Timing it wisely – Interceptive Orthodontics

“The wait is as much journey as the motion because timing is pivotal.” ― Innocent Mwatsikesimbe

Interceptive Orthodontics is all about intercepting the development of malocclusion in its incipient phase, in a growing child, at the right biological age, to prevent it from becoming a full-blown malformation of such a grave nature that rectifying it becomes a challenge for the orthodontist. The treatment becomes a long-drawn course not only for the patients themselves; it also increases the burden of care for their parents who have to sacrifice several work hours to accompany their children to the orthodontist’s office.

Interceptive Orthodontics procedures are, by and large, simple interventions which effectively interrupt aberrant physiological processes, for example, a swallowing pattern that has gone haywire due to compulsive oral habits like thumb sucking. The deviant muscle forces generated by these inadvertent but harmful habits are recurrent, prolonged, and powerful enough to distort the shape of the dental arch leading to an incompetent lip seal and deglutition; setting in a vicious cycle of progressive deterioration of both form and function.

Counseling the child about the ill effects of oral habits is a gentle way to initiate the interception process which often has to be followed by giving an appliance to ‘help’ or ‘remind’ the child to drop the habit. At no stage should the child view the appliance as a form of ‘punishment’ to put an end to the compulsive habit. As the adverse digit, tongue, and cheek forces stop striking the dentition, the deformed dentoalveolar complex regains normal shape, and a pleasing transformation from an anterior open bite and excessive overjet to normal overbite and overjet ensues.

By virtue of our training, we orthodontists have learned to keep a vigil on the growth graph of our patients as they approach the late mixed dentition/early permanent dentition stages because we know how helpful the pre-adolescent or circumpubertal growth spurt is in transforming faces. Using suitable designs of functional appliances we often find success in unlocking a mandible that has been restricted in its free growth due to a narrow maxillary arch.

Rapid increments in the physical stature of patients are useful clues to initiate orthopedic therapy to hold/restrict an aggressively growing upper jaw and combat skeletal maxillary prognathism. Thus growth modification therapy (Headgears/ functional appliances/palatal expanders) used to treat skeletal jaw disharmony during peak height velocity has the potential benefit of achieving a beautiful facial balance in the vertical, sagittal, and transverse planes.

It also helps eliminate or at least mitigate the requirement of orthognathic surgery for patients having severely protruded/retrognathic maxilla, vertical maxillary excess, transverse maxillary deficiency, and retruded mandibles. Once jaws achieve an optimum relationship with each other the teeth need to be moved minimally for a stable outcome. This goes a long way in improving periodontal health and longevity of the dentition.

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Several other interceptive steps taken by an orthodontist like early correction of crossbites, the guidance of tooth eruption/serial extractions to alleviate crowding in selected cases, and removing barriers to allow free eruption of teeth are invaluable services to facilitate the growth of jaws along a normal vector, thereby promoting the possibility of a markedly reduced treatment time with braces in the permanent dentition.

I will like to conclude with a quote that sums up the value of Interceptive orthodontics for an astute orthodontist:

“Time is an illusion, timing is an art” – Stefan Emunds

Tag:growing childhabitsInterceptive Orthodonticstimely intervention

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