Dental Conditions



I. DEFINITION OF TERMS

  • Occlusion

    • The way the maxillary and mandibular teeth fit together when the jaws are closed, as when biting

  • Class I Occlusion (normal)

    • Normal dental arch relationship, although the teeth may be misaligned

    • The front outside cusp of the first maxillary molar fits in the outside groove of the first mandibular molar

    • Occlusions don’t look at the incisors but by the alignment of the maxillary molar with the mandibular molar

    • Upper teeth should extend over lower teeth

    • When you close your mouth, there is no gap in between




  • Malocclusion

    • The arches of maxillary and mandibular teeth do not close together normally during biting 



II. ETIOLOGY

Moyer’s Classification of Etiology of Malocclusion

  • Heredity

    • Neuromuscular system, bone, teeth, soft parts

    • Development defects of unknown origin

  • Trauma

    • Prenatal development and birth injuries

    • Postnatal trauma

  • Physical agent

    • Premature extraction of primary teeth

    • Nature of food

  • Habit

    • Thumb sucking (incisors are more forward) and finger sucking, tongue, lip sucking and lip biting, posture, nail-biting, other habits

  • Diseases

    • Systemic disease, endocrine disorders, local diseases, malnutrition 



III. PREVALENCE AND INCIDENCE

  • Estimated oral diseases affect nearly 3.5 billion people

  • 3 out of 4 people living in middle-income countries affected

    • They don’t have sufficient nutrition and thus teeth of children gets affected 

  • 2 billion people suffer from caries of permanent teeth and 514 million children suffer from caries of primary teeth

  • Periodontal (gum) disease: 19% of the global adult population



IV. TYPES OF MALOCCLUSION

  • Class I Malocclusion

    • Overlap of upper teeth over the lower teeth due to prolonged bottle use or thumb sucking in childhood

    • Doesn’t affect bite that much and can be fixed with minor malocclusion treatment

  • Class II Malocclusion

    • When the upper front teeth are biting down right into the gums, or the roof of the mouth

    • Maxilla is protruded compared to the mandible

  • Class III Malocclusion

    • Aka anterior crossbite

    • When the lower front teeth are positioned far forward than the upper front teeth



A. OTHER DENTAL ANOMALIES

  • Overcrowding

    • Due to lack of space resulting from overlapping or crooked teeth (sungki-sungki)

    • Growth of teeth is not aligned properly

      • Related to how the maxillary or mandibular arch are formed

      • Smaller maxilla or mandible with teeth growing normally → teeth can overlap with each other

  • Spacing

    • Too much or too little space for the teeth, results in crowding which can impact the eruption of permanent teeth



  • Open Bite

    • Results in formation of opening leading straight into the mouth when the upper and lower front teeth do not overlap each other

    • Implications on the sounds produced

    • Prone to tongue thrusting since bukas

  • Overjet 

    • When the top front teeth extend beyond the lower front teeth horizontally, disrupting chewing food and speaking

    • Implications in speech sounds and how you speak

    • Not necessarily due to unallignment of mandibular molar, more on teeth protruding forward

  • Crossbite

    • Can happen on either or both the sides of the jaw when the upper front teeth are biting right inside the lower teeth

  • Diastema

    • Refers to the space between two adjacent teeth, usually the front teeth

    • Resolved by dental procedures

    • Happen in normal individuals

  • Missing tooth

    • Aka hypodontia

    • This condition occurs as a result of trauma or improper development of teeth

  • Impacted tooth

    • The one that cannot erupt from the gum naturally needs to be extracted or exposed so that a brace can be fitted

    • Cause a lot of pain



V. SIGNS, SYMPTOMS, AND PATHOMECHANICS

  • Depending on the type of malocclusion, the symptoms may be mild, moderate, or severe. Common symptoms include:

    • Misaligned teeth

    • Discomfort when biting or chewing food

    • Speech problems

    • Difficulty in breathing through the mouth

    • Frequent biting of tongue or cheeks

    • Change in the facial structure

  • Dental conditions affect some speech sounds produced and chewing



VI. MANAGEMENT

  • Orthodontics

    • Correction of malocclusions

      • Braces or retainers

        • Here in PH, braces are a sign of wealth

  • Orthognathic surgery

    • Surgery to align the jaw and face

    • Break the jaw then align it

  • Prosthodontics

    • Provision of prostheses

      • Dentures, replacement of soft or hard tissues



VII. IMPLICATION OF DENTAL CONDITIONS ON COMMUNICATION AND SWALLOWING

  • Articulation

    • Placement of articulation

      • Dentals, labiodentals, bilabials, interdentals, alveolars

  • Feeding

    • Oral phase of swallowing

      • Chewing

  • Psychosocial

    • Self-conscious

    • Negative self-concept

    • Shy 



VIII. HEALTHCARE PROFESSIONALS INVOLVED IN THE MANAGEMENT OF DENTAL CONDITIONS

  • General dentist

  • Endodontist

  • Oral and maxillofacial radiologist

  • Oral pathologist

  • Oral and maxillofacial surgeon

  • Orthodontist

  • Pediatric dentist/pedodontists

  • Periodontist

  • Prosthodontist 

  • Dental anesthesiologist