PREVENTIVE ORTHODONTICS

By
K. Venu gopal reddy
1 st year MDS
Department of orthodontics
S.R.M. Dental college
 Graber (1966) defined preventive
orthodontics as” the action taken to
preserve the integrity of what appears
to be normal occlusion at a specific
time”

 Profit and Ackerman (1980)defined as

“ prevention of potential interference
with occlusal development”
 Preventive orthodontics means a dynamic,
ever constant vigilance, a routine, a discipline
for both dentist and patients.

 It requires a continuing long-term approach

and is not a one shot service. Without this,
the complex timetable of growth,
development, tissue differentiation,
resorption, eruption which are all under the
influence of continuous functional forces,
cannot be assured.
 Dental neglect in the primary dentition is the
principal cause of malocclusion in the permanent
dentition.

 Early, regular and satisfactory dental care will

help in maintaining the primary teeth in healthy
condition until the time for their normal exfoliation.
 Preventive procedures

 Parental counseling prenatal

postnatal

 Caries control
 Space maintenance
 Extraction of deciduous teeth
 Treatment of abnormal frenal attachments
 Treatment of locked permanent first molars
 Abnormal oral musculature related habits
 Education of parents
Parents should be educated regarding
 Increase in food intake to meet the special

physiological changes in the body to support

the growth of the foetus and facilitate normal
labour.
 Dental development of their child

 Dental disease process

 Oral hygiene measures appropriate for infants

 Expecting mother should be
educated on proper nursing and
care of the child.
conventional
 In case the child is being bottle-
fed, the mother is advised to use
physiologic nipple and not the
conventional nipple.

phys
 As the child grows, parents should be educated
regarding the need for maintaining good oral
hygiene.

 In infants small gauze is used over the ridge of top

and bottom jaws for cleaning

 Proper brushing techniques and brushing habits to

be explained and evaluated periodically.

 Fone’s method of brushing is preferred in children.

 Fluoride application and dental checkup every 6

months
Caries control procedures:

 Diet and oral hygiene Maintenance

 Regular Checkup
 Fluoride applications
 Prophylactic odontomy
 Pit and fissure sealants.
 Restorative procedures like silver amalgam,
Glass Ionomers, Cermets, Stainless steel crown.

 Immunization
Diet and Oral hygiene maintenance

Balanced diet

 which contains varieties of food, in such quantity and

proportion that the need for energy ,amino acids, vitamins, fats,
carbohydrates and other nutrients is adequately met for
maintaining health.

The cariogenic potential of food depends on

many variables such as
presence of fermentable sugar –sucrose

• ability to be retained by teeth.

• ability to form acids.
• ability to dissolve enamel.
 The solid foods containing sucrose are more cariogenic
than liquid foods.

 The frequency in time of ingestion of foods are also

important. The sucrose containing food becomes more
dangerous if it is eaten more frequent.

The patient should be aided in identification of those foods

which are likely to cause oral diseases.
The 3 to 6 yrs olds require parental assistance to achieve
effective plaque removal.

Parents should be instructed to brush for the child at least

once a day.

Bedtime is the ideal time to establish this routine because the

salivary flow rate slows during sleep

Additional brushings may be performed by the child.

Parents need to remain active in supervising the home care

practices of 6-12 yrs old
Regular check-up:

The parents should bring their child for his/her

first dental visit early at least by the time the baby
is 6 months of age.

Frequency of recall visits have to be decided

according to the individual needs. Usually a 3
monthly recall checkup is advised to monitor oral
hygiene status.

Half yearly visit to the dentist should be routine.

Care of Deciduous dentition

 Deciduous teeth act as natural space maintainers until the

developing permanent teeth are ready to erupt into oral
cavity.

 All efforts are taken to prevent early loss of deciduous teeth.

 Simple preventive procedures such as proper and timely

application of fluoride topically/ pit and fissure sealant
application help in preventing caries.

 More complex treatment procedures to prevent the natural

space maintainer includes pulp therapy (pulpotomy,
pulpectomy ) and stainless steel crown.
 Caries involving proximal surface of
deciduous teeth if not restored early
may lead to loss of arch length into
that space.

 Caries can be detected by clinical and

Radiographic examination.

 Bitewing Radiograph proves to be of

great help in detecting proximal caries.

 Once detected, proper restoration of

affected teeth should be undertaken
immediately to prevent loss of arch
length.
 Restoration should restore the mesio-distal
dimension of tooth, but should not be over/under
extended allowing drift of contiguous teeth or
promote food impaction.

