ORTHODONTIC PROBLEMS IN PEDIATRIC PRACTICE

ONE of the most important phases of oral health is the form and function of the oral mechanism. That specialty of dentistry which has as its goal the correction of dental malformations and restoration of the continuity and proper function of the teeth and jaws is called orthodontics. While parents have long been concerned with the obvious esthetic disabilities of malposed teeth, the pathologic implications of these malposed teeth have been the primary concern of the orthodontist. Frequently, tooth malpositions or dental malocclusions reflect growth and developmental disturbances of the upper and lower jaws. Crooked teeth are unsightly, but more important, they probably are functioning improperly, or not at all, which seriously impairs the health and longevity of the teeth and investing tissues. Recent studies of facial growth indicate that dental malocclusions may be grouped in three morphologic categories, on the basis of jaw development and individual tooth malpositions. First, are those types of disturbances which are primarily skeletal in nature. These are problems where the maxilla or mandible has assumed an abnormal relationship to one another, usually through an upset in the timetable of normal development. The teeth in each dental arch may be normal in their position when compared to their respective jaws, but the abnormal jaw relationship means that the upper and lower teeth meet improperly during mastication, deglutition and speech. The second group consists of relatively local disturbances, with the teeth malposed, but with normal jaw relationship. The third group is a combination of the first two, with both improper jaw relationship and with teeth in abnormal positions. Within these three broad categories one may find all sorts of tooth malpositions and jaw relationships; the premaxillary segment may be displaced anteriorly, the whole lower dental arch may be retruded, the upper cuspids may be erupting in the palate, etc. Such conditions may be separate or occur in combination.