Malocclusion

A malocclusion is a misalignment or incorrect relation between the teeth of the two dental arches when they approach each other as the jaws close. Edward Angle, who is considered the father of modern orthodontics, was the first to classify malocclusion. He based his classifications on the relative position of the permanent MAXILLARY FIRST MOLAR. Angle believed that the anteroposterior dental base relationship could be assessed reliably from first permanent molar relationship, as its position remained constant following eruption. In case where the first molars were missing, CANINE relationship is used.

CLASSIFICATION OF MALOCCLUSION

NORMAL OCCLUSION
Molar Relationship: According to Angle, the mesiobuccal cusp of the maxillary first molar aligns with the buccal groove of the mandibular first molar.

Canine Relationship: The maxillary canine occludes with the distal half of the mandibular canine and the mesial half of the mandibular first premolar.

Line of Occlusion: The teeth all fit on a line of occlusion which, in the upper arch, is a smooth curve through the central fossae of the posterior teeth and cingulum of the canines and incisors, and in the lower arch, is a smooth curve through the buccal cusps of the posterior teeth and incisal edges of the anterior teeth. There is alignment of the teeth, normal overbite and overjet and coincident maxillary and mandibular midlines.

ANGLE Class I: NEUTROOCCLUSION
Molar Relationship:
 The mesiobuccal cusp of the maxillary first permanent molar occludes with the mesiobuccal groove of the mandibular first permanent molar.

Canine Relationship:
- The mesial incline of the maxillary canine occludes with the distal incline of the mandibular canine. The distal incline of the maxillary canine occludes with the mesial incline of the mandibular first premolar
.

Line of Occlusion: ALTERED in the maxillary and mandibular arches
.
– Individual tooth irregularities (crowding/spacing/other localized tooth problems).

– Inter-arch problems (open bite/deep bite/cross bite)
.

Mesognathic: normal, straight face profile with flat facial appearance.

ANGLE Class II: DISTOOCCLUSION (overjet)
Molar relationship: The molar relationship shows the mesiobuccal groove of the mandibular first molar is DISTALLY (posteriorly) positioned when in occlusion with the mesiobuccal cusp of the maxillary first molar. Usually the mesiobuccal cusp of maxillary first molar rests in between the first mandibular molar and second premolar.

Canine Relationship:
 The mesial incline of the maxillary canine occludes ANTERIORLY with the distal incline of the mandibular canine. 
The distal surface of the mandibular canine is POSTERIOR to the mesial surface of the maxillary canine by at least the width of a premolar.

Line of occlusion is not specified but irregular, depending on facial pattern, overcrowded teeth and space needs.

Retrognatic: convex face profile resulting from a mandible that is too small or maxilla that is too large.

Class II Malocclusion has 2 subtypes to describe the position of anterior teeth:

  • Class II Division 1: The molar relationships are like that of Class II and the maxillary anterior teeth are protruded. Teeth are proclaimed and a large overjet is present.

 

  • Class II Division 2: The molar relationships are Class II where the maxillary central incisors are retroclined. The maxillary lateral incisor teeth may be proclaimed or normally inclined. Retroclined and a deep overbite exists.

ANGLE Class III: MESIOOCCLUSION (negative overjet)

Molar relationship: The mesiobuccal cusp of the maxillary first permanent molar occludes DISTALLY (posteriorly) to the mesiobuccal groove of the mandibular first molar.

Canine Relationship: Distal surface of the mandibular canines are mesial to the mesial surface of the maxillary canines by at least the width of a premolar
. Mandibular incisors are in complete crossbite.

Line of occlusion is not specified but irregular, depending on facial pattern, overcrowded teeth and space needs.

Prognathic: concave face profile with prominent mandible is associated with Class III malocclusion.

CLASS III Malocclusion Class III malocclusion has 2 subdivisions:

  1. TRUE class III malocclusion (SKELETAL) which is genetic in origin due to excessively large mandible or smaller than normal maxilla.

 

  1. PSEUDO Class III malocclusion (FALSE or postural) which occurs when mandible shifts anteriorly during final stages of closure due to premature contact of incisors or the canines. Forward movement of the mandible during jaw closure can also result from premature loss of deciduous posterior teeth.

 

Class III Sub-division: Class III molar relationship exists on one side and the other side as a normal Class I molar relationship.

