The American Association of Orthodontists (AAO) estimates that 50-75% of the population would benefit from orthodontic therapy with up to 50% of U.S. children in some type of orthodontic care. Additionally, the number of individuals seeking orthodontic treatment has exponentially increased over the past 10 years with a growing number of adults entering into treatment. Treatment times range from 12-36 months with an average of 24 months and a variety of treatment options and philosophies continue to generate interest in this ever-evolving science and specialty of dentistry.
As the trend for adult therapy has increased, so has the number of men seeking care. The AAO lists the following rationale for adult orthodontic treatment:
- Can help prevent or improve periodontal problems
- Can help prevent or reduce further bone loss around teeth
- Improves ability of the dentist to restore missing teeth
- Improves aesthetics for a better smile and facial appearance
- Improves function of teeth
- Improves self-confidence and self-esteem
- Improves oral health
Orthodontic Options:
The science of tooth movement has seen recent technological advances. From clear polymer aligner systems, which do not require bracketing of the teeth; to self-ligating brackets, which is a minimally invasive form of orthodontic therapy; to invasive surgical procedures, there are now many options. As a result, it is essential to collaborate with referring orthodontists to determine what they offer and gain knowledge regarding the various treatment options, including costs, benefits, and drawbacks.
Today, orthodontic therapy is not confined to a particular age range and the adult population a growing number of patients choosing corrective treatment. Clearly, the easiest method to determine a potential orthodontic patient is through assessment of smile satisfaction and occlusion. Your role in education and supportive care during therapy will assure the best result and a healthy smile.
Dental Hygiene Care Plan
Prior to orthodontic therapy, the periodontal and hard tissue status should be carefully evaluated and treated appropriately. Pre-therapy dental hygiene intervention will include full-mouth instrumentation, evaluation of daily care strategies, planning for dental hygiene care during therapy and post-therapy considerations. Patients’ health, risk factors, and current oral hygiene practices will dictate the care plan. Additionally, if periodontal infection exists, full-mouth periodontal debridement is indicated as active infection is a contraindication for orthodontic therapy. Thus, consideration of full-mouth disinfection protocols is warranted. Below are suggested processes of care based upon the health of the orthodontic patient:
Healthy Patients
- No evidence of periodontal disease or gingivitis
- Caries-free for the past 12 months
- Normal salivary function
- Diet low in fermentable carbohydrates
- Excellent oral hygiene practices
Dental Hygiene Care Plan – Healthy Patients
- Full mouth debridement/instrumentation with hand instruments and dental ultrasonic scalers
- Tongue deplaquing tools
- Application of 5% NaF fluoride varnish at initial appointment, continuing during orthodontic therapy
- Oral hygiene instruction/reinforcement with recommendation for electric toothbrushes & methods for electric flossing systems and/or irrigation systems
- Additional daily care recommendations to include daily tongue deplaquing and calcium phosphate systems
- Recare visit at least every 6 months and/or based on need
Gingivitis/Periodontal Patients
- Existing gingivitis or periodontal infection
- May have dentin sensitivity
- Caries-free for the past 12 months
- Normal salivary function
- Diet low in fermentable carbohydrates
- Questionable oral hygiene practices
Dental Hygiene Care Plan – Gingivitis/Periodontal Patients
- Accelerated periodontal instrumentation protocol (FMD) using hand & Dental Ultrasonic Scalers For more information on this process of care read Accelerated Instrumentation: Fast Tracking Clinical Success
- Application of Periodontal Pharmaceuticals
- Tongue deplaquing
- Application of 5% NaF fluoride varnish
- Oral hygiene instruction/reinforcement with recommendation for electric toothbrushes & methods for electric flossing systems and/or irrigation systems
- Additional daily care recommendations to include daily tongue deplaquing, oral rinses, and home desensitizing agents
- Appropriate recare based on periodontal status
The goal is to keep the orthodontic patient infection-free. The role of the dental hygienist is to ensure access to the tools to maximize oral health while providing education and motivation for optimal results.