Orthodontics outside the box – Rachel Pointer for Tandex

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  Posted by: Dental Design      11th January 2019

According to the results of a new study, 7 per cent of child orthodontic patients were found to be a high risk for sleep-disordered breathing.[i]Sleep-disordered breathing (SDB) covers a range of conditions, from snoring to apnoea. Early diagnosis and treatment are essential, because childhood SDB is associated with many health problems, including “behaviour problems, deficits of general intelligence, learning and memory deficits, evidence of brain neuronal injury, increased cardiovascular risk, and poor quality of life.”[ii] 

The study assessed an orthodontic population of 303 children, aged between 9 and 17, using a questionnaire to ascertain their level of risk of SDB. With 7.3 per cent of the sample screening at high risk, higher than expected, it was concluded that SDB is likely to be widely under-reported. The author hopes that his study will help more orthodontists to recognise the signs and symptoms of SDB, so that referral to a specialist can be made.

This latest study builds on previous work, which looked at the link between SDB and craniofacial morphology in children aged between six and eight.[iii]It found that children with a cross bite and children with a convex facial profile were at greater risk of having SDB than those with no cross bite, or with a normal facial profile. Pinpointing SDB in the young and correcting the problem early will have important, positive repercussions for their general health as they grow older. Regular poor sleep affects mental wellbeing at any age and can have dramatic consequences on physical health, putting an individual at risk of a range of serious conditions, such as heart disease and obesity.

What does this mean for dental practitioners? Well, in the UK more children than ever are having orthodontic treatment – around 20,000 a year.[iv]In some cases the reasons are clear, for example when there is obvious crowding or protrusion once the adult teeth have erupted. But parents should be told to look for other signs that could indicate orthodontic work may be necessary. These include problems with eating, chewing and biting food, a ‘popping’ of the jaw and mouth breathing – so, not just things associated with poor dental appearance.

Modern childhood orthodontics ispreventive dentistry. It can mean the young patient can avoid invasive dental treatment and even surgery in the years that follow. It can halt the progress of developmental flaws in the jaw area – flaws that may compromise their long-term general health as well as the health of the teeth and periodontium. As per the SDB research above, orthodontics can be the gateway to diagnosing other health conditionsandsolving them. The benefits of inceptive orthodontics are enormous – helping a child eat, speak, brush, clean and sleep better are up there alongside ‘traditional’ reasons to embark on this treatment: to improve a patient’s self-esteem and confidence through improved aesthetics.


If parents are still wary of orthodontics, they need to know that the latest appliances are more sophisticated, less obtrusive and can give stable, long-term results. New clear aligners have improved the reputation that braces had in the past; it’s no longer about having uncomfortable, unattractive metal bands placed around your child’s teeth. Retention techniques have improved too, so good orthodontics really can last forever.

A big reason for practitioners to bang the drum for childhood orthodontics is it encourages a lifelong commitment to daily preventive care. Tip-top oral hygiene is essential for successful orthodontics. Children and adolescents who get fitted with an appliance are more susceptible to decay and cavities, simply because there are more spaces for food debris and plaque to hide. This can only be removed mechanically, which means brushing thoroughly with a soft brush, twice a day and using the correct technique. A child who isn’t good with dental hygiene before wearing an appliance isn’t necessarily going to improve after their treatment has finished – decay and periodontal problems will continue to advance even with corrected teeth! When children get older, they can add interdental and interproximal brushing to their daily routine, plus a good alcohol-free mouth rinse.

The Danish producer of oral hygiene products, TANDEX, has everything your patients need, including brushes, interdental brushes and other adjunctive products. They can be safely used with orthodontic appliances and long after to maintain long-term oral hygiene. Regular appointments are also fundamental to ensuring a daily routine is effective. Parents should also be encouraged to eliminate fizzy drinks and sugary foods from their children’s diets and regulate their intake of acidic foods. These valuable lessons will hopefully stay with them forever.

Orthodontics is part of preventive dentistry and early treatment can incept a wide range of dental andgeneral health problems. By encouraging patients to see how it’s about more than ‘just’ straighter teeth, we can help them fully understand how much this treatment is able to achieve.


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[i]Rohra AK, Demko CA, Hans MG, Rosen C, Palomo JM. Sleep disordered breathing in children seeking orthodontic care. American Journal of Orthodontics and Dentofacial Orthopedics. 2018 Jul 31; 154(1): 65-71.


[ii]Halbower AC, McGinley BM, Smith PL. Treatment alternatives for sleep-disordered breathing in the pediatric population. Current Opinion in Pulmonary Medicine. 2008 Nov; 14 (6): 551.


[iii]Ikävalko T, Tuomilehto H, Pahkala R, Tompuri T, Laitinen T, Myllykangas R, Vierola A, Lindi V, Närhi M, Lakka TA. Craniofacial morphology but not excess body fat is associated with risk of having sleep-disordered breathing – The PANIC Study (a questionnaire-based inquiry in 6–8-year-olds). European Journal of Pediatrics. 2012 Dec 1; 171(12): 1747-52.


[iv]British Orthodontic Society (BOS). Why Orthodontics? Found at: http://www.bos.org.uk/Public-Patients/Orthodontics-for-Adults/Why-Orthodontics

(accessed August 2018).


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