PREVENTIVE
ORTHODONTICS
Dr Debaleena
Chowdhury
Dept. of Orthodontics
KGF Dental College
PREVENTIVE ORTHODONTICS
Definitons
“Action taken to preserve the integerity
of what appears to be a normal occlusion
at a specific time.” - Graber (1966)
“Prevention
of potential interferences
with occlusal development.”
- Proffit & Ackerman .
Preventive measures
 Parent
counselling
 Caries control
 Space maintanence
 Management of abnormal frenal
attachments
Preventive measures (contd.)
 Treatment
of locked permanent
first molars
 Abnormal oral musculature &
management of related habits
 Extraction of supernumerary teeth
Parental education
A. Prenatal counselling
Education of the expecting mother
B. Postnatal counselling
Associated with the clinical examination of
the child at
a. 6months - 1 year
c. 3 years
b. 2 years
d. 5- 6 years
Caries control
 Caries
of decidious teeth can cause
malocclusion
a. Nursing bottle caries
b. Rampant caries
Nursing bottle caries
Rampant caries
Proximal caries causes loss of arch length
 Treatment
-Diet counselling -Pulpectomy &
pulpotomy
-Topical flouride application
-Stainless steel crown

Stainless steel crown
Space maintenance


Indicated in early loss of decidious teeth
Two types of space maintenance
Removable
Functional ( teeth incorporated )
Non functional
Fixed
-Band & loop
-Nance holding arch
-Crown & loop
-Lingual arch
-Distal shoe
Band and loop
Crown and loop
Distal shoe
Nance holding arch
Lingual holding arch
Treatment of locked permanent
first molars
 Prominent
distal bulge of second
decidious molar prevents proper
eruption of first permanent molars.
Treatment
- Proximal stripping
Management of abnormal frenal
attachments
 Gingival
frenal attachments lead to
malocclusion ,e.g. midline diastema
 Ankyloglossia
 Surgical treatment
Ankyloglossia
INTERCEPTIVE
ORTHODONTICS
Dept. of Orthodontics
Yenepoya Dental College
INTERCEPTIVE ORTHODONTICS
 Interceptive
orthodontics has been
defined as that phase of the
science and art of orthodontics
employed to recognize and
eliminate potential irregularities
and malpositions of the developing
dentofacial complex
Interceptive Procedures







Serial extraction
Correction of developing cross bite
Control of abnormal habits
Space regaining
Muscle exercises
Interception of skeletal malrelation
Removal of soft tissue or bony barrier to
enable eruption of teeth
Serial extraction

Procedure that indicates the planned
extraction of certain decidious teeth
and later specific permanent teeth in an
orderly sequence and predetermined
pattern to guide the erupting permanent
teeth into a more favorable position
Rationale for serial extraction
Arch length tooth -material discrepancy
 Physiologic tooth movement : By
selective removal of some teeth the
rest of the teeth which are in the
process of eruption are guided by the
natural forces into extraction spaces

Serial extraction :Indications


Class 1 malocclusion showing harmony
between skeletal and muscular system
Arch length deficiency ; features:
Absence of physiologic spacing
Malpositioned or impacted laterals
Crowded upper and lower anteriors
Abnormal eruption pattern
Ankylosis of one or more teeth
Serial extraction indications (contd.)
where
growth is not enough to
overcome the discrepancy
Patients
profile
with pleasing and straight
Serial extraction - Contraindications






Class II & III malocclusions with skeletal
abnormalities
spaced dentition
Oligodontia
Open bite & deep bite
Midline diastema
Mild discrepancy between arch length and
tooth material
Methods of serial extraction
 Dewel’s
 Tweed’s
 Nance
method
method
method
Dewel’s method

CD4
Tweed’s & Nance method

DC4
Nance method
DEVELOPING ANTERIOR
CROSSBITE

Condition characterised by reverse
overjet wherein one or more maxillary
anterior teeth are in lingual relation to
the mandibular teeth.

Early interception is necessary.
ANTERIOR CROSS BITE

Reasons for early treatment:
crossbite in deciduous dentition may
progress to permanent dentition.
simple problem may progress
towards more complex skeletal
problems.
CLASSIFICATION OF ANTERIOR
CROSSBITE
DENTOALVEOLAR
 Rx – tongue blade, Catalan’s appliance,
double cantilever spring with P.B.P.
 SKELETAL
 Best treated during growth by growth
modification procedures
 FUNCTIONAL (pseudo-crossbites)
 Rx - removal of occlusal interferences.

INTERCEPTION OF HABITS
Thumb sucking
Rx  bitter solvents
thumb cap
palatal crib
 Tongue thrust
Rx  palatal crib
tongue exercises

 Mouth
breathing
Rx  oral screen
 surgical removal of nasal
obstructions
SPACE REGAINING
 Space
gained by distalization of
first molar which have been moved
mesially due to early loss of
deciduous molars.

Gerber space regainer

Space regainer using jack screws

Space regainer using cantilever spring
MUSCLE EXERCISES
Exercises for masseter muscle
 clenching of teeth by patient while counting
to 10.
 Exercises for lips (circumoral muscles)
 Holding and pumping of water back and forth
behind the lips.
 Massaging of the lips
 Button pull exercises
 Tug of war exercises

 Exercises
for tongue
One elastic swallow
Tongue holding exercises
Two elastic swallow
Hold-pull exercise
INTERCEPTION OF SKELETAL
MALRELATION
Interception of Class II malrelation
 Face bow with headgear
 Myofunctional appliances

• Interception of Class III
Chincup with headgear
FR III
Facemask therapy
REMOVAL OF SOFT AND HARD
TISSUE BARRIERS
 Surgical
excision of soft tissue and
any overlying bone above the
crown of unerupted tooth