Orthodontics For GP

Echains Always pre stretch echain before using them.

Always check for non vital teeth before starting of ortho tt. That's why case history is important. If pt has history of previous orthodontic tt with removable appliance, then chances of non vital teeth increases.

Tongue thrusting Pt unable to achieve proper lip seal while swallowing. It's like thumb sucking, with thumb replaced by tongue. We cannot swallow with open lips. There has to be lip seal. In such pt, they achieve swallowing by creating seal with tongue  with upper teeth.  Clinical- ask pt to swallow saliva. You can see pt unable to close his lips, a typical sound can be heard, seal with upper teeth and tongue, hypotonic lips. Most of the time,it correct during ortho tt. But sometimes habit breaking appliances may needed. Blue grass appliances are positive reinforcement. Ask pt to keep it rolling at anterior palate. Given after the completion of treatment.

How to identify if the child is right candidate for myofunctional appliance?? It depends of growth spurt.. But how to identify it clinically.. What I do is as follows. Calcification of sessamoid bone is indicator of end of growth spurt. Place rvg medial to thumb. If only outline is seen, then growth is remaining.   In female, start of menstrual period  is indicator of end of growth spurt.

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In case of adult orthodontic treatment, it's not always necessary to complete full wire sequence.  No need to change tip and torque of molars ,if not required. Also u can bond till second premolar. And finish your case at 18SS.

Always have a extra set of brackets while starting a new case. Many times patient loses bracket or after debonding ,it's difficult to bond same bracket as u will encounter frequent debonding of same bracket.  In that case, u can use the same one from extra set.  It happens with everyone. You may not able to find same prescription . So better , be prepared.

Water flosser is a good way to maintain proper oral hygiene during orthodontic treatment.  Do suggest to your next patient..

Bonding 7 -second molar Most of the time we ignore to bond second  molar while bonding. If possible always try to bond second molar. It has many advantages. Yes, it's difficult,but practically makes them easy.  Try it yourself

Something about modules.. Don't buy elastic modules and echains in bulk. You can stock for next 4-6 months. This is because they loses their elastic properties and it's difficult to use them after they becomes stiff..