Preventive orthodontic is that part of orthodontic practice that concerned with patient and parents education, supervision and development of dentition and craniofacial structures

1. Preventive orthodontic

2. Contents
 Preventive orthodontic
 Why the need for preventive orthodontic ?
 The procedures undertaken in preventive orthodontics

3. Preventive orthodontic
Is that part of orthodontic practice which is
concerned with patient and parents education ,
supervision of growth and development of
dentition and craniofacial structures , the
diagnostic procedures undertaken to predict of
malocclusion and treatment procedures
instituted to prevent the onset of malocclusion

4. Why the need for preventive orthodontics ?
Preventive orthodontic provide dental professionals with a way to identify and
intercept teeth problems in children , that when caught early enough , help to
avoid more aggressive treatment later on

5. The procedure undertaken in preventive
orthodontics
 Parent education
 Caries control
 Care of deciduous dentition
 Extraction of supernumerary teeth
 Occlusal equilibration
 Maintenance of tooth shedding time
 Management of ankylosed teeth
 Management of abnormal frenal attachment
 oral habit check up
 Deeply locked permanent first molars
 Space maintenance

6. Parents education
Knowledge of preventive dentistry for the parents especially mothers should
ideally begin during prenatal period as this is the time they are most
encouraged about the well being of the un born child and should continue till
at least 6 years of age after which focus shift on child dental education

7. Prenatal education

8. Postnatal education
This is the more age specific and can be divided into 4 types :-
 Birth to one years of age:-
This is the most important period of counseling
 Stress on brest feeding
 Bottle feeding with high sugar exposures should be avoided

9. Soon after birth the mother should be educated on proper nursing and care of the
child . It is thought that breast feeding may be beneficial for jaw development , as
sucking involves mandibular movement and the tongue exerting upward and
outward forces on the mother’s breast, which the infant’s pre maxillary region,

10. while posterior acting forces of
the buccinators during bottle
feeding , pacifier use and digit
sucking oppose forward acting
forces of sucking during breast
feeding

11.  In case the child is being bottle fed , the mother is advised on the use of
physiologic nipple and not the conventional nipple

13.  Gum pads and newly erupted teeth should be cleaned with clean , soft cotton
cloth dipped in warm saline
 Gradual progression should be made from cloth cleaning to finger brush
without the use of dentifrices

14.  One to three years of age :-
 Importance of weaning
 Bottle feeding should be withdrawn completely by 18 to 24 months of age
 Brushing should be initiated twice in a day
 Parents should be taught the correct method of brushing the teeth as this age
they have to brush their children’s teeth

16.  3-6 years of age :-
 The parent should informed about the effect of oral habits on the
development of malocclusion
 The parents should encourage the child to begin brushing on his own
at least once a day

17.  6 years onward of age :-
 The parents should be informed about the initiation of exfoliation of
deciduous teeth and eruptive pattern of permanent teeth
 Parents should be educated about the need for constant review and recall on
regular basis

18.  In case of extraction of deciduous teeth due to decay or any other cause then the
importance of space maintainers should be explained to the parents

19. Caries control
Caries in proximal surface of deciduous teeth if not restored lead to loss of arch
length by movement of adjacent teeth into the space

20. Caries control
Diet counseling
Topical fluoride
Pit and fissure sealant

21. Care of deciduous teeth
 All effort should be made to prevent early loss of deciduous dentition by the
way of caries prevention and timely restoration of caries teeth
 Deciduous teeth by themselves act as natural space maintainer , which not only
maintain the space for their succeeding permanent teeth but also guide the teeth
in their proper position in dental arch

22. Consequence of premature loss of deciduous
teeth

23. Extraction of supernumerary teeth
 Their prevalence range between 0.3 and 0.8 percent in primary
dentition and 0.1- 3.8 percent in the permanent dentition with more
predilection in male and anterior region

25. 

26. Occlusal Equilibration
All functional prematurities should be eliminated as they can lead to
deviations the mandibular path of closure and also predispose to bruxism

28. Management of deeply locked permanent first
molar
The deciduous second molars occasionally have prominent distal bulge which
prevent the eruption of first permanent molars

29. Maintenance of tooth shedding time table
There should not be more than 3 months difference in shedding of deciduous
teeth and eruption of permanent teeth in one quadrant as compared to other
quadrants , delay in eruption may be due to one of the following factors:-

31. Management of ankylosed teeth

32. Management of abnormal frenal attachement
The presence of a thick and fleshy maxillary labial frenum that is
attached relatively low prevent the maxillary central incisor from
approximating each other

34. Presence of ankyloglossia or tongue tie prevent normal functional development
due to lowered position of the tongue and abnormalities in speech and
swallowing

35. Surgical correction of tongue tie

36. Oral habit check up and education

37. Space Maintainers

39. Objective of space maintenance
 Preservation of space
 Preservation of the integrity of dental arches
 Preservation of normal occlusal plane
 In case of anterior space maintenance , it should aid in esthetics
and phonetics

40.  Time elapsed since loss of tooth:- Maximum loss of space
occurs within 2 weeks to 6 months of the premature loss of deciduous tooth

41.  Stage of root formation :- The developing tooth buds begins to
erupt actively if root is three-fourth formed

42.  Thickness of bone covering the unerupted teeth:-
According to Mc Donald 1mm of bone resorbs in 4 to 5 months and so if the
bone is present over the succedaneous tooth it is an indication for space
maintainer

43.  Delayed eruption of permanent teeth:- Over retained or
ankylosed primary teeth or impacted permanent teeth, can result in delay of
eruption process with the removal of these types of primary teeth an appliance
may be needed to hold the space until the permanent tooth erupt

44. Types of space maintainers
 Removable

45. Fix space maintainers

46. Thank you