one-quarter of 12-year olds need orthodontic treatment, say experts
By Azoma Chikwe
Master Richard Okeke’s jaws and teeth did not develop properly. The 12-year old boy had crooked, misaligned teeth. Experts say this may develop because of injury to the teeth or facial bones, frequent thumb sucking, or for reasons unknown. His teeth became a source of embarrassment that he could not smile freely. To worsen matters, his mates at school gave him a nickname, Dracula. He was emotionally and psychologically tormented.
His parents took him to a dentist who referred him to an orthodontist. When the specialist began treatment on Richard, many wondered what the outcome would be. He had to use braces for some time to reposition his teeth. At the end of the treatment, the misaligned teeth were properly positioned and he could smile confidently.
Speaking with Health and Wellbeing, his father, Evans, said they were surprised the boy’s teeth were arranged properly. “ We only knew about dentists, we knew nothing about orthodontists until Richard was referred to one. The outcome of the treatment was both impressive and surprising,” he said.
The Okekes are one of millions of families who don’t know about orthodontists though they need their services.
Nigerians have been advised to patronise orthodontists to ensure a better oral care. The specialists lamented that most dental patients are not aware that the specialty exists, thereby denying themselves of the services they could have accessed .
Speaking with Health and Wellbeing, Secretary-General, Nigerian Association of Orthodontists (NAO), Dr Nkiru Folaranmi, said orthodontistry is a sub-specialty of dentistry. “Nigeria is a developing nation, likewise post-graduate training for orthodontistry is developing. Qualified dentists who want to specialise in the area are trained during residency training. The issue now is how many teaching hospitals do we have now and how many of them offer the programme.
“However, we want Nigerians to realise that if it is not an orthodontist seeing you when it comes to teeth problems that our specialty handles, the patient cannot receive the real thing. Some people go the wrong places, worsen their cases, before seeing the orthodontist,” she said.
Contributing, Dr Oluranti da Costa said: “ It is not just realigning the teeth, it is also cosmetic, dealing with cleft-lip palate. If we increase the awareness, we can increase the demand. If we increase the number of orthodontists, we will increase the awareness of orthodontistry.”
Another contributor, Prof. Otuyemi Olayinka noted that about 28 per cent of adults need orthodontists treatment. “We are not only responsible for correcting bad teeth arrangement, but also handle the psychological aspect of it. Some people with malocclusion may want to commit suicide because of marriage, job and other social issues to handle.
“Orthodontists are not only for children, but for everybody. To qualify as a dentist, you go through a dental school, spend five to six years training. After qualifying as a dentist, you decide on which of the 10 sub-specialities of dentistry, one of which is orthodontistry you want to specialise.. You have to train for another four to six years in post-graduate medical school to qualify.”
Orthodontic treatment is used to improve the appearance, position and function of crooked or abnormally-arranged teeth. It can straighten the teeth and move them into a better position. Health care professionals specialising in orthodontics are known as orthodontists..
Orthodontists use devices such as a brace to correct the position of the teeth. The exact treatment will depend on the problems with the teeth. In some cases, they may have to wear a headgear at night as well as a brace, and may also need to have some teeth removed as part of treatment. The duration of treatment will depend on how complicated the problem is, but it’s usually between 18 and 24 months.
Who needs orthodontic treatment?
Many people have crowded or crooked teeth, or their teeth don’t meet correctly when they bite. These problems can mean the teeth are more likely to become damaged or put a strain on jaw muscles.
In some cases, abnormal development of the teeth and jaw can affect the shape of the face. Problems with crooked and out-of-place teeth are quite common in the country. It’s thought around a third of 12-year olds would benefit from some degree of orthodontic treatment.
In most cases, a patient will be referred to an orthodontist by the dentist, although you may be able to seek treatment directly. If orthodontic treatment is recommended, you may have to decide whether to have treatment in a privately or public hospital.
