Patient Issue

Patient Selection

The TRAINER¨ program is easy to implement, requiring minimal chairside time. Every child with a developing malocclusion should have the opportunity to use one. Parents are usually motivated to do something for their child to lessen the effects of a developing malocclusion. The key to success is daily use. Therefore, the parent and child must be motivated to get results. This is not for the patient who does not want treatment. A minimum of one hour per day (more if possible) plus overnight, over a minimum period of 12 months, is the essential commitment to achieve consistent results. Review progress each month. If wearing time is less than minimum, advise the patient and parent that the treatment "will not work." Take photos at the start of treatment. Show the patient and parent facial and dental changes to assist motivation. Tell the parent that this is pre-orthodontic treatment primarily directed at the myofunctional causes of the malocclusion, which MUST be corrected to get a stable orthodontic result.

Show the patient the TRAINER¨ and point out the tongue tag. Tell the child to "place the TRAINER¨ into the mouth with the tongue tag uppermost. Feel the tongue tag with the tip of the tongue." Show the child the raised section on the tongue tag, touch the tongue tip with a mirror handle. "This is where the tongue tip should be all the time, with the TRAINER¨ in or out." The patient now places it into the mouth.

"Keep lips lightly together and breathe through your nose."

"Do not chew on the TRAINER¨ . Close the teeth into the TRAINER¨ and keep lips together. Feel it trying to straighten your teeth." Show the parent how "closing into the guidance channels assists tooth alignment in the same way as braces do." Closing into the TRAINER¨, not chewing, is all that is necessary as long as the lips are kept together.

"Use daily, while doing homework, reading, watching TV or playing."

Minimum daily use is 1 hour. Two half hour sessions are as effective. One hour is considered minimum and of course if they want to use it more, that will increase effectiveness. Daily use is the conscious training of the tongue position.

Night use is absolutely essential, and should be commenced only when the child is used to daytime use, usually after 1-2 weeks. If it falls out (which mostly it does in the early stages of treatment), just tell them to persevere as this is a training program and once it stays in all night that is a major success! Mouth breathers and tongue thrusters in particular have this trouble, however they must be made to realise that any orthodontics will fail unless these habits are corrected and they must persevere. Night use is the passive phase stopping the detrimental effect of tongue thrusting and mouth breathing.

Review the patient every 4-6 weeks

Check progress. Ask "how are you going with your TRAINER¨?" Confirm that it is being used every day as the instructions say. Then have the patient place the TRAINER¨ into the mouth to show it is being used regularly and correctly. Observe the facial and dental changes against the original photographs. (Apparent after 2-3 months of use, sometimes sooner) Motivate by showing progress from these photographs. You will see facial changes first, particularly in the lower third of the face, then jaw position improvement and finally dental changes. These facial changes are usually more dramatic to the patient (and Dentist) than the slower dental changes. Progress to the hard (pink) TRAINER¨ after 6-8 months when facial changes indicate myofunctional problems are improving, the TRAINER¨ is staying in most nights and dental alignment has started to improve.

Remind the parent that this is an essential part of the child's orthodontic treatment. The TRAINER¨ is a myofunctional appliance that is used at the stage the child is still growing to eliminate habits that cause incorrect growth and malocclusion. If these habits are not corrected, any future Orthodontic treatment will be prolonged and the result will be less stable.

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Patent No. 5 259 762