Very few patients will seek Orthodontic treatment for functional needs. Human occlusion is like a fine pair of scissors it cuts through the food but never cuts each other. This is what happens in perfect occlusion which is in harmony with TMJ. But in malocclusion of any form scientifically speaking there is always the possibility of the scissors cutting each other. The teeth, TMJ and the periodontium form the three corners of a triad. In order to function properly all three have to function in harmony. Whenever there is malocclusion the harmony is disturbed and the weaker link fails.
When we see the dentition of a 60 or a 70 yr old, more often we will see missing teeth, mobile teeth and attrited teeth. The most obvious reason for this which will come in our mind would be dental caries or periodintitis. And many a times we might also wrongly interpret it as an aging change. But what does recent scientific research say? “Very minimal or no evidence of aging is there of periodontium”. So there is some third cause of damage to the supporting structure of the teeth. And this third cause is ‘Trauma from Malocclusion’ which is popularly known as ‘Trauma from Occlussion’ or TFO which is a misnomer. Malocclusion increases the chance of increased force concentration on certain areas of the dentition. There are oblique lines of force during function which itself lead to angular bone loss. You would be surprised to know that when you chew a piece of apple or any other food of similar consistency the amount of force that comes between teeth has been measured to be 50- 70 kgs. Now if that level of force is acting continuously in malocclusion then teeth and periodontium and TMJ are bound to suffer in the long run. We dont need any statistics to prove it. Picture is on our floor every day.
The Ideal time to get first screened by an Orthodontist is Age 7 years. Although most 7 years may only receive check-ups and no early intervention, however only a few cases which have traumatic influences like cross-bites or traumatic deep bites will require immediate preventive or interceptive measures. The reason being that cross-bites can cause growth disturbances especially growth restriction of the maxillary arch. And if the restriction is not corrected at 7 years then maxillary growth is deficient many a times. This is a more serious concern because in everyone maxilla stops growing in the front direction by age 8 years. So if a patient walks into your clinic with anterior cross-bite after 8 years you can be certain that he is already late for treatment.
If there is no cross bite Orthodontic intervention will happen roughly at age 11 years. One should not wait till all permanent teeth erupt as the patient’s skeletal growth might complete before that. And one might lose on the opportunity of growth modification procedures that take place during active growth spurts.
Cross bite are the most detrimental of all malocclusions. They can lead to maxillary growth deficiency in children. They can cause irreversible tempero-mandibular joint (TMJ) derangement in future. Besides they can also cause PDL breakdown and asymmetric jaw growth due to functional shifts. Hence correcting at the earliest is the best treatment.
Yes, with the introduction of modern ceramic and composite braces along with white colored wires Adult Orthodontics is quite popular in India today. If the gum structure is healthy Orthodontics today is done at any age. There is no upper age limit. When an adult patient is made aware of the esthetic and future functional problems properly he often gets motivated for treatment.
Whether the prospective patient actually gets the treatment depends 90% on your motivation. You play a pivotal role in our practice. Any Orthodontic patient comes to show us after listening to your first concerns about his medical condition. So your concern matters more to him than ours. So Dear Doctors we look forward to a stronger association with you in future.
Thanking you for your patient reading.
Best Regards
Yours Truly
Dr. Ashok Surana
BDS( Cal), MDS(Ortho)(Ahm)
Consultant Orthodontist
Diplomate, Indian Board of Orthodontics.
Director, Indian Board of Orthodontics.
