Occlusion defects and orthodontic prophylaxis

Proven content

Malocclusion can be divided into: posterior or anterior in relation to the frontal plane (undershot bite, undershot bite), vertical in relation to the horizontal plane (open bite, deep bite, overbite), transverse to the sagittal plane (jaw narrowing, cross bite, overhang, lateral displacement of the mandible). There is also excessive or insufficient growth of the mandible or the jaw as a whole. Another disadvantage is the crowding or incorrect positioning of individual teeth in the dental arch.

A few words about malocclusion …

The masticatory organ is one of the earliest human organs, the jaw begins to form in a few weeks old fetus. Sometimes a child is born with a retracted lower jaw, which corrects itself over time, but not always …

Malocclusion is diagnosed in children aged 7-18. Very often they are caused by an incorrect structure and the position of the jaw bones in relation to each other. Also, the wrong arrangement of the dental arches is of great importance here. Malocclusion may be congenital (genetic predisposition) or may result from external factors that affect the fetus through the mother’s body, e.g. taking certain medications. It also happens that the child causes malocclusion by unnecessary habits, e.g. compulsive biting of pens and other various objects.

Malocclusion – causes

Occlusion defects may be of the following origin:

1. internal (heredity, maternal diseases during pregnancy, endocrine abnormalities, rickets, infectious ailments);
2. external – before birth (intrauterine pressure, injuries during pregnancy and malposition of the fetus) or during childbirth and after birth (unfavorable positioning of the baby and feeding), incorrect habits, survival of the infant type of swallowing, mouth breathing, soft tissue defects in the oral cavity .

Factors increasing the risk of malocclusion:

1. mouth breathing
2. bruxism (teeth grinding),
3. sucking lips and cheeks,
4. forceps or facial childbirth,
5. sucking a badly constructed soother,
6. thumb sucking
7. compulsive biting of certain items, e.g. pens,
8. wrongly latching the baby to the breast and bottle-feeding (the breast and the bottle should be at an angle of 45 degrees during feeding),
9. incorrectly putting the child to sleep (head and neck in the side position should always be slightly higher),

Types of malocclusion

The most common malocclusions are:

1. Open bite – the occurrence of this defect causes that the teeth do not touch each other at all, which results in a non-bite gap. This condition makes it difficult to chew and bite off bites of food. In addition, people with this defect have problems with proper speech, especially with pronouncing the pre-linguistic dental consonants, e.g. d, s, t, dz, c, n, ł. Characteristic for an open bite are: a gothic palate, reduced lip muscle tension, elongation of the lower part of the face and an enlarged angle of the jaw.

2. Cross bite – as a result of this defect, the lower teeth overlap the upper teeth in certain areas or in the entire dental arch.

3. Oversized bite – this is the most common malocclusion, which accounts for about 70 percent. all defects. Characteristic for this defect is the retraction of the lower dental arch in relation to the upper arch, with the front teeth not in contact. In extreme cases of this defect, the upper incisors may be inclined towards the upper lip, and the face may be distorted due to the retraction of the lower jaw and the lowering of the mouth corners. Overshot bite causes that pronouncing sounds such as s and z resembles ś, ź.

4. Deep bite – characterized by a strong overlap between the upper teeth and the lower teeth. This condition causes the face to become asymmetrical and causes the teeth to grind. Such a defect should be corrected immediately as it can cause dental problems such as periodontitis and gingivitis.

5. Overshot bite – for this defect the overlapping of the lower dental arch over the upper one is specific; the face clearly shows the protrusion of the chin and lower lip (people with this defect are perceived as people with a threatening expression on their face).

6. Crowding – having too large teeth in relation to the alveolus; very often they grow at the wrong angle and turn because there is no room for them in the jaw.

7. Separated teeth – a defect characterized by visible gaps between the teeth due to excess space in the maxilla and mandible.

How to treat malocclusion?

Treatment of malocclusion includes:

1. teeth grinding,
2. treatment with a spatula, chin sling, vestibular plate,
3. muscle exercises,
4. if there is a need to remove teeth,
5. re-education of chewing, breathing, swallowing and speech,
6. treatment with functional, movable and fixed appliances.

Obviously, there is no point in implementing orthodontic treatment too early. The dental apparatus is a torment for a few-year-old child, which it will try to get rid of at every opportunity. Therefore, the treatment of malocclusion in a few-year-old child is implemented when the defect is very visible and hinders everyday functioning. Orthodontic treatment at the right time lasts about a year, while too late or in adulthood – a little longer. Very often the stimulus to start treatment is other people, e.g. a friend or colleague says – you have crooked teeth – this is enough for the desire to get rid of the complex and shame to be greater than the discomfort.

Untreated malocclusion causes:

1. excessive tightening of the facial muscles,
2. disorders of the functioning of the temporomandibular joints,
3. incorrect position of the jaw and mandible,
4. caries,
5. periodontal diseases,
6. damage to the mucosa of the lips and cheeks,
7. problems with speaking (correct speech),
8. problems with biting and chewing,
9. unsightly appearance of the face.

Orthodontic prophylaxis

Malocclusion prevention should cover children in the period of infancy, pre-school and school years.

1. Babies to sleep should be placed on their backs on a fairly firm, springy and flat mattress, with their head on a flat pillowpositioned so that it is slightly raised and slightly tilted forward. Under these conditions, the lips touch each other, closing the mouth, breathing is regular, and the tension in the muscles of the face and neck is reduced. Too high a position of the head causes the jaw and tongue to move forward. The upper lip can slide between the gingival shafts. On the other hand, too low, completely horizontal position of the head causes the jaw and tongue to shift backwards; the mouth then opens and the child breathes through it. These incorrect positions lead to unfavorable changes in the position of the mandible, muscle disorders and the temporomandibular joint.

2. During natural or artificial feeding, the baby’s head and torso should be in an upright position. The lower part of the baby’s body should rest against the mother’s abdomen and thighs. The bottle should be held at a certain distance from the lips, slightly above the mouth of the baby, at an angle of 45 degrees to the mouth. If the baby is in a horizontal position during feeding, the lower jaw growth is weaker upstream. It also makes it difficult to swallow and breathe through the nose.

3. Feeding teats should be similar to a woman’s nipple. The part of the teat placed into the mouth is to be short, dome-shaped. The right shape of the nipple and the size of the opening are important (preferably a few small holes). Artificially fed babies are more likely to develop the habit of sucking a nipple and a finger than those fed with natural food. Breastfeeding is a natural stimulus for the proper and full development of the chewing function and the formation of a correct bite.

It is physiologically correct nose breathingwhich positively influences the shape of the jaws. In addition, the air, passing through the nose, is adequately warmed, moisturized and partially purified. The habit of mouth-breathing promotes distortions of the masticatory organ.

In the post-infancy period, it is important to pay attention to proper breathing, rational nutrition, swallowing and preventing bad habits.

During early childhood, in the so-called at preschool age, the importance of proper chewing of hard foods should be emphasized, and at school age, speech and breathing control should be emphasized.

Do orthodontic prophylaxis belongs:

1. motivating to the proper performance of oral hygiene procedures,
2. caries treatment and prevention as early as possible to counteract the effects of premature tooth loss.
3. all kinds of orthodontic appliances should be properly cleaned, including fixed appliances, and removable appliances should be removed and washed several times a day, especially after meals, just like the teeth. For brushing teeth with orthodontic appliances, the Vitamma SMILS sonic toothbrush with 5 brushing programs is available on the Medonet Market.

Read also: Orthodontic appliances