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阻断性正畸:认识与预防是首要的治疗方法。

Interceptive orthodontics: awareness and prevention is the first cure.

作者信息

Paglia L

机构信息

Editor in chief European Journal of Paediatric Dentistry.

出版信息

Eur J Paediatr Dent. 2023 Feb;24(1):5. doi: 10.23804/ejpd.2023.24.01.01.

DOI:10.23804/ejpd.2023.24.01.01
PMID:36853207
Abstract

It is widely recognised by the scientific dental community that the correct development of the deciduous and mixed dentitions is paramount to the oral health of paediatric patients. In this respect, interceptive orthodontics plays a fundamental role in the process. Specifically, the paediatric dentist monitors the condition of the mouth from early childhood, distinguishing three age brackets for intervention, each defined by their own characteristics. It would also be desirable for other professionals who treat young patients and their mothers to various extents, such as paediatricians, gynaecologists, obstetricians and speech therapists to share valuable information with us. What follows is a brief summary of important conditions and key information regarding interceptive orthodontics. Age range 0-3 years: breastfeeding during the first months of life has been shown to have a positive effect on the development of the jaws. Later on, the transition to solid food, promoted by the eruption of the deciduous teeth, further stimulates their growth. During this phase, it is recommended to monitor and intercept any muscular hypotonia and low tongue postures. Additionally, it is essential to instruct parents on the proper dietary and lifestyle behaviours needed to ensure the physiological growth of the child, while protecting the health of their oral cavity. Age range 4-6 years: attention should be paid to the deciduous dentition and the development of the upper and lower maxillary bones, along with prompt interception and correction of bad habits such as the continued use of the pacifier, finger sucking, oral breathing and atypical swallowing. Age >6 years: within this phase, the careful monitoring of the space available in the arch, the natural exfoliation of milk teeth, the eruption of the permanent teeth and their occlusal relationship, as well as the maxillomandibular relationship are all important. If necessary, in addition to removing any risk factor, fixed or mobile orthodontic appliances can also be used during the above stages, especially stage 2 and 3, depending on the occlusal and skeletal status of the patient. Early diagnosis of malocclusion is crucial, as well as the sharing of information with other clinicians that deal with children and their parents, who need to be informed about the various therapies that their child may need. The paediatric dentist could, in fact, directly reach out to families to make them understand that malocclusion and other manifestations linked to conditions affecting oral functions such as breathing, sleeping, chewing and feeding often show the first signs as early as pre-school age, long before eruption of the first milk tooth, which is the time when the first dental visit is usually booked! We trust that awareness is the first form of prevention, and this is the message that must be conveyed to all of those involved in paediatric dentistry, patients and professionals alike: awareness and prevention is the first cure.

摘要

科学牙科界广泛认识到,乳牙列和混合牙列的正确发育对儿童患者的口腔健康至关重要。在这方面,阻断性正畸在这一过程中发挥着重要作用。具体而言,儿童牙医从幼儿期开始监测口腔状况,区分三个干预年龄组,每个年龄组都有其自身特点。对于在不同程度上治疗年轻患者及其母亲的其他专业人员,如儿科医生、妇科医生、产科医生和言语治疗师,与我们分享有价值的信息也是很有必要的。以下是关于阻断性正畸的重要情况和关键信息的简要总结。年龄范围0 - 3岁:已证明在生命的最初几个月进行母乳喂养对颌骨发育有积极影响。后来,随着乳牙萌出促使向固体食物过渡,进一步刺激颌骨生长。在此阶段,建议监测并纠正任何肌肉张力低下和低舌位情况。此外,指导家长采取适当的饮食和生活方式行为以确保孩子的生理生长,同时保护其口腔健康至关重要。年龄范围4 - 6岁:应关注乳牙列以及上颌骨和下颌骨的发育,同时及时阻断和纠正诸如持续使用安抚奶嘴、吮指、口呼吸和异常吞咽等不良习惯。年龄>6岁:在这个阶段,仔细监测牙弓内的可用空间、乳牙的自然脱落、恒牙的萌出及其咬合关系,以及上下颌关系都很重要。如有必要,除了消除任何危险因素外,还可根据患者的咬合和骨骼状况,在上述阶段,尤其是第2和第3阶段使用固定或活动正畸矫治器。错颌畸形的早期诊断至关重要,与其他治疗儿童及其家长的临床医生分享信息也很重要,这些家长需要了解他们孩子可能需要的各种治疗方法。事实上,儿童牙医可以直接与家庭沟通,让他们明白错颌畸形以及与影响口腔功能(如呼吸、睡眠、咀嚼和进食)的状况相关的其他表现,早在学龄前就常常会出现最初迹象,远在第一颗乳牙萌出之前,而第一颗乳牙萌出时通常才是首次预约看牙的时间!我们相信,提高认识是预防的首要形式,这就是必须传达给所有参与儿童牙科的人员、患者和专业人员的信息:提高认识和预防是首要的治疗方法。

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