Early-phase treatment of prominent upper front teeth in children may have benefits

Prominent (or sticking out) upper front teeth are a common problem in children around the world. For example, this condition affects about a quarter of 12-year-old children in the UK. The correction of this condition is one of the most common treatments performed by orthodontists (dentists who specialise in the growth, function and position of teeth and jaws). This condition develops when the child’s permanent teeth erupt. Children are often referred to an orthodontist, for treatment with dental braces, to reduce the prominence of the teeth. Prominent upper front teeth are more likely to be injured and their appearance can cause significant distress. If a child is referred at a young age, the orthodontist is faced with the dilemma of whether to treat the patient early or to wait until the child is older and provide treatment in adolescence.

In ‘early treatment’, treatment is given in two phases: first at an early age (seven to 11 years old) and again in adolescence (around 12 to 16 years old). In ‘late treatment’ (one phase), there is only one course of treatment in adolescence.

As well as the timing of treatment, this review also looked at the different types of braces used: removable, fixed, functional, or head-braces. Continue reading

Lasers may help to reduce pain in orthodontic treatment: but more high quality research is needed

orthodontics-4Pain is usual during orthodontic treatment, especially when a brace is placed on the teeth. Later adjustments of the brace can also result in pain, sometimes lasting up to a week or more. This can make people stop their orthodontic treatment, meaning that the benefits are lost. Painkillers have been recommended to reduce pain, but an effective non-drug solution would lower the risk of side effects and help people follow the full course of treatment. Continue reading

Evidence inconclusive on giving painkillers to children before dental treatment

Child_dentist 3Dental pain is common after dental procedures and can lead to increased fear of dental treatment, avoidance of dental treatment and other associated problems. Reduction of pain is important, particularly in children and adolescents. One way of managing this might be to give painkillers before treatment so that the painkillers can start to work right away. This updated review looked at evidence for using painkillers in children, aged up to 17 years, undergoing treatment without sedation or general anaesthetic, but who may have had a local anaesthetic. The treatments included extracting teeth, restoring teeth and fitting braces. Continue reading

Retaining tooth position after orthodontic treatment

Retention proceduresOnce people finish having their teeth straightened with orthodontic braces, the teeth will tend to get crooked again. Orthodontists try to prevent this by using different retention procedures. Retention procedures can include either wearing retainers, which fit over or around teeth, or stick onto the back of teeth, or by using something called ‘adjunctive procedures’. Adjunctive procedures either change the shape of the contacts between teeth, or involve a very small procedure to cut the connection between the gum and the neck of the tooth. This is an update of a Cochrane review published previously in 2006. Continue reading

Two-phase orthodontic treatment can significantly reduce damage to incisor teeth

Malocclusion Class IIProminent (or sticking out) upper front teeth are a common problem affecting about a quarter of 12 year-old children in the UK.  This condition can develop when a child’s permanent (adult) teeth erupt, and children are often referred for treatment with dental braces to reduce the prominence of the teeth. Prominent upper front teeth are more likely to be injured and their appearance can cause distress.  In two phase treatment, treatment is given first at an early age (7-11) and then again in adolescence (11-16). In one phase treatment, there is only one course of treatment, in adolescence. This review looks at whether one or two stage treatment is more effective, and also looks at the different types of braces used. Continue reading