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Bad Teeth: Pediatric Orthodontics - Hyperplasia

Cause and Effect Issues in Patient Compliance

Patient compliance issues become a primary determinant in how smoothly and how successful an orthodontic outcome can be.

Some children, and teenagers too, dread the inconvenience, cosmetic impact and functional impact (eating, chewing favorite foods) so much that some have resorted to being compliant on a part time basis.

Typically, this involves insisting to their parents that they are doing what they are supposed to be doing, as prescribed by their treatment provider. Yet, when parents are off to work or the child is off to school or otherwise not within range of "parent observation" they will commonly remove anything that can be removed or not exercise proper oral hygiene habits.

In an effort to address the potential oral health hygiene habits (which can be difficult for any ortho patient), more and more orthodontists recommend the use of water irrigation appliances as an alternative to common, abrasive flossing. WaterPik and HydroFloss are two popular products that can relieve the misery of old fashioned flossing that can, for some patients, even cause bleeding gum symptoms.

For young patients who are not compliant, for a variety of reasons, and for ortho patients who have been a victim of the broad economic downturn we are all wrestling with, certain types of "sequelae" (secondary results) can occur that not only render the current treatment plan ineffective... but can actually make symptoms or treatment needs worse.

This gallery contains examples of orthodontic issues that are caused by the major event of interruption of service, non-compliance or inadequate oral hygiene habits (unexpected or intentional) that complicate and/or worsen the treatment need.

This is an exaggerated example of how bad things can get when a patient is unwilling or is unable to follow through or comply with treatment procedures or protocols that are required for nearly any orthodontic treatment to be successful.

The build up of calculus and bacteria for this patient is extreme and results from a long history of cumulative events and/or conditions that are predictable in cases of non compliance. Tartar and calculus accumulation are at an alarming level.

Whether the faulty monitoring (should be done daily by parents or others who are defraying the expense of treatment) is due to patient behavior or to events or conditions that are outside of a young patient's control is questionable but nonetheless a moot point.

Ortho Gone Bad
Pediatric Ortho Failure
Paul Sussman, DMD

This is