 Contact size and position should also be correct.

 Re establishment of proper inclined plane

relationship with proper anatomic carving will be
esthetic and results in normal function and stability
of occlusion.
 PIT AND FISSURE SEALANT

Fissure sealants are defined whereby pits and

fissures that occur principally on the occlusal
surfaces of the molar and premolar teeth are
occluded by application of fluid materials, which
are the then polymerized.
Classification
Mitchell and Gordon (1990)
Polymerization methods
a. Self activation (mixing two components)
b. Light activation
- First generation: U.V Light
- Second generation: Self cure
- Third generation: Visible light
- Fourth generation: Fluoride releasing

Resin Systems
 BIS-GMA
 Urethane acrylate
Filled and unfilled
Clear or tined
Indications
 Newly erupted both primary molars and
permanent bicuspids and molars with
complete recession of pericoronal operculum and
with open and/or sticky grooves and fissures.
 Stained pits and fissures with minimum
decalcification.
 The tooth in question should have erupted
less than 4 years ago.
Contraindications
 Individual with no previous caries experience
pit and fissures,monitor if the individual
and the teeth are not at risk.
 Radiographic or clinical evidence of caries on
the proximal surface of the tooth should not
be sealed.
 Wide and self-cleansable pit and fissures.
 Tooth that can not be isolated of partially
erupted tooth.
 Pit and fissures that have remained carious
free for 4 years or longer.
 Fluoride application
Knutson’s Technique – Sodium fluoride – 2% (3,7,11,13)
- Weekly internals – 4 times
- After prophylaxis – 3min

 Personal attention of parents towards child with respect to dental care is

a must.

 The attitudes of parents and child towards dental health and dental care
are very much influenced by the attitude of the dentist towards
preservation of primary dentition and preventive outlook.
 FLOURIDE VARNISH
Bifluoride 12(2.71% NaF, 2.92% CaF)
Technique - Do the through prophylaxis and dry the
teeth.
Drop the varnish onto the brush or
foam pellet.
Paint the varnish thinly first on the
lower arch and then on upper arch
starting from the proximal surfaces.
Semiannual Application
With correct application and proper mouth hygiene
varnish remains in place of several days. During this time
fluorides act on the treated surface.
 Prophylactic odontomy

Caries occurs frequently in the pit and

fissures of posterior teeth.
As a preventive procedure the pit and
fissure may be minimally prepared and
restored before visible attack by caries.
Immunization

Immunization with Streptococcus mutans should induce an

immune response which might prevent the dental caries in
following ways :
•It will prevent ability of the microorganisms to colonize on to

the tooth surfaces.

•Itcan alter the pattern of polysaccharide metabolism by the

bacteria and thereby reduces adhering capacity on to the tooth
surfaces.

•Oral administration or subcutaneous injection of killed

Streptococcus mutans can induce the formation of specific IgA,
IgG, IgM in the blood.
Various new approaches have been tried out in
order to overcome the existing disadvantages.
Active immunization
1) Synthetic peptides
2) Coupling with cholera toxin subunits
3) Fusing with salmonella
4) Liposomes
Passive immunization
1) Monoclonal antibodies
2) Egg-yolk antibodies
3) Transgenic plants
 Indicators of future Orthodontic Problems:

 Aberrant resorptive pattern

 Altered eruption cycle of permanent teeth
 Contingency of extraction
 A visual examination of the patient will quickly reveal a
gross malocclusion, in which there is an anterior open
bite, excessive overbite and overjet, cross-bite, basal
mal-relationship and other problems.
 A large percentage of class I malocclusions exist
because of what happens during the critical
developmental years, with most of the activity
below the surface.

 So,not only a visual dental examination, but a

complete and accurate radiographic examination
should be made soon after the first visit.
 Deciduous canines and second deciduous molars
are particularly prone to aberrant resorption
patterns.

 In an ideal sequence, right and left deciduous

incisors should be lost at about the same time,
deciduous lateral incisors should be lost at about
the same time, all canines should be lost within a
short period.
Contingency of extraction

 As a rule of Thumb, the shedding of the

deciduous dentition should be kept on
schedule by extracting the tooth or teeth on
one side of the arch, when they have been
lost through natural process on the other side.

