General Dentist + Orthodontist = Essential Partnership

Most people overlook the role of the general dentist in the success or failure of orthodontics. Generally, the dentist is the first line of defense in diagnosing crowding of teeth or a malocclusion. The timing of when to see an orthodontist is critical for many of our younger patients. This timing can ensure a smooth transition into orthodontic treatment as well as utilize phases of growth to help with tooth movement. A good general dentist will also be able to find a well trained orthodontist with the skills and personality to fit your child’s needs.

When To Refer To An Orthodontist?

Many children are ready for an orthodontic consult by age 7. This could be even earlier if the dentist or parent have further concerns regarding development. By age 7 enough of the permanent teeth have erupted to gauge the need for early orthodontic intervention. Luckily, most children do not need early orthodontic intervention but for those that do it makes the seemingly impossible possible again.

Severe crowding of teeth can be difficult to fix without removal of teeth, so it is essential to get an early look. Many people see orthodontics as simply a cosmetic procedure but it most definitely is more than that. The benefits go beyond cosmetic as they effect our occlusion, periodontal health, and prevent trauma due to misalignment.

Top Reasons For An Orthodontic Referral

• -Insufficient Space For The Eruption Of Permanent Teeth.
• -Anterior Or Posterior Crossbite.
• -Primary Tooth Loss Timing. Early or late loss can have its own unique implications.
• –Thumb Sucking or finger sucking habits.
• -Speech Difficulty.
• –Extreme protrusion of teeth. This can leave them at increased risk of trauma.
• -Open Bite. This occurs when the upper front teeth do not cover the lower front teeth.
• -Facial imbalance or facial asymmetry.

General Dentist Role Once Orthodontic Treatment Begins

Once the general dentist refers the patient to the orthodontist the co-treatment begins. The patient will continue to see their general dentist for routine dental work including dental examinations and professional cleanings every 3-4 months. The dentist and orthodontist will confer on the case and keep the parents updated.Without proper oral hygiene maintenance, and teamwork between the dentist and orthodontist, the entire orthodontic treatment can be placed in jeopardy.

The most preventable issues with orthodontic care are periodontal disease (inflammation of the gingival tissues), decalcification of the enamel (also referred to as white spot lesions), and cavities. Maintaining good oral hygiene during orthodontic treatment requires special tools and training. Simple tooth brushing is not enough to get the job done.

Some of these tools include:

• –Electric toothbrush with an oscillating head. This will ensure good coverage around orthodontic brackets to remove plaque and food debris.
• -Waterpik. This is a fabulous tool to clean in and around the teeth but also around the brackets and wires. It has been shown that water flossing in orthodontic patients can remove as much as 3x the plaque and bacteria vs traditional flossing.
• -Floss Threaders. This can help make flossing easier, and thus be done more often.
• -Mouthwash. A good antibacterial mouthrinse will help kill bacteria where the toothbrush doesn’t reach.
• -Interdental Brushes. These work great to remove large particles of food from between larger spaces, they are also recommended for brushing around molars that have not yet come all the way through the gum tissue.
• -Fluoride Rinses. Rinsing with fluoride should help lessen the possibility of white spots on the teeth and decay.

Orthodontic Treatment Conclusion

Communication between patient, parent, general dentist, and orthodontist should be an ongoing process. All should be intimately involved to ensure that everything is going smoothly and to head off any trouble issues as soon as possible. A team approach only works when all parties communicate their needs and issues so they can be addressed properly. Maintaining oral hygiene can be challenging during orthodontic treatment but it can be overcome with the proper tools, techniques, and more frequent professional cleanings.