Introduction to Orthodontics

Jonathan Chapple Jonathan Chapple Department of Orthodontics Department of Orthodontics Newcastle Dental Hospital Newcastle Dental Hospital

Good morning!
If you are 3rd year dental students attending a lecture on Orthodontics Then we are all in the right place.

3rd year BDS 15th December 2006

Objectives of this lecture

Orthodontics
What is orthodontics? What do we do? What will you get to do? Those who are interested..

3rd year BDS 15th December 2006

Orthodontics
What is Orthodontics?
The branch of dentistry concerned with the treatment and prevention of irregularities of the teeth and jaws

3rd year BDS 15th December 2006

Where does orthodontics sit?

Clinical Dentistry
Restorative Dentistry
Prosthodontics Conservative Dentistry Periodontology

Oral Medicine and Surgery

Oral and Maxilofacial Surgery Oral Medicine Oral Pathology

Child Dental Health

Paedodontics Community Dental Services Orthodontics 3rd year BDS 15th December 2006

What does orthodontics deal with?

Aesthetics

3rd year BDS 15th December 2006

What does orthodontics deal with?

Function

3rd year BDS 15th December 2006

What does orthodontics deal with?

Aesthetics Function Stability

3rd year BDS 15th December 2006

Orthodontics Prevention
Interceptive orthodontics
Advice on extraction of teeth to relieve crowding or allow eruption of certain teeth

3rd year BDS 15th December 2006

Unerupted Teeth - incisors

Impeded by supernumerary

3rd year BDS 15th December 2006

Orthodontics Prevention
Interceptive orthodontics
Advice on extraction of teeth to relieve crowding or allow eruption of certain teeth Advice on extraction of certain teeth with poor prognosis to allow for spontaneous alignment.

3rd year BDS 15th December 2006

Extractions
First molars

3rd year BDS 15th December 2006

Orthodontics Treatment
Skeletal discrepancy Dento-alveolar disproportion(too little or too much space for all permanent teeth)

Also Missing teeth/small teeth Trauma

3rd year BDS 15th December 2006

Treatment for Skeletal Discrepancy

Facial proportion (vertical) Increase in overjet (horizontal) Increase in overbite

3rd year BDS 15th December 2006

Dento-alveolar Disproportion
What does that mean? Crowding Spacing

3rd year BDS 15th December 2006

Treatment for Missing Teeth

Where are they?
Impacted Congenitally missing Syndrome Extracted for decay or periodontal disease

3rd year BDS 15th December 2006

Treatment for Trauma

Trauma may result in loss to upper central incisors Treatments
Acute Removal and space closure Space opening and prosthesis
Transplant Implants
3rd year BDS 15th December 2006

3rd year BDS 15th December 2006

Treatment methods
Orthodontics only
Removable appliances Fixed appliances

Growth modification
Functional appliances Headgear

Orthognathic surgery combined approach with Maxillofacial Surgery

3rd year BDS 15th December 2006

Treatment for skeletal discrepancy

Growing patient growth modification Adult patient accept or surgery

3rd year BDS 15th December 2006

Growth modification
Functional appliances
Twin blocks Medium opening activators

3rd year BDS 15th December 2006

Skeletal disproportion OJ
Severe class II

3rd year BDS 15th December 2006

Skeletal disproportion OJ
Severe class II

3rd year BDS 15th December 2006

Growth Modification
Headgear
Cervical High pull Reverse pull

3rd year BDS 15th December 2006

Orthognathic surgery
Treatment for skeletal discrepancy where functional appliances have failed or patient wanting treatment is an adult

3rd year BDS 15th December 2006

Orthognathic Surgery
Combined approach with Maxillofacial Surgery Approach where orthodontics alone is insufficient

3rd year BDS 15th December 2006

Orthognathic surgery
Single jaw or Bi-maxillary osteotomy

3rd year BDS 15th December 2006

So, after all that

What do dental students get to do?

3rd year BDS 15th December 2006

Orthodontics - Appliances
Removable appliance

Elssa.jpg

Elssa.jpg

3rd year BDS 15th December 2006

Orthodontics - Appliances
Fixed appliances

3rd year BDS 15th December 2006

And of course
Functional appliances

3rd year BDS 15th December 2006

What else is there?

Move teeth which are impacted Commonly maxillary canine Exposure by the maxillo-facial surgeons

3rd year BDS 15th December 2006

What else do we get involved in?

Osteogenic Distraction

3rd year BDS 15th December 2006

3rd year BDS 15th December 2006

3rd year BDS 15th December 2006

3rd year BDS 15th December 2006

3rd year BDS 15th December 2006

Orthodontic Treatment
Is it worth it?

3rd year BDS 15th December 2006

3rd year BDS 15th December 2006

Orthodontics in the NHS

Service is provided by
General Dental Services Specialist Practitioner Community Dental Services Hospital services

3rd year BDS 15th December 2006

GDS, Specialist Practice & CDS

Treats most patients Mostly bread and butter orthodontics Efficient with high throughput variable training; Combines GDP with interest and practitioners with specialist training CDS may treat medically compromised or more difficult cases
3rd year BDS 15th December 2006

Hospital service
Consulation service for patients referred from primary and secondary care Management of multidisiplinay patients (cleft, restorative, orthognathic, paedodontic, medically compromised) Treatment of complex orthodontic cases Training of specialists/ GDP with interest
3rd year BDS 15th December 2006

Is orthodontics fun?
Its slooowwwwwwwww And some people say its boring It works and mostly, you get results

3rd year BDS 15th December 2006

Is orthodontics fun?
If you want instant gratification -

3rd year BDS 15th December 2006

Is orthodontics fun?
Or if you want more excitement

3rd year BDS 15th December 2006

Is orthodontics important?
It is to pass your final BDS examination You may not provide any orthodontics in general practice But you need to know how it can benefit your patients Advances in techniques and increased public awareness
Higher expectations Improved outcomes Increased multidisciplinary care 3rd year BDS 15th December 2006

Do I want to be an orthodontist?
Yes
If you like making nice smiles If you like wire bending

3rd year BDS 15th December 2006

Do I want to be an orthodontist?
Yes
If you like doing puzzles If you want to make loads of money (the top 10 earning dentists in the UK are all orthodontists)

No
If you dont want to study for another 5 years (minimum)

3rd year BDS 15th December 2006

Those who are interested..

Postgraduate qualification BDS (Obviously) 2-3 years clinical experience, involving either
GPT, or VT and SHO in maxillofacial or dental hospital

MFDS, MFD
Audit projects Publications

Apply for 3 year training programme

M. Sc. M. Orth.

Further 2 years training15th December 2006 a consultant to become 3rd year BDS

3rd year BDS 15th December 2006

3rd year BDS 15th December 2006

Finally - The End

Questions?

3rd year BDS 15th December 2006