 Should not wait longer than 3 months for nature

to do the job, particularly when there is
radiographic evidence of abnormal resorption –
Which would otherwise lead to Malocclusion.
Effects of premature loss of primary teeth

 Oral health and functions

 Supra eruption of opposing teeth
 Psychological effect on child and parent
 Position of permanent teeth.

Primary dentition is essential

for growth of jaws, for normal function and
eventually for normal position and occlusion of
permanent teeth and so premature loss of
primary tooth is to be avoided.
 Parents usually accept loss of anterior teeth after
6years of age, but when lost at an early age,
some parents are concerned by appearance of
remaining dentition.

 Attitudes of parents and child towards dental

health and care is largely influenced by
attitude of dentist towards preservation of
primary dentition.
 Any suggestion that the primary dentition is
important is reflected is a positive awareness
and motivation towards dental care in minds of
parent and child.
Sequence of eruption and clinical
significance:

According to MOYERS normal sequence of

eruption provides the highest percentage of
normal occlusion.

 Eruption in
Maxillary arch - 6124537

Mandibular arch - 6124357

Abnormal order of arrival may permit shifting
of the teeth, with resultant space loss.

Change in the sequence of eruption is a much

more reliable sign of a disturbance in normal
development than generalized decay or
acceleration.

The more a tooth deviates from its expected

position in the sequence,the greater the
likelihood of some problem.
An asymmetry in rate of eruption on the two
sides of dental arch is a frequent variation.
When this happens, there is lack of space to
accommodate the erupting teeth on one side
compared to the other.

As a general rule, if permanent tooth on one

side has erupted but its counter part has not,
within three months, a radiograph should be
taken to investigate the cause of the problem.
 SPACE MAINTAINANCE

 Maintenance of arch length during the primary,

mixed and early permanent dentition is of great
significance for the normal development of
future occlusion.
 Loss of arch length has been related mainly
with migration of teeth following early loss of
primary teeth.
 18th Century – Fauchard reported it
 19th Century – Hunter
 20th Century – Willet, Seward,and Davey
 Causes of space loss
 Trauma
 Interproximal caries in primary molars
 Ectopic eruption of first perm molars
 Delayed eruption
 Ankylosis of primary molars.
 Congenital absence of permanent teeth
 Macrodontia can cause arch length deficiency
 ‘Space maintaining’ is utilizing an appliance to
preserve space without necessarily an
awareness of the dynamics of the situation.

 The preferable approach for space maintenance

is to evaluate the space available, whether the
space is sufficient for eruption of the
succedaneous teeth or regaining space is
necessary.
Classification of space maintainers:
 According to Hitchcock:

Removable or fixed or semi fixed

With bands or without bands
Functional or non functional
Active or passive
 Certain combinations of above.
According to Raymond C.Thurow:
 Removable
 Complete arch

Lingual arch
Extra oral anchorage
 Individual tooth.
According to Hinrichsen

Fixed space maintainers:

Class I
1.Non functional types
- Bar type
- Loop type
2. Functional type
- Pontic type
- Lingual arch type
class II
- Cantilever type
- Distal shoe
- B and E loop
Removable space maintainers

Removable

Non functional – acrylic plate

Functional – acrylic plate with teeth

Active –acrylic plate with clasps, springs

Passive - acrylic plate with clasps.

  Fixed appliances
 Band and loop
 Crown and loop
 Band and bar
 Distal shoe
 Lingual arch
 Nance palatal arch
 Transpalatal arch.
 Semi Fixed

 Removable arch wire with molar bands

Indications of space maintainers

 If space after premature loss of deciduous

teeth shows signs of closing.

 If use of space maintainer will aid in or make

the future orthodontic treatment less
involved.

 If the need for treatment of malocclusion at a

later date is not indicated.
 Even though space maintenance is not
necessary in case of anterior tooth loss, a
functional space maintenance or partial
denture should be given as tooth loss
affects speech, induce abnormal tongue
habits which leads to malocclusion .
 Contra indications of space maintainers

 If radiograph of extraction region shows that

1/3rd of the root of succedaneous tooth is
already calcified.
 When the space left by the prematurely lost
primary tooth is less than the space needed
for the permanent successor as indicated
radiographically.
 If the space shows no signs of closing
 Advantages of Removable type of
Space Maintainers.
 They are easy to clean and permit maintenance of
proper oral hygiene
 It maintains and restores the vertical dimension.
 It can be worn part time allowing circulation of the
blood to soft tissues.
 They serve other important functions like
aesthetic,mastication,phonetics
 Dental checkup for caries detection can be
undertaken easily.

