Early Orthodontic Management of Class 2 malocclusions- Part 2

In this part 2, Orthodontist Dr Andrew Chang discusses: Treatment Options: No treatment Interceptive Treatment now: Functional Appliances with U maxilla expansion + referral to speech therapist. Wait till permanent dentition, then camouflage with upper arch extractions, U expansion is less effective. Treatment Timing: Is it too early? Primary dentition? If have habits eg: thumb sucking or dummy, best to cease habit first  Mixed dentition: best time for maximum orthopedic effect (CVMS 2: Baccetti 2002): Shape of vertebral bodies of C2-4 and inferior borders of C3-4 Adult. Is it too late? What happens with functional appliances? Compliance and success rate (due to temporary speech disruptions), greater lower incisor proclination. Jaw surgery and risks of morbidity. Adv & Disadv of Early Treatment- Gingival trauma, Upper incisor trauma, psychosocial. Adv & disadv of Late mixed dentition or Permanent dentition Tx: Orthopedic effects best retained. What should dentists be looking out for? Age and Dental Status. Mobile D’s and E’s at 10-11 yrs may be difficult to retain functional appliances. Habits - ask about thumbsucking, dummy, mouth breathing etc.  Signs of Risk Factors manifesting as gingival trauma, narrow jaw, Upper Incisor trauma. Assessing risk factors through their lifestyles and habits ie: sports, mouthbreathing >7mm Overjets and referral to orthodontist My experience has been parents would prefer to do a combined functional appliance + teeth alignment that address root causes, rather than orthodontic camouflage and adults are not keen on jaw surgery procedures due to significant risks.