Dental News - Severe overjet better treated from an early age

Dental Tribune International

Thu. 27. July 2017

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GOTHENBURG, Sweden: Research conducted by the Sahlgrenska Academy has found that children with severe overjet have a higher chance of success with adjustment procedures when their teeth are corrected at an early age. Focusing on children between 7 and 14 years old, whose lips did not cover their teeth, the aim of the research was to explore and describe the pre-adolescents’ experiences of the treatment, compare social discomforts, prove the clinical effectiveness and functionality of the treatment and assess the costs of reducing large overjet with an Andresen Activator (AA) and a Prefabricated Functional Appliance (PFA).

"How a person experiences it, is very individual,” said Emina Čirgić, a postdoctoral researcher in odontology and senior orthodontic consultant within the National Dental Service in Gothenburg. “Some were ashamed and didn’t want to tell anyone at all that they wore an appliance—only their best pal knew. Others immediately took it with them to school and displayed it as a trophy.”

For younger children with a so-called mixed dentition (both milk teeth and permanent teeth in their mouths) a removable appliance is the answer. A removable appliance fixes the upper and lower jaw to each other, renders speech impossible and is mostly used at night. The alternative is to wait until all the permanent teeth have come up and correct the overjet with a fixed brace. However, the protruding teeth remain unprotected during several sensitive years.

“In this situation, you have to tell parents and children that if we don’t reduce the overjet there is a risk they will knock their teeth out and have injuries for life. But treatment is difficult, all orthodontics hurt and in order to cope, all parties must be involved,” said Čirgić.

In measuring the effectiveness between the PFA and AA in correcting overjet, overbite, sagittal molar relationship and lip seal, research showed no difference between the two appliances. It also showed no difference in experienced functional and social discomfort after 6 months of using the appliance, however out of the 100 participants who were interviewed, 13 per cent had been subjected to bullying. Cost-minimisation results clearly show that the PFA is the preferred approach for the reduction of large overjet of patients in the mixed dentition period.