 They stimulate eruption of permanent teeth

 Band construction is not necessary

 Room can be made for permanent teeth to

erupt without changing the appliance
 They prevent development of tongue thrust
habit into the extraction space.

 More than one tooth can be replaced.

 Being tissue-borne, they impose less stress

on remaining teeth.

 Easier to fabricate, less chair time.

 When there is general lack of sufficient arch
length and where space maintainer would
further complicate existing malocclusion.

 When succedaneous tooth is absent.

 When well developed occlusion and cuspal

inter digitations or over eruption of opposing
tooth prevent space closing.
 Disadvantages:
 Patient may not wear it, patient compliance in
3-6year age group and uncooperative children
is poor.

 It may be lost or broken by the patient.

 It may restrict lateral growth of the jaws if clasps

are incorporated

 They may cause irritation of the underlying soft

tissues.
 Fixed Space Maintainers;
 Band and Loop
 Band and Bar
 Crown and Bar
 Trans palatal arch
 Lingual arch
 Pin and tube space maintainers.
 Bonded space maintainers.
Modifications of Band and Loop Space
Maintainers.

 Crown and loop

 Band and loop
 Extended band and loop
 Bonded band and loop
 Nance’s palatal arch space maintainers
 Advantages of Fixed Space Maintainers:

 They do not interrupt with passive eruption of

abutment teeth.
 Jaw growth not hampered
 Succedaneous permanent teeth are free to
erupt in oral cavity.
 Can be used in uncooperative patients.
 Disadvantages:

 Elaborate instrumentation with expert skill is

needed
 It may result in decalcification of tooth
material under the bands
 Supra eruption of opposing teeth can take
place if pontics are not used.
 If pontics are used, it can interfere with
Vertical eruption of abutment tooth and
may prevent eruption of replacing
permanent teeth, if patient fails to report.
 BAND AND LOOP SPACE MAINTAINER

Indications:
 Unilateral loss of primary first
molar before or after the eruption
of permanent first molars.
 Bilateral loss of single primary
molar before eruption of
permanent incisors.
 When second primary molar is
lost after the eruption of first
permanent molar.
 Sometimes it is given in cases of
premature loss of primary
canines.
 Usually Band- loop space maintainers is not
indicated to preserve the space created by
two adjacent primary molars.
 The lengthy loop created in these situations is
more susceptible to the forces of mastication.

Advantages:
 It is an effective space maintainer for unilateral

loss of single tooth in buccal segments.

 Economical

 Construction is simple
 Takes little chairside time, especially if
preformed bands are used.
 It adjusts easily to accommodate the changing
dentition.

Disadvantages:

 Requires constant supervision. Like any other

fixed maintainers, decalcification under the
bands is a problem.
 It will not prevent the continued eruption of the
opposing teeth.
LINGUAL ARCH:
 The lingual arch is the most effective
appliance for space maintenance in
posterior region and minor tooth
movement in the lower arch.

 The lingual arch space maintainer

consists of two bands cemented to the
1st permanent molars or sometimes
2nd deciduous molars, which are joined
by a SS wire butting against four
incisors.

 Usually indicated to preserve the spaces

created by multiple loss of primary
molars when there is no loss of space in
the arch.
 The use of lingual arch is a good preventive measure,
since it helps in maintaining the arch perimeter by
preventing both mesial drifting of the molar teeth and also
lingual collapse of the anterior teeth.

 Spurs that is Projections of wire, may be used as stoppers

distal to anterior teeth to prevent their migration distally
in the arch.

 These help in maintaining symmetry of centre lines,

especially in cases of unilateral tooth loss.
Advantages:-

 Causes little inconvenience to patient

 Less bulky them removable acrylic space maintainers.
 Less conspicuous than other space maintainers
 Serves as a space maintenance for more than one
succedaneous tooth in the arch.
 Prevents arch collapse
 Prevents mesial migration of banded tooth.
Disadvantages
 Prolonged use of orthodontic bands – decalcification of the
tooth.

 Arch wire may become embedded into the soft tissue.

This seems to occur more often in patients with poor oral
hygiene.

