In this part 2, Orthodontist Dr Andrew Chang discusses:
Treatment Options:
No treatment
Interceptive Treatment now: Functional
Appliances with U maxilla expansion + referral to speech
therapist.
Wait till permanent dentition, then camouflage
with upper arch extractions, U expansion is less
effective.
Treatment Timing:
Is it too early? Primary dentition?
If have habits eg: thumb sucking or dummy, best
to cease habit first
Mixed dentition: best time for maximum
orthopedic effect (CVMS 2: Baccetti 2002): Shape of vertebral
bodies of C2-4 and inferior borders of C3-4
Adult. Is it too late? What happens with
functional appliances? Compliance and success rate (due to
temporary speech disruptions), greater lower incisor proclination.
Jaw surgery and risks of morbidity.
Adv & Disadv of Early Treatment- Gingival
trauma, Upper incisor trauma, psychosocial.
Adv & disadv of Late mixed dentition or
Permanent dentition Tx: Orthopedic effects best
retained.
What should dentists be looking
out for?
Age and Dental Status. Mobile D’s and E’s at
10-11 yrs may be difficult to retain functional
appliances.
Habits - ask about thumbsucking, dummy, mouth
breathing etc.
Signs of Risk Factors manifesting as gingival
trauma, narrow jaw, Upper Incisor trauma.
Assessing risk factors through their lifestyles
and habits ie: sports, mouthbreathing
>7mm Overjets and referral to
orthodontist
My experience has been parents would prefer to
do a combined functional appliance + teeth alignment that address
root causes, rather than orthodontic camouflage and adults are not
keen on jaw surgery procedures due to significant
risks.
About the Podcast
Dr Chang and his friends from the healthcare industry will enrich your mind and take you on the journey of transforming smiles and the impact this has on lives.