Dr Samintharaj Kumar
What Causes Crooked Teeth?
“The majority of children have a developing crooked teeth condition.”
Many children have crooked teeth, which manifest as early as five years of age. Previously genetic and hereditary factors have been blamed for crooked teeth and poor jaw development.
Recent advances in research as now produced evidence that other causes are likely to be culprit. These are known as incorrect myofunctional habits and are described as mouth breathing, tongue thrusting, reverse swallowing and thumb sucking.
We now know that allergies, asthma and habitual open mouth posture can also contribute to incorrect jaw development as we grow throughout childhood.
So why do we need to straighten teeth in the first place?
By improving the alignment of teeth we know that there are clear advantages apart from the social effect of a pleasant smile. Straight teeth will also mean less food get stuck in between and hence the patient typically has a lower risk of both gum disease and decay incidence.
How does orthodontic treatment align teeth ? What are the potential problems or disadvantages ?
Traditional orthodontics (braces or aligners) have been used for years to straighten teeth in their early teenage life when all the permanent teeth have appeared.
Whilst orthodontic treatment will straighten teeth, it does not attempt to solve the underlying causes of crooked teeth and incorrect jaw and facial development.
There are also well documented disadvantages that traditional orthodontic techniques may predispose teeth to. These include tooth and root damage with the problem of relapse - unless the patient is willing to commit to wearing a permanent fixed or removable retainer.
To summarise, the main risks and limitations of treatment are:
Relapse- up to 90% after retainers are removed
Root Damage- 100%
Retention - life long
What are other options to straightening teeth and are there advantages ?
Removable appliances like the Myobrace® have been shown over years not to cause root resorption because of the protocol of intermittent versus continuous use. The Myobrace®System can can be combined with braces or aligners. Typically, the orthodontic treatment time following Myobrace is typically much shorter and with much lighter forces.
What is Myobrace ?
The Myobrace®System was developed as preventive pre-orthodontic treatment which focuses on addressing the underlying causes of crooked teeth. Thereafter there is often no need for braces or extraction of teeth, unlocking natural growth and development. Treatment is best suited to children aged 3 to 15 and involves using a series of removable intra-oral appliances that are worn for 1-2 hours each day plus overnight while sleeping.
Myobrace® treatment benefits :
Corrects poor oral habits
Develops & aligns the jaws
Straightens the teeth
Optimises facial development
Improves overall health
Promotes healthy eating habits
How does it do this? By helping the child:
Breathe through the nose
Correct tongue resting position
Keep the lips together
Myobrace - Early Orthodontic Treatment for Children Aged 3 - 15.
How It Works
Waiting until all permanent teeth have come through to begin treatment with braces can unfortunately lead to irreversible damage affecting not only the teeth, but also the child’s overall health and development.
Poor myofunctional habits (poor oral habits) are evident before all permanent teeth are present, which means treatment of the causes can begin much earlier than originally thought. This can be as early as three years of age.
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"What Myobrace® does is look at those underlying causes and tries to deal with them."
Dr Barry Raphael, Orthodontist (Clifton, New Jersey, USA)
Myobrace® is designed to deal with these incorrect myofunctional habits by teaching children to breathe through their nose, rest the tongue correctly in the roof of the mouth, swallow correctly and continue widening the jaws so they grow to their full and proper size. This results in sufficient room for the teeth, allowing them to come in naturally straight and often without the need for braces.
The Myobrace®System consists of a series of intra-oral appliances that are worn for one hour each day plus overnight while sleeping. These appliances assist in correcting poor oral habits and expand the jaw whilst exerting light forces to align the teeth and jaws. Depending on the child’s age and specific type of orthodontic problem, separate appliances may be prescribed by your Nuffield Dentist. All children will be enrolled in our patient education program, known as Myobrace®Activities, to further correct the myofunctional habits causing the incorrect dental and jaw development. The Activities are performed twice daily in conjunction with wearing the Myobrace® appliance and consist of a series of breathing, tongue, swallowing, lip and cheek exercises.
Myobrace Stages of Treatment
Myobrace® treatment starts with habit correction and works using a combination of three or more appliances to correct the causes of orthodontic problems. This aims to align the teeth as they grow into the mouth. Treatment can begin once poor myofunctional habits are recognised. Treating children at a younger age produces better results because older children have had more time for the incorrect habits and wrong growth patterns to establish, which can require extra effort for a successful treatment outcome.
With good compliance, excellent results can be achieved.
The four stages of treatment with Myobrace® are: habit correction, arch development, dental alignment and then retention.
Stage 1 - Habit Correction
The first and most important stage of Myobrace® treatment is Habit Correction. This involves teaching the patient to breathe through the nose instead of the mouth. Retraining the tongue to rest in the correct position, swallowing the right way and keeping the lips together when not eating or speaking.
If these incorrect oral functional habits are corrected, your child will have a great chance to grow their jaws to their appropriate size and have a much better facial profile. Such changes will often eliminate the need for braces later on.
Stage 2 – Arch Development
Along with habit correction, additional arch development may be required to widen the upper jaw allowing sufficient space for the teeth and tongue. Children with underdeveloped jaws over 7 years of age can be recommended to use appliances and techniques in combination with The Myobrace®System such as the Biobloc or Farrell Bent Wire System™ (BWS™) to achieve additional jaw development which will speed up the treatment process. The Myolay™ is suitable for the younger age groups and is used in conjunction the Myobrace®.
Stage 3 – Dental Alignment
Just as the last of the permanent teeth erupt, your child will be given Myobrace®for Teens to align the teeth into their natural position.
Because Myobrace is a removable appliance, compliance and parental supervision is essential. Myobrace® appliances should be worn daily and overnight while sleeping. Patient co-operation and motivation is paramount when it comes to achieving optimal results. Depending on the child's individual requirements and compliance, final alignment of teeth may still require refining the final stages with braces or aligners.
Stage 4 – Retention
Retention is the final phase of Myobrace® treatment. It is important to ensure that good oral habits are maintained. This often prevents the need to wear a permanent retainer or wire.
Once braces are removed a retainer is typically required to prevent teeth from moving back and undergo relapse. Provided the taught oral habits have been maintained, With good compliance and providing the correct oral habits are maintained, Myobrace® treatment will allows more stable orthodontic results and improved overall health.
* Success of Myobrace® treatment relies on compliance and the child's ability to correct their poor myofunctional habits. Results and treatment time vary for each individual case.
Further Health Benefits
As well as straightening the teeth, jaws and improving facial and jaw development, Myobrace® pre-orthodontic treatment provides many additional health benefits by addressing the primary issues relating to airway dysfunction as well as educating children about good eating and dietary habits.
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