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If there is defect in the soul, it can’t be corrected on face, but if there is defect on the face… and one corrects it, it can correct a soul- Jean Cocteau
Orthodontics is a branch of dentistry that deals with the study of growth and development of the jaw and face and the factors that influence the position of the teeth, study of action and reaction of internal and external influences on the development, prevention, and correction of arrested and perverted development. The term, orthodontics, is composed of two words: “ortho”, which means bone, and “dontics”, which means teeth. So, basically, this branch deals with the treatment of any anomaly of teeth or bone or combination of both. Generally, people understand this specialty as just the management of crooked teeth; however, this is not the true understanding of the subject. The prevalence of orthodontics is very high. We do not have a national data on the prevalence of malocclusion, but some studies done in Kathmandu school children have shown that as high as 45 % of school children have some kind of malocclusion. It clearly indicates that the prevalence is really high and alarming. Treatment is related to changing a person’s personality and overall quality of life. The ultimate goal of treatment is restoring the functional efficiency, structural balance, and esthetic harmony.
Causes of Orthodontic Problem
Malocclusion is the result of multiple factors. It’s rarely due to a single factor. It may be due to heredity, trauma during intrauterine period or post natal period or trauma during birth. Many times, it may be even related to the mother’s sickness and the medication taken by her either knowingly or unknowingly. It may also be related to a deleterious habit, such as thumb sucking, tongue thrusting, or nail biting. Systematic disease, endocrine disorders, and local disease may also be the cause of malocclusion. Local disease may include factors like dental caries, retained deciduous teeth, nasopharyngeal disease, and disturbed and altered respiratory function, tumors, and gingival or periodontal disease. Last, but not the least, the cause of malocclusion may be malnutrition.
Varieties of Malocclusion
The different varieties of malocclusion may include macrodontia, microdontia, small mandible, small maxilla, or combination of both, spacing in teeth, deep bite, open bite, collapse arch, cross bite, crowding, bimax jaw, cleft lip and palate, macroglossia, or microglossia. The treatment of different varieties of malocclusion may be different according to the cause.
Impact of Malocclusion
The impact of malocclusion may vary from negligible impaction to very vast psychosocial problems. The most common problem seen in malocclusion is poor dental condition, unsettled and poor occlusion, poor oral hygiene un-esthetic and unbalanced face, carious teeth, halitosis, and many times, severe depression. The author of this article has encountered multiple cases that have even attempted or planned suicide due to the appearance of poor face and dentition. Although the orthodontic problem is one of the neglected problems, the consequences may be sometimes a fatal one. Many times, we come across people who have lost their job just due to poor esthetics. Poor facial pattern and peer harassment in school may hamper the overall development of kids. They may stop socializing. This can lead to severe psychiatric problems. One may also be deprived of front desk jobs just due to poor facial esthetics.
Management of Malocclusion
The management of malocclusion depends on the type of malocclusion. The treatment modality depends on the basis of cause. The determining factors of management depend on diagnosis, age, and type of malocclusion. Sometimes, it also depends on demand of the patient. We may have to determine the treatment according to the need. Sometimes, multiple extractions of teeth may be needed if the teeth material is more than the space available on the jaw. If the age of the patient is favorable, which means that he still has potential to grow, then deficient bone can be grown to normal shape with appropriate orthodontic appliance. This may save a patient from major orthognathic surgery in adulthood. The ultimate aim of orthodontic treatment is restoration of esthetic and balanced face and functional stability. The treatment modality is divided into three phases.
Preventive orthodontics: Prevention is better than the cure. This means that action taken to preserve the integrity of what appears normal for that age. It means—let’s preserve the teeth until the age of natural exfoliation. Let’s make sure that the child does not have any deleterious habit.
Interceptive orthodontics: It is the phase of early intervention before the malocclusion gets worsened. It reduces the degree of worsening and includes treatment with appropriate myofunctional appliance.
Corrective orthodontics: It is done in patients who do not have any chance of bone growth or remodeling due to crossing of a certain age. It includes treatment such as surgical correction or camouflage treatment.
Conclusion: The branch of dentistry the author discussed so far, which we all call orthodontics and dentofacial deformities, is a boon to the modern dentistry. It can change a patient’s life in a holistic way. We carve a way to a beautiful, confident, and healthy smile. The orthodontic problems are not life-threatening, but still, the right management of the problem can change the personality and confidence of a patient if planned well.
