Orthodontia

THUMB SUCKING

• Infant even sucking while in Uterus
• Thumb sucking normal up to 4 1/2ys.
• Sucking gives emotional security
• If sucks after 4 ½ year causes dental problem depending on the intensity, frequency and duration cause protrusion of teeth.
• Can interfere in pronunciation and effect the roof of the mouth.
• Child sucks to get attention from parents and their love and care

Infant in Uterus

Thumb Sucking

Proclination

• More seen in children whose both parents are working, gets less time to care them and love them.
• Give attention, so child can discontinue such habit
• Some mothers use bitter tasting applications on thumb sucking is in order to stop sucking
• Never punish children, but give love and give more attention.
• Some children use pacifiers, but never dip pacifiers in sweet solutions.
• Child sucks to get attention from parents and their love and care

Tongue Thrusting

• Normal person, swallow 800 times day time and 200 times at night
• Child during breast feeding thrust tongue to suck the milk from mother’s breast nipple
• When teeth erupted, child stops breast feeding
• Due to some irritation, abnormal use of tongue can make habit to come back
• Tongue Thrust cause open bite in front or back showing some space between teeth when teeth are closed.
• Can cause protrusion of teeth

Tongue Thrust

Open Bite

Tongue Thrust Correction by:

• Corrected by tongue exercise in day time
• Use habit breaking appliance by removable or by Fixed appliance during day time
• Damage occurred due to tongue thrust while swallowing can be corrected by fixed orthodontic treatment combine with elastic and Habit Breaking Appliance at any age

Habit Breaking

Lip Sucking

• Holding lower lip beneath the upper front teeth, combine with Thumb sucking
• Upper teeth will protrude, lower teeth will incline lingualy
• Child does this to get attention from parents
• Seen more in children whose both parents are working
• Parents get less time to care and love them

Sucking lip

Lip Sucking Corrected by

• Appliance to be worm during day and night
• Give more attention, care and love the child

Appliance for lip sucking

Mouth Breathing

• Child with mouth breathing
• Can be due to bad habit.
• Due to growth in nose called adenoid.
• Makes child forced to mouth breathing

Mouth Breathing Corrected by

• Child must be seen by ENT specialist to remove the adenoids if any
• Give oral screen appliance to change mouth breathing to normal nose breathing

Appliance for Mouth Breathing Correction

Bruxism

• Is a neurological disorder where excessive teeth grinding at night
• It is a unconscious act done at night
• Causes rapid tooth to wear
• Main cause can be mental tension

Due to Bruxism teeth worn

Due to Bruxism teeth worn

Bruxism Corrected by

• Using night guard made of soft acrylic material
• Comfortable to wear at night prevent teeth getting worn out

Night Guard

If not corrected

• Using night guard made of soft acrylic material
• Comfortable to wear at night prevent teeth getting worn out

Patient Bite with strain | Corrected by crowning all teeth to increase vertical height

TMJ dysfunction syndrome

It is a TMJ disorder due to myofunctional problem

• Patients complaints of pain, aching jaw, clicking, cripitation sound while opening and closing jaw.
• Pain radiates to bones of skull over ear (called temporal region), neck and to shoulder
• Cause is due to deviation of jaw while opening and closing
• Can cause disc to come out protrude which makes bone to rub each other causes pain and abnormal sounds.

TMJ dysfunction treated by

• Adjust the food habits to prevent wide opening mouth
• Restrict yawning and laughing
• Prevent eating raw fruits
• Use spoons to eat
• Cut raw fruits and eat
• Orthodontist give systemic medication, give anti inflammatory gel ask patient to do hot Fermentation, & given TMJ appliance
• To wear for 3-4 hours per day to get disc to correct position in joint space
• Stop clicking, cripitation sound and stops the radiating pain

• Appliance correct TMJ joint and cranio mandibular muscles
• Correct extra capsular by relaxing facial muscles
• Correct intra capsular by reducing symptom of jaw joint and bone structure, reduce the sounds

Cross Bite

• Seen anteriorly (front teeth) or posteriorly (back teeth)
• Can be due to early loss of milk teeth or delay in shedding of milk teeth
• Defective of palatal arch growth.

Corrected

• If child is below 14 yrs corrected by palatal expansion palates
• Either removable or fixed expansion by rapid palatal expansion Plate
• After cross bite correction, child must go to fixed orthodontic treatment for stable occlusion

Types of Expansion plates

Hyrax (Rapid Maxillary Expanding)

RME

Rapid lower expanding

Nance ( Lungal Holding Arch)

Pendulam Appliance with TMA

Quad helix

Fixed Blue Grass Appliance