Orthopedic dentistry or stage I ortho treatment consist on helping the maxilla and mandible grow to their full potential to prevent bite and aesthetic discrepancies in the future. The way this is achieved is through active retainer appliances. Sometimes our arches do not develop to its fullest capacity creating a big problem in the bite and as a consequence in the tmj; which is a very important joint that connects the skull to the lower jaw. Also by having kids use active retainers we avoid the need for extraction of permanent teeth in the future and IPR in the case of invisalign.
Stage I – Orthodontic Treatment
The profile of the patient is examined with growth pattern and it is determined if the upper jaw or lower jaw need expansion in width or length. If expansion is recommended then this appliances are made and can be placed permanently for a period of time and the dentist can adjust it or a removable appliance is done and the parent adjust it at home and the dentist checks patient once a month.
The permanent appliance ensures the patient will wear it (compliance). This is a great option for some parents who don’t have the time to be on top of their children making sure they are wearing the appliance. However; for those children who play sports and cant have a fixed appliance while playing; the removable appliance is a better option.
When the maxillary arch is constricted causing the upper teeth to be inclined inward they trap the lower teeth inward as well and the lower jaw stays somewhat underdeveloped as a result. In these cases the tmj suffers in the long run because the lower jaw is not in the ideal position and the disk in between the joint is displaced causing a click or pain in the future. The best way to fix this problem would be expanding the upper jaw and that could have allowed the lower jaw to grow to its fullest potential. Another scenario is when lower jaw is underdeveloped and the upper jaw is protruded. The old school way was to extract some upper teeth to create space in the upper jaw and move front teeth back to match with the lower ones. At the end patients who received this treatment suffer from the same tmj problem previously described because the lower jaw is trapped again. The best way of fixing the problem at an early age here would be expanding the lower jaw, which would have prevented the extraction of virgin teeth. These are just some examples where orthopedic dentistry can make a significant difference.