Sequelae of Malocclusion PDF

# Sequelae of Malocclusion ## What causes malocclusion? ## What does malocclusion cause? ### Sequelae of Malocclusion #### Psychosocial effect (Quality of life) * Oral function * Dental diseases ##### Psychosocial effect * How does a person perceive oneself? * How is a person perceived by other...

# Sequelae of Malocclusion ## What causes malocclusion? ## What does malocclusion cause? ### Sequelae of Malocclusion #### Psychosocial effect (Quality of life) * Oral function * Dental diseases ##### Psychosocial effect * How does a person perceive oneself? * How is a person perceived by other people? - Malocclusion affects people negatively, one person could see himself ugly because of the malocclusion - The impact of malocclusion on oral health related quality of life in children - a systematic review and meta analysis #### Method * Oral health related quality of life questionnaire (OHRCO) #### Results * 40 studies * OHRQOL was significantly lower in children with malocclusion including appearance and self esteem * Do dental esthetics have any influence on finding a job? * persons with ideal smiles are considered more intelligent and have a greater chance of finding a job * those with good occlusion are seen in a more positive affective/romantic relationships * Crowding had the highest impact ##### Panels were asked to rate people according to different characteristics: * Attractiveness * Intelligence * Extraversion * Agreeableness * Persons with normal occlusion were rated more attractive, intelligent, agreeable and extraverted * Persons with underbite were rated as least attractive Intelligent and extraverted ##### The effect of physical attractiveness of teacher expectations (Clifford and walster (1973)) * Physical attractiveness affected teacher's expectation and teacher's grading * Children with attractive faces were expected to perform better. ##### Bullying * Nicknames, Teasing, Harassment and the silence of Dental Features Among School Children. * "dental features" could provide a significant target for abuse * Many children experience bullying because of their dental or facial appearance #### Quotes on twitter about people who were bullied because of malocclusion : * Front teeth gaps are not fun, because throughout my childhood I was bulled about it to the point I stopped smiling & talking * Yeah I know before I got my braces I was teased about my teeth I still feel insecure even without braces today ##### Orthodontics mainly done for psychological/ esthetic reasons no mortality and generally no morbidity from a malocclusion * I’m content with 90 percent of me, I like my teeth, sometimes I wonder if my orthodontist realizes how important he was * Beauty is in the eye of the beholder and it may be necessary from time to time to give a stupid or misinformed beholder a black eye #### Oral function * Mastication * Speech * Temporomandibular joint disorder * **Mastication** * Q: Does malocclusion affect masticatory performance? * Particle size were largest in class III followed by class II and then normal occlusion. * Class III subjects reported highest difficulty in the ability to chew carrots and celery. * **Speech** * Speech difficulties related to malocclusion. * | Speech sound | Problem | Related malocclusion | |----------|---|---------| |Sz| lisp | Anterior open bite large gap between incisors | | TD | Difficulty in production | Irregular incisors especially lingual position of maxillary incisors | | FV | distortion | Skeletal class III | | Th, Sh, Ch | Distortion | Anterior open bite | * **Temporomandibular joint disorders (TMD)** * Studies failed to find a strong association between TMD and malocclusion. * Studies did not agree which malocclusion causes TMD. * Anterior open bite was the most common malocclusion. (20% of the studies) * Anterior open bite cause or effect? * Internal derangement * Condylar resorption * Open bite retrognathic mandible. * Malocclusion cannot be considered as the principle cause for TMD more of contributing factor * **Dental diseases** * Caries * Periodontal diseases (generalized, OH related) & trauma from occlusion * Tooth fracture * Studies showed that the main determinants is oral hygiene, not tooth irregularities * **Trauma from occlusion:** * Treat as soon as possible * Single tooth cross bite * Common during incisor eruption * Impinging bite * class II deep overbite * **Trauma to incisors** * Large overjet * **Trauma to incisor risk factors** * Rask increases as overjet increases * Odds ratio=1.94-2015 * **trauma to incisors other risk factors** * Boy (odds ratio= 1.25-1.88) * Inadequate lip coverage. (odds ratio= 2.09-3.08) * Previous history of trauma (odds ratio =2.79) * So if we treat It early, do we reduce the incidence of incisor trauma? * Yes, but the effect is not remarkable * Early orthodontic treatment for class II malocclusion reduces the chance of incisal trauma. Such as (functional appliance -headgear) * **Miscellaneous** * Difficulty in prosthetic rehabilitation * Eruption problems eg: premature loss of E (caries or ectopic eruption) * Malalignm * stutment ### Clinical implications * With good oral hygiene practices, caries and periodontal diseases can be prevented even in the presence of malocclusion * TMD cannot be blamed solely on the presence of malocclusion * Treat the following as early as possible to avoid periodontal break down and tooth loss * Single anterior cross bite * Impinging bite * Trauma and increased overjet. * An increased overjet is significantly associated with higher odds of experiencing incisor trauma at all ages and stages of dental development. * Early overjet correction can **Reduce the incidence of incisor trauma** in children but there is wide variation on effect and the evidence base is heterogeneous and at high risk of bias.