POHS 3 Orthodontics Reading Assignment PDF

# SUNY Orange ## Department of Dental Hygiene ### DHLP: POHS 3 ### TOPIC: ORTHODONTICS #### Reading Assignment: - Wilkins, See Syllabus, Article - Bath-Balogh and Ferenbach, (MFA) - Review Mixed Dentition and Occlusion Module in Patient Assessment Tutorials Text - MFA Occlusion Study Guide - POHS...

# SUNY Orange ## Department of Dental Hygiene ### DHLP: POHS 3 ### TOPIC: ORTHODONTICS #### Reading Assignment: - Wilkins, See Syllabus, Article - Bath-Balogh and Ferenbach, (MFA) - Review Mixed Dentition and Occlusion Module in Patient Assessment Tutorials Text - MFA Occlusion Study Guide - POHS 1-Oral Examination - Dental Bio-Materials - Ortho Lab - Dental Radiography - Orthodontic Assessment - OHE - Oral Self Care Ortho Patient #### Foundational Knowledge: - 1.2; 2.1; 2.2; 2.3; 3.2; 4.1; 5.2; 6.1; 6.3; 6.5; 7.1; 8.1; 9.1; 9.2 #### Competencies Addressed: Upon completion of the reading assignment, DHLP and class meeting, the student will be able to: 1. Define orthodontics. 2. State the goals of orthodontics. 3. Review classifications and consequences of malocclusion. 4. Review normal growth and development of the oral cavity and dentitions. 5. Describe the role of the Dental Hygienist in the dental specialty of orthodontics. 6. Explain and perform assessment techniques used to evaluate and analyze orthodontic problems. 7. Define and describe interceptive orthodontic techniques. 8. Recognize parafunctional habits, the results on the oral cavity, and methods to correct. 9. Recognize key words and terminology used in orthodontic therapy. 10. Apply the Dental Hygiene Process of Care for patients before, during, and after orthodontic treatment. 11. Explain principles of tooth movement as it relates to treatment, appointments, and frequency of visits. 12. Describe clinical procedures for band removal and debonding. 13. Provide information to pediatric patients and his or her parent/guardian about occlusion, malocclusion, and any notable findings. 14. Discuss the role of the Dental Hygienist in the referral process to the Orthodontist. 15. Name three internet resources about occlusion. 16. Develop oral self-care recommendations for the ortho patient to reduce risk for caries and periodontal disease. # Orange County Community College ## Department of Dental Hygiene ### POHS III ### DHLP: Orthodontics ## I. Introduction **A. Definition:** - Orthodontics: A dental specialty that deals with the recognition, prevention and treatment of conditions involving irregularities of the teeth, jaws, and face and their influence on the physical and mental health of the individual. **B. Goals of Orthodontics:** 1. To establish or maintain a normal functioning occlusion. 2. To improve facial aesthetics. 3. To diagnose and correct conditions associated with preventive orthodontics. **C. Malocclusion:** - Any deviation from the normal relationship of the maxillary arch and/or teeth to the mandibular arch and/or teeth. **D. Consequences of Malocclusion:** 1. psychosocial problems – facial aesthetics 2. enunciation of words – speech problems. 3. retention of biofilm debris and stain 4. temporomandibular dysfunction (TMD); difficulty chewing, swallowing and speaking 5. Injury - caused by trauma or breaking or protruding teeth. ## II. Planning Orthodontic Treatment **A. Interceptive Orthodontics:** 1. Definition – Phase I of treatment during the adolescent growth spurt to help guide the growth and development of the patient to decrease the cost, time, discomfort and negative consequences of orthodontic care. **B. Assess the Skeletal Age:** 1. Radiograph hand and wrist 2. Assess shift and position of teeth and growth of the mandible **C. Adolescent Growth Spurt Ages 7 – 12 Years:** 1. Girls - 2 years before boys 2. Duration: - 3 ½ years girls - 4 years boys **D. Habit Control:** - Is another interceptive procedure: 1. The most common habits are thumbsucking and tongue thrusting. 2. Forces produced by normal action of the muscles in the tongue, lips and cheeks aid in the proper growth of the orofacial region. 3. Abnormal muscle behavior can generate forces that alter normal growth. This is what we see with thumbsucking and tongue thrusting. **E. Thumbsucking (Fingersucking):** 1. Malocclusion can be profound, mild or none. This depends on skeletal makeup, frequency of habit, vigor and method used. - Anterior open bite (frequently) maxillary teeth tipped labially, mandibular teeth tipped lingually - Tongue-thrusting (the open bite causes the tongue thrust needed to create a seal during swallowing). - Vigorous thumbsucking creates a suction pulling the cheeks against posterior teeth. This can result in narrowing of arch forms of the jaws. 2. Treatment: - Discuss/educate child to stop habit. - Appliance can be inserted to remind child to keep thumb out of mouth. **F. Tongue Thrusting:** - Forceful movement of tongue against anterior teeth during swallowing. It is the resting posture of the tongue, not the swallow process force, which moves teeth. 