 Wire may become distorted by masticatory forces and move

teeth into undesirable positions.
 Appliance should be removed every year and inspected for
damage and further usefulness, recemented after topical
fluoride treatment
 Transpalatal Arch :
 Recommended for stabilizing the maxillary first permanent
molars.
 Best Indication for transpalatal arch is when one side
of the arch is intact, and several primary teeth on
the other side are missing.
 Also indicated when primary molars are lost bilaterally.
 Appliance is designed to prevent the molars from rotating
around the palatal roots ,which is the first movement
resulting in loss of space in the arch perimeter.
 The transpalatal arch runs directly across the palatal vault
connecting the permanent first molars, avoiding contact
with the soft tissue.
 Advantages:
 No food lodgment
 Simple design
 No inflammatory changes in palate

Disadvantages:

 If given in case of bilateral missing deciduous molar,

it cannot prevent drifting of abutment teeth.

 If not passive ,unexpected vertical and transverse movement

of the permanent molars can occur.
 Distal Shoe Appliance:
 Eruption guiding appliance
 Intra alveolar appliance
 One of the early designs of distal
space maintainers was cast Gold or
Willet distal shoe – Now rarely used
because of increased cost, difficulties
in tooth preparation, and more
complicated fabrication procedures.

 The distal shoe appliance is used to

maintain the space of a primary
second molar that has been lost
before the eruption of the permanent
first molar.
 Normally,the distal surface of the 2nd
primary molar provides a guide for the
unerupted 1st permanent molars, when
the 2nd primary molar is removed prior to
the eruption f the first permanent molar,
the Distal Shoe appliance provides greater
control of the path of eruption of the
unerupted tooth and prevents undesirable
mesial migration.
 Indications:
 When 2nd primary molar is extracted or lost before the
eruption of first permanent molar.

Contraindications:
 Poor oral hygiene
 Medically compromised patients like patients with
congenital heart disease, juvenile diabetics, Rheumatic
fever, immunosupression
 If several teeth are missing in same quadrant as there lack
of abutment.
 Lack of patient cooperation
 Nance palatal holding arch
 Indicated in premature loss
of first deciduous molar.
Advantages:
 Economical
 Allows growth transversely
in the inter-canine areas.
Disadvantages:
 Requires more clinical skill
 Palatal button may cause
food accumulation; causes
inflammation.
 Abnormal frenal attachments
 Abnormalities of the maxillary labial frenum are
associated with a midline diastema .

 At birth frenum is attached to the alveolar ridge

with fibers running into the incisive papilla.
The teeth erupts and as alveolar bone is
deposited,the frenum attachment migrates
superiorly with the alveolar ridge.
 
 Fibers may persist between the maxillary
central incisors and in the ‘V’ shaped
intermaxillary suture , attaching to the outer
layer of the periosteum and connective tissue
of the suture.
Faustin weber noted that diastema may be
due to other factors, the possible
causative factors :
Microdontia,Macrognathia,Supernumerary
teeth,Peg laterals,Missing lateral incisors.
Habits such as thumb sucking, tongue
thrusting & midline pathologies.
Oral Habits in Children and their Management

These habits bring about harmful unbalanced

pressures to bear upon the immature, highly
malleable alveolar ridges, the potential changes in
position of teeth, and occlusions, which may become
decidedly abnormal if these habits are continued for a
long time.
. Boucher – a tendency towards an act or an act
that has become a repeated performance, relatively
fixed, consistent, easy to perform and almost
automatic
Prevention starts with proper nursing, proper choice
of physiologically designed nursing nipple & pacifier to
enhance the normal function and deglutitional maturation

Proper kinesthetic, neuromuscular gratificational activity

at this time may ell prevent abnormal finger, lip and
tongue deforming action.

Constant tongue thrust into an edentulous area make

cause an open bite that remains in the permanent
dentition.

An unfavorable oral condition to frequently stimulates a

child to place his fingers in his mouth- this can well lead
to finger sucking or nail biting.
 THUMB SUCKING
Definition

 Repeated and forceful sucking of thumb with associated

strong buccal and lip contractions.(Moyers)

 Defines digit sucking as placement of thumb or one or

more fingers in varying depths into the mouth(Gellin)

