The purpose of this blog post is to educate parents in recognizing a developing malrelation of teeth in their children. At every orthodontic consultation before I begin to explain the problem with the patient’s teeth I first start with normal occlusion/bite. So let me start by doing that here.
Normal occlusion/Normal Bite:
Overjet: The horizontal overlap of the upper teeth to the lower teeth. This ideally needs to be 2 mm, which basically means that the upper teeth are ahead of the lower teeth by 2 mm in the front when you bite down.
Overbite: The vertical overlap of the upper teeth to the lower teeth. this again needs to be 2 mm, which means that upper teeth cover 2 mm of the lower teeth in bite
Also when you bite down all the upper teeth are on the outside and the lower teeth are on the inside of the uppers.
The first malrelation of teeth I would discuss is the anterior openbite as I feel that it is one of the most complicated malrelations of teeth and the sooner it is recognised and corrected the better the stability and the less likelihood of a relapse.
as the word suggest “Anterior” is in the “front” and “Openbite” is when the teeth come in contact in bite at the back, there is a gap between teeth in the front.( fig 1). Apart from having a genetic reason for its occurrence, mouth breathing at night has also been recognised as a causative factor . Other habits such as thumb sucking, digit sucking, prolonged dummy sucking have known to cause varying degrees of Anterior open bite.
Why is anterior openbite so important to treat?
If a person has an anterior open bite the tongue is pushed between teeth in the front which is called a “tongue thrust habit” (usual position of tongue during swallowing is above the teeth on the palate) to create a seal to allow food and water to be pushed down the throat during the acts of swallowing. This position of the tongue results in worsening of the Anterior openbite and teeth get pushed more forward. Also the patient with this problems would have speech difficulties trying to pronounce certain words as air would escape between teeth which usually results in a lisp. Treatment of Anterior open bites should consider tongue posture to finally prevent a relapse post braces.
Correction of anterior openbites is extremely important in overall growth and development. My next post would be on crowding of teeth and reasons for lack of space for adult teeth and its treatment .
FIG 1: BEFORE BRACES
FIG 2: AFTER BRACES