1. Possible Causes of Tongue Thrusting: - Possible improper bottle feeding - Discomfort in the throat area (tonsillitis, pharyngitis). (At completion of normal swallow, tongue will press painful area, so child opens slightly and thrusts tongue forward away from tender area.) - If chronic, it becomes a habit even through sore throat may go away. - Enlarged tonsils/adenoids can reduce size of airway. Move tongue forward to breathe easier. - Seal open bite (from thumbsucking) in order to swallow. 2. Observation of Tongue Thrusting: - Part lips with fingers during swallow to: - See if tongue comes forward - Feel for contraction of muscles at mouth/chin which help contain tongue within mouth (i.e., patient has difficulty in keeping lips together during swallowing). ## III. Principles of Tooth Movement **A.** Orthodontic appliances apply force to the crown of the tooth that is transmitted apically through the root to the periodontium. **B.** When force is applied to the tooth, some areas of the periodontal ligament become compressed causing the alveolar bone to resorb through the actions of the osteoclasts. **C.** Formative function of the PDL at the same time other areas of the periodontal ligament are stretched which stimulates osteoblasts to product new bone. **D.** The tooth moves as the areas of the alveolus under compression resorb. New bone is produced behind the moving tooth in areas of the alveolus that are under tension. **E. Time Factors:** 1. Force must be applied for 6 hours to produce biological activities. 2. Continuous force (static) - force maintained between orthodontic appointments. 3. Interrupted force – forces where magnitude gradually drops to zero between visits. 4. Ortho appointments every 4 weeks to allow healing and prevent damage to the teeth. 5. Resorption of bone = 10 days after activation. - Repair and regeneration = 10-14 days **F. Retention** ## IV. ADPIED - for Patient at Risk for Potential Orthodontic Problems: **A. Assessment:** 1. habits 2. occlusal analysis/survey 3. extra oral exam 4. dental chart - mixed dentition 5. radiographs 6. study models/photos **B. Diagnosis:** 1. occlusal classification 2. actual or potential problems 3. dentist examination and referral **C. Planning:** 1. therapeutic strategies 2. preventive strategies 3. set goals - time line for consultation 4. informed consent - inform parent and patient **D. Implementation:** 1. prevention of caries and perio condition risk factors **E. Evaluation:** 1. referral orthodontist, speech therapy, oral surgeon **F. Documentation:** 1. correspondence with orthodontist 2. send current radiographs, photos, study models 3. establish recall intervals ## V. Debonding **A.** Definition: removal of brackets and residual adhesive **B. Cement removal** 1. mechanical - bur low speed, light brush stroke 2. electrothermal 3. laser 4. ultrasonic **C. Rinse, air dry, and evaluate** **D. Restore pretreatment enamel** 1. polish aluminum oxide points and cups. 2. rubber cup with pumice 3. brown and green polishing cups **E. Fluoride treatment and therapy** # Orange County Community College ## Department of Dental Hygiene ### POHS III ### DHLP: Orthodontics Activities ## I. Define the terminology - write the definition of the following terms: **Braces:** a generic term used to include appliances in the mouth used for tooth movement. - Brackets - Band - Separators - Arch Wire - Elastomer - Intraoral Elastics - Aligners (Invisalign®) System - Retainer - Hawley Retainer (appliance) - Space Maintainer - Space Regainer - Appliance - Fixed Appliance - Orthodontic Appliance - Orthopedic Appliance - Ligature - Bonding - Debonding ## II. Oral Self-Care **A.** List oral physiotherapy aids used for orthodontic patients. **B.** Briefly explain the reason for recommending daily fluoride mouthrinse for the patient with orthodontic appliances. ## III. Instrumentation Name two devices that may be used in dental hygiene instrumentation for patients with ortho appliances. ## IV. Describe the clinical procedures for band removal and debonding. What are the objectives of debonding? ## V. Describe the role of the Dental Hygienist in post-orthodontic care (retention, prevention, and documentation).