 Most children would stop digit sucking by the age of three

to four years. But an acute increase in child’s level of stress
and anxiety due to some underlying psychological or
emotional disturbances can account for continuation of digit
sucking habit, with conversion of an empty habit into a
meaningful stress reducing response.
Causative factors:
 Parent’s occupation
 Working mother
 Number of siblings
 Order of birth of the child
 Social adjustment and stress
 Feeding practice
 Age of the child
 - proclination of maxillary incisors
- increased maxillary arch length
- anterior placement of apical base
Effects - increased SNA
on - increase in clinical crown length of anteriors
maxilla - counter clock wise rotation of occl.plane
- decreased SN to ANS-PNS angle
- decreased palatal arch width
- atypical root resorption in primary central

incisors
- trauma to maxillary central incisors

Effects - proclination or reteroclination of the mandibular

on incisors
mandible - increased intermolar distance
- distal position of point B
 -↓ maxillary and mandibular incisal angle
- increased over jet

Effects on - decreased over bite

interarch - posterior cross bite

relationship - uni-bilateral class-II occlusion

Effect on lip - incompetence lips

placement and - lower lip function under the maxillary
function incisors
Effect on - tongue thrust

tongue - lip to tongue resting position

placement and - lowered tongue position

function
Other effects - thumb deformity
- speech defects, lisping
Treatment

 Psychological therapy
 Reminder therapy

Extra oral approaches

Intra oral approaches
 Mechanotherapy

Blue glass
Quad helix
 Tongue trusting:

Definition:

 Schneider 1982: tongue thrust is forward

placement of the tongue between the
anterior teeth and against the lower lip
during swallowing
Tongue trusting:
 -Tipping of the palatal plane
-Proclination of maxillary anteriors resulting

Maxilla in increase in over jet

- Generalized spacing between the teeth
- Teeth may be mesially inclined
- or all parameters may be norm

-Retroclination or Proclination of mandibular

teeth depending on the type of growth
Mandible -Generalized spacing between the teeth
-Teeth may be mesially tilted
- or all parameters may be normal

Anterior or posterior open bite depending on

Inter arch
-

the posture of the tongue

- Posterior cross bite
- lack of interdigitation of the posterior teeth
- Or all the parameters may be normal
 - Convex profile
- Increased LAFH
Facial form

- Short upper lip/normal upper lip

lips - Hyperactive mentalis/ normal
- Enlarged
- Forwardly placed
Tongue - Normal position

-Tongue thrust children are more likely to have

various speech disorders, such as sibilant distortions,
Speech
lisping problems in articulation of s, n, i, d, l, th, z, v
sounds
Mouth Breathing
Definition:
 Sassouni (1971) defined mouth breathing as
habitual respiration through the mouth instead
of the nose.

 Merle (1980) suggested the term oro-nasal

breathing instead of mouth breathing.

 F.M. Chacker defined mouth breathing as the

prolonged or continued exposure of the tissues
of the anterior area of the mouth to the drying
effects of the inspired air.
PREVENTION – MYOFUNCTIONAL APPLIANCES

Oral myofunctional therapy has been shown to be

effective in correcting oral myofunctional disorders
such as tongue thrust swallow, improper tongue and
mouth resting posture, improper use of muscles of
the mouth, tongue, and lips for chewing and
swallowing, and late thumb/finger sucking habits.
 Lip habit
 It may involve either of the lips , with a higher
predominance of lower lip
Definition
 Habits involving manipulation of the lips and

perioral structures are termed as lip habits.

Classification
 Wetting the lips with the tongue

 Pulling the lips into the mouth between the

teeth (schneider1982)
 Treatment

 Correction of malocclusion
 Treating the primary habit

Appliance therapy
 Lip bumper
 Nail biting
 Nail biting is one of the most commonest habit in
children and adults. It is a sign of internal tension

Etiology
 Emotional problem

Effects
 Dental

 Crowding, rotation, attrition of incisal edges

Effects on the nails

 Inflammation of the nail beds
 Conclusion
 Prevention of malocclusion and the success of minor
and/or major orthodontic intervention in a developing
malocclusion depend upon the diagnostic skill and a
clinical ability to reverse the process of the dentition’s
maldevelopment.
 The concept of prevention is based on the belief that
some, if not many, minor dental developmental
problems, in the younger age group become major
orthodontic needs.
 Early attention to many, if not all problems in dental
development of children can be helpful in reducing the
severity of malocclusion
References

Orthodontics Current Principles and Technique –

T.M.Graber.

Hand Book of Orthodontics - Robert E Moyers

Contemporary Orthodontics - Proffit WR

Text Book of Orthodontics - G.Singh

Essential of Preventive and Community

Dentistry- Shoban Peter

Text Book of Pedodontics – Shoba Tandon.

Thank you