A common complication of orthodontics is tooth decay. The mouth is full of bacteria that combines with small food particles and saliva to form a sticky film known as plaque which causes the enamel to decay. Many people with appliances find it difficult to keep their teeth clean, so additional brushing is essential during treatment.
To reduce the risk of enamel decay, your orthodontist may recommend using toothpaste with high levels of fluoride or a mouthwash that contains fluoride. Also try avoiding sugary foods and fizzy drinks.
Dr Gerald Isiekwe said, “orthodontics is a branch of dentistry that specialises in treating patients with improper positioning of teeth when the mouth is closed (malocclusion), which results in an improper bite.
“It also includes treating and controlling various aspects of facial growth (dentofacial orthopedics) and the shape and development of the jaw. An orthodontics specialist is called an orthodontist. Orthodontics used to be called orthodontia – the word comes from the Greek orthos, meaning “straight, perfect or proper”, and dontos, which means “teeth”.
“Orthodontics also include cosmetic dentistry; when the patient’s aim is to improve his/her appearance. An orthodontist uses a range of medical dental devices, including headgears, plates, braces, etc. to help in: Closing wide gaps between the teeth, making sure the tips of the teeth are aligned, straightening crooked teeth, to improve speech or eating (oral function), to improve the long-term health of gums and teeth, to prevent long-term excessive wear or trauma (of the teeth), treating an improper bite.”
Malocclusion literally means bad bite. Some children’s jaws and teeth do not develop properly. Malocclusion refers to crooked, misaligned teeth and a fault in the relation between the bottom and top set of teeth (the two dental arches). This may develop because of injury to the teeth or facial bones, frequent thumb sucking, or for reasons unknown.
Thumb sucking (or finger sucking) can result in localised deformation of the teeth and supporting bone. In order to restore a natural improvement, the thumb sucking habit has to be stopped.
Generally, malocclusions do not affect physical health, it is not a disease, it is a variation in the normal position of teeth. However, it may impact on the shape of the person’s face and the appearance of their teeth, which can lead to embarrassment, a lack of self-confidence, and even depression. Severe malocclusion may affect eating, speech and keeping the teeth clean.
Health authorities say that approximately one third of all 12-year olds probably need orthodontic treatment.
People may require orthodontic treatment for different problems: The front teeth protrude – treatment not only improves the patient’s appearance, but also protects the teeth from damage; people with protruding front teeth are more likely to injure them in sports, falling down, etc. Crowding – if the patient’s jaw is narrow, there may not be enough space for all the teeth. In such cases, the orthodontist may have to remove one or more teeth to make room for the others.
Impacted teeth – as the adult teeth come through, they are not in the right position. Asymmetrical teeth – the upper and lower teeth do not match, especially when the mouth is closed but the teeth are showing. Deep bite (overbite) – when the teeth are clenched, the upper ones come down over the lower ones too much.
Reverse bite – when the teeth are clenched, the upper teeth bite inside the lower ones. Open bite – when the teeth are clenched, there is an opening between the upper and lower teeth. Underbite – the upper teeth are too far back, or the lower teeth are too far forward (“bulldog” appearance)
Crossbite – at least, one of the upper teeth does not come down slightly in from of the lower teeth when the teeth are clenched; they are too near the cheek or the tongue. Spacing – there are gaps or spaces between the teeth, either because a tooth is missing, or the teeth simply do not fill-up the mouth (opposite of crowding)
When can orthodontic treatment start?
Treatment will not usually commence until the child is about 12 or 13 years old; when the adult teeth have come through and developed fully. In some cases, treatment may start a couple of years later if teeth problems had not become noticeable beforehand. Children with a cleft lip and palate may require orthodontic treatment before their adult teeth have developed completely.
Good oral hygiene is essential before any orthodontic work can begin. When devices are placed on the teeth, bits of food are much more likely to become stuck; the patient will need to brush much more carefully and more often to prevent tooth decay while treatment is ongoing. Patients who have not reached good oral hygiene standards beforehand are much more likely to suffer from tooth decay after treatment begins.