Be ready to expand your knowledge one turn at a time!
The Expander contains great information delivered in a small package.
Turn #19 Consider taking a lateral picture especially in class II patients to record the overjet. Simply retract the left side with a contrastor and retract the right side with a retractor.(Thank you Ayman M. El Nigoumi for taking time and sharing this great clinical tip and photo with us!)
Turn #18 Be creative when you have to bring an impacted canine. This is a modified transpalatal arch with a spring to anchor the canine towards the arch.
Turn #17 One of the most common areas of irritation on a lower removable retainer is the posterior lingual acrylic. Make sure to adjust those areas and your patients will love you forever
Turn #16 If a patient has large tori, lower bonded retainer or Essix type of retainer are better options for retention than lower Hawley or spring retainers.
Turn #14: Make sure you retain any edentulous spaces after debond. While waiting for the implant and restoration to be done, the teeth can drift. Bonded retainers are the best in this case. Don’t forget to monitor and follow-up with the restorative dentist.
Turn #13: Bonding lower second molars helps leveling the curve of spee in deep bite cases. Try it…works like magic🃏
Turn #12: At alignment, overlapping triangular shaped incisors will develop black triangles. Interproximal reduction will solve this problem.
Turn #11: Tongue piercing is a risk for gingival recession on lingual of lower incisors. Inform your patients about the risk. They might also need a periodontal consult. Think twice before getting a piercing.
Turn #10: Make sure to coordinate your wires as you progress through treatment and check for posterior crossbites – they might occur more often than you think.
Turn#9: In patients with anterior crossbite always check if there is a functional shift and ask your patient about family history of class III. Those cases have a way of surprising you.
Turn #8: Something looks off?…Having trouble leveling the gingival margins in the anterior region? You might be able to correct this with simply adjusting the torque.
Turn #7: Are your upper or lower 7’s getting you down? When you see ectopic eruption of the 7s and they are blocked out slightly gingival to the 6s, one solution is to place separators between the proximal contact of the 6’s and 7’s for better uprighting and alignment of the 7’s.
Turn #6: Look out and treat white spot lesions. If you see a white spot lesion developing, please consider applying flouride varnish to prevent further decalcification and possible caries.
Turn #5: Retention is essential after closing a diastema. The chances of relapse are high and spaces might re-open. Consider to deliver an upper bonded retainer.
Turn #4: Make it easier for your patients to know where to place elastics and put different color O-ties on specific teeth that will support rubber bands. You can also draw a diagram of various elastic patterns on the back of the packet of elastics to help demonstrate where you want the patient to wear them. Photos and selfies will also help them. NOTE: If hooks are unavailable with the brackets needed, a Kobayashi tie may be used.
Turn #3: When assessing arch length, look for red flags of posterior crowding such as delayed eruption or partial impaction of second molars. This can influence your decision and pattern of extractions in order to prevent impaction of second molars.
Turn #2: Look out for “submerging“ primary molars; they are suspect of ankylosis. Clinical characteristics are: infraocclusion, tipping of adjacent teeth, low inter-proximal bone level. If patient is growing, consider extraction or de-coronation when there is no successor tooth.
Turn #1: Don’t forget to steel tie brackets on teeth that support rubber bands in order to avoid rotations.
- Temporo-mandibular disorders – Handouts for the doctor and patient:
- Table with TMJ Diagnosis
- Understanding the jaw problem. Pamphlet
- Bruxism Pamphlet
- Exercises for jaw muscles
- Exercises to increase mouth opening
- Sleep Hygiene Pamphlet
- Patient instructions PDF series:
- Useful diagnosis and treatment planning worksheets: