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Contents Indications for the Contra-Indications
for the |
Indications for the Pre-Orthodontic Trainer
- Lower anterior crowding
- Anterior open bite
- Class II both Div I and II
- Deep bite
- Class I crowding
- Mild Class III
- Thumb suckers
- Oral habits
- Posture
Lower Anterior Crowding (see case study)
Lower anterior crowding cases are the most common reason for orthodontic consultation from 6 years of age. Parents see the lower lateral incisors do not have sufficient space. Serial extractions were done in the past for theses cases resulting in greater space loss, bite deepening and the need to extract permanent teeth later. The crowding is a result of the underdevelopment of the anterior alveolar arch NOT due to tooth size discrepancies. Many have a "flattened" arch producing a pseudo-crowding due to overactive mentalis/reverse swallow.
The TRAINER¨ is designed to stretch and de-activate the mentalis (lip bumper) and also retrain the swallowing habit. The tooth guidance feature improves arch form and anterior dental alignment. Note some passive arch expansion is achieved from the reposturing of the tongue into the palate. This is reflected in improved facial development.
Anterior Open Bite (see case study)
Early treatment of
anterior open bite is essential to prevent untreatable malocclusion and
aberrant facial growth. The causative factor is a tongue thrust swallow
with or without thumb sucking. The tongue guard stops the tongue going
between the anterior teeth when in place and the tongue tag actively 'trains'
the correct tongue position. Removing the influence of the tongue habit
allows the anterior teeth to erupt into the correct position. Parents
can be told that it is essential to eliminate this habit for the success
of any future orthodontic treatment.
Tip: For severe open bites, shorten the distal end to allow the
anterior teeth to close into tooth guides.
Class II both Div I and II (see case studies for Space Loss and Retrognathic)
Myofunctional bad habits such as tongue thrusting, incorrect swallow and mouth breathing all contribute to the severity of class II cases. Facial growth is also compromised. Parents often notice the underdeveloped lower face as the first sign of this malocclusion. The TRAINER¨ program should be implemented in these cases for the purpose of removing the oral habits and mode of breathing, plus bringing the anterior teeth into the correct alignment. The TRAINER¨ acts like a functional appliance in that it "trains" a class position with some "headgear' effect on the uppers similar to class II elastics used in fixed appliances. Research has shown improved maxillary and mandibular growth is achieved with changed mode of breathing. 8 (i.e.: CII correction).
Deep Bite (see case study)
Correction of a deep bite is essential to prevent long term soft tissue damage. The TRAINER¨ opens the bite with the mechanics of the aerofoil base and the elimination of habits such as mouth breathing. Bite opening without facial lengthening.
Class I Crowding from Chronic Mouth Breathing
Research shows how important the mode of breathing is for influencing craniofacial growth. Chronic mouth breathers cannot position the tongue correctly in the maxilla, which consequently develops narrow with a shortened arch length causing crowding. Tooth size is not the cause of class I crowding, mouth breathing very commonly is. The TRAINER¨ should be used on a mouth breather in the mixed dentition stage to maximise arch development and minimise the need for extraction of permanent teeth. Passive arch development can be seen in the majority of TRAINER¨ cases after 12 months of continuous use.
Mild Class III and Pseudo Class III
Class III malocclusion can be primarily hereditary but many mild class III's are the result of chronic ENT problems causing mouth breathing and associated lowered tongue posture. This can be the primary cause of the Class III and can be improved with early TRAINER¨ treatment. The retraining of the tongue position alone can bring these cases into at least an edge to edge situation (or better), making future orthodontic correction possible without surgery.
These children develop a malocclusion routinely. Treatment to stop the habit should be implemented as soon as the diagnosis is made, to prevent further deterioration of the occlusion and craniofacial growth. Parents must be told of the damaging effects of this habit which are usually permanent. Get the child to use the TRAINER¨ at the time the thumb sucking is most frequent. Use the TRAINER¨ like an orthopaedic pacifier. Obviously the TRAINER¨ prevents the thumb going into the mouth, but it also stops the associated tongue thrust which will perpetuate an anterior open bite if not corrected. No future orthodontic treatment can be successful without the elimination of this habit.
Oral Habits, Incorrect Swallow, Speech Problems
Use the TRAINER¨ as a primary therapy for myofunctional training to correct oral habits. Speech and myofunctional therapists use exercises based on the principles incorporated into the TRAINER¨ . It can be used as a secondary "home care" to reinforce the myofunctional exercises the child uses to correct these habits.
Posture - Mandibular and Spinal
Incorrect mandibular posture and poor spinal (body) posture have common causes. Mouth breathers and tongue thrusters have forward head posture as well as the craniofacial problems. As an added bonus, children with poor posture will be improve amazingly in facial appearance and posture immediately the TRAINER¨ is placed into the child's mouth. Demonstrate this to parents and they will see they are getting more than just orthodontics. It appears, over time from observation of these growing children, that their posture does improve.
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Patent No. 5 259 762