By Dr. S. Fatahi, DDS

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DENTAL SEALANTS

Dental sealants act as a barrier to prevent cavities. They are a plastic material usually applied to the chewing surfaces of the back teeth (premolars and molars) where decay occurs most often.

Thorough brushing and flossing help remove food particles and plaque from smooth surfaces of teeth. But toothbrush bristles cannot reach all the way into the depressions and grooves to extract food and plaque. Sealants protect these vulnerable areas by “sealing out” plaque and food.

Sealants are easy for your dentist to apply. The sealant is painted onto the tooth enamel, where it bonds directly to the tooth and hardens. This plastic resin bonds into the depressions and grooves (pits and fissures) of the chewing surfaces of back teeth. The sealant acts as a barrier, protecting enamel from plaque and acids. As long as the sealant remains intact, the tooth surface will be protected from decay. Sealants hold up well under the force of normal chewing and may last several years before a reapplication is needed. During your regular dental visits, your dentist will check the condition of the sealants and reapply them when necessary.

The likelihood of developing pit and fissure decay begins early in life, so children and teenagers are obvious candidates. But adults can benefit from sealants as well.

Key ingredients in preventing tooth decay and maintaining a healthy mouth are:

  • brushing twice a day with an ADA-accepted fluoride toothpaste
  • cleaning between the teeth daily with floss or another interdental cleaner
  • eating a balanced diet and limiting snacks
  • visiting your dentist regularly

Support for Dental Assistants

Support for Dental Assistants

Support for Dental Assistants

 

Dental Assistants can find themselves easily overwhelmed with the level of responsibility they have and the many duties of their job. Since they work hard to meet all of these requirements, it is no wonder they can find themselves stressed out and needing someone to talk to. It is always easier to talk to those who know exactly what you are talking about. The medical and dental professions are known for taking enthusiastic qualified individuals and squeezing the very life out of them will took much be asked of them on a daily basis.

 

Dental Assistant support groups are not meant to be an arena to negativity to breed and escalate. It is to provide Dental Assistants with social interactions with others in the field who are experiencing the same types of things in their employment endeavors as well. Too often, individuals in the dental field are their own worst enemy. They demand too much of themselves. Being part of a Dental Assistant support group will help you set realistic goals and expectations for yourself.

 

Dental Assistant support groups can be formed of your co-workers if you work in a fairly large dental facility. If not, consider advertising for Dental Assistants from other facilities to get together and form a group. This can offer valuable insight as to how other organizations deal with issues that you are experiencing in your role as a Dental Assistant. Most dental facilities will support your endeavors as they understand the restraints of the Dental Assistant field. You may also want to open the group up to those interested in pursing a career as a Dental Assistant, those in a Dental Assistant program, and those who have retired from a career as a Dental Assistant. Each can offer unique perspectives on the dental field of being a Dental Assistant.

 

Often, each dental facility can take a turn hosting the meeting. Another option is to get a

Church or library to allow you to meet in their facility free of charge. You can host meetings once a week, every other week, or monthly depending on how in depth you want your support group to be.

 

Another great option is to join a support group online. You can stay anonymous, as well as interact from the comfort of your home. Most online support groups for Dental Assistants are free of charge and hosted by dental organizations. They offer tips, advice, online magazines, chat rooms, and message boards. All available at your fingertips with the touch of a few simple keys. These are an excellent source of support for those not wanting to put effort and time into organizing a Dental Assistant support group.

 

A career as a Dental Assistant can proof to be challenging. To avoid burnout and the effects of stress, consider joining a Dental Assistant support group. It can be a wonderful opportunity to meet new people in the field, gain information, share your experiences, and just get some needed support from those who know best what your experiences are on a daily basis in your role as a Dental Assistant.

 

Support groups are known to offer social interactions, stress relief, and friendships. Having a support group for Dental Assistants is no different. To make sure your support group is effective, set some ground rules. The support group is to stay positive. It is available to discuss problems, but not just as a complaint mechanism. The goal needs to be to offer support and solutions to the issues Dental Assistants are experiencing. You will also want to keep your meetings set on a regular day and time. An agenda will also prove to be useful as is a newsletter. Just make sure to get plenty of help with organizing the details or the support group can overwhelm you. Ironically, that will result in your career as a Dental Assistant proving to be even more stressful for you!