORMS

Slide Series on Minor Tooth Movement

Introduction

A. Definition.

Orthodontics is the area of dentistry concerned with the supervision, guidance, and correction of the growing and mature dental facial structures. Conditions that require movement of teeth or correction of malrelationships and malformations of related structures by the adjustment of relationships between and among teeth and facial bones by the application of forces and the stimulation and reduction of the functional forces within the craniofacial complex are included.

B. Scope of Care.

Orthodontics includes space maintenance, tooth guidance, minor tooth movement, interceptive procedures, and full orthodontic treatment to influence growth or tooth position and in conjunction with orthognathic surgical procedures. Removable or fixed appliances may be used to accomplish these goals. Candidates for orthodontic treatment should be in good general health and have excellent oral health maintenance.

C. General Considerations

1. Many features of evaluation in orthodontics are common to all dental practice and will not be discussed. Only those aspects important specifically to orthodontics will be included.
2. The timing of treatment is of particular importance in orthodontic correction. Any particular problem may be better treated in the deciduous dentition, mixed dentition, or the permanent dentition. Appropriate treatment may require one or more phases of active treatment. The demands of treatment timing may conflict with patient availability and, when such conflict arises, the ultimate decision must place the patient’s best interest first.
3. The principles of preventive dentistry should be employed during the diagnosis and treatment of orthodontic problems, including counseling of the patient on dietary concerns, plaque control, and the need for the continuance of routine dental examination and treatment. Topical fluoride should be applied at appropriate intervals for patients at risk for caries.
4. Orthodontic treatment should be directed toward the attainment of an optimal result for each patient in regard to dentition, supporting bone, occlusion, overbite, and overjet to achieve aesthetic improvement and stability of the correction. Active treatment should be followed with appropriate retention when the patient is available.
5. A satisfactory result in orthodontics is dependent upon the combination of professional skill, patient cooperation, the age of the patient, severity of the presenting malocclusion, treatment objectives, and the individual growth and development patterns occurring during treatment and retention.

Orthodontic Procedures

Preventive Maintenance Orthodontics

Procedure:

Space maintenance devices are used to conserve space for the eruption of the permanent tooth or teeth when deciduous teeth are lost prematurely. Habit breaking devices are used to modify digital, tongue, or breathing habits so that adverse forces to the developing dentition and skeletal components of the craniofacial complex are minimized or reversed. Habit breaking devices may be either removable or fixed.

Criteria:

• Appropriate diagnostic criteria are used.
• A psychological profile assessment of the patient is considered.
• No permanent damage to the teeth or soft tissues results from treatment.
• Appliance and results of treatment are monitored at appropriate intervals.
• Appliance is removed once its purpose has been served.

Interceptive (Mixed Dentition) Orthodontics

Procedure:

Interceptive appliances are used to prevent or correct malalignment or malocclusion problems of both individual teeth and tooth segments, and to modify growth in skeletal problems. The interceptive device may be removable or fixed.

Criteria:

• Appropriate diagnostic criteria are used.
• A psychological profile assessment of the patient is considered.
• Appliance is monitored and adjusted at appropriate intervals
• Active appliance therapy is discontinued once the treatment goals have been met.
• Retention demands are considered.

Comprehensive Orthodontics

Procedure:

The study of growth of the craniofacial development of the occlusion, and associated abnormalities is based on the comprehensive orthodontic spectrum. Orthodontic therapy is directed toward the correction or minimization of problems caused within the occlusion, growth of the craniofacial complex, and function of the neuromusculature bordering the dental complex. A variety of appliances, both removable and fixed, can be used.

Criteria:

• Adequate medical, familial, and dental histories are obtained.
• Adequate diagnostic data is obtained for the complexity of the presenting problem.
• Growth assessment of forecast as appropriate.
• No adverse clinical signs or symptoms are experienced during therapy.
• Minimal or no damage to the teeth results from treatment.
• The teeth are placed in a physiologically functional position at the end of treatment.
• The best aesthetics for the individual patient is achieved at the end of treatment.
• The active appliance is removed at the end of active treatment.
• Retention needs are assessed and provided for.
• Transfer notes and materials are provided following the American Association of Orthodontists protocol when transfer notice is given by the patient or parent before the completion of active appliance treatment.