Orthodontics

Orthodontics: Correction of the position of the teeth

It is common for children born with clefts to have crooked or irregular teeth. The “baby teeth” are not as affected as the permanent teeth. Proper maintenance of the baby teeth is important as they act as a support structure for the permanent teeth that are developing in the jaws and under the baby teeth. Early loss of the baby teeth can create or complicate orthodontic problems.

The cleft might result in a gap in the gum and bone of the upper jaw. The teeth either side of the cleft can be twisted or in the wrong position. There might even be extra or missing teeth either side of the cleft.

Children born with a cleft lip only or a cleft of the palate only do not usually need special orthodontic treatment.

Orthodontic treatment is usually limited to two or three treatment stages.

First stage:

When the fi rst permanent front teeth come into the mouth and are in “cross bite” (when the upper teeth fit inside the lower teeth), a short course of treatment can be started to straighten the teeth and correct a minor cross bite.

Second stage: (Not necessary in all cases)

When the child is about 9 years of age, and has a gap in the gum, a bone graft can be used to close the gap. It might be necessary at this stage for the orthodontist to widen the upper arch of teeth to an ideal shape before having the bone graft.

Third stage:

When most of the permanent teeth are in the mouth the fi nal stage of orthodontic treatment can start. This stage usually takes at least two years, during which time you will need to see the orthodontist almost every month. The treatment is a gradual process where the teeth are moved with metal brackets attached to the teeth and with wires and elastics applying gentle pressure.

Orthodontic treatment for baby teeth is not recommend because small children do not tolerate the braces and there is little lasting benefit from early treatment.

REFERENCE: “A PARENTS' GUIDE TO THE TREATMENT OF CLEFT LIP AND PALATE” / "‘n OUER-HANDELING VIR DIE BEHANDELING VAN ‘n GESPLETE LIP ENVERHEMELTE" / ISIKHOKELO KUBAZALI NGONYANGO LOMLEBE OCANDEKILEYO NENKALAKAHLA EVULEKILEYO. © Haydn Bellardie 2006.

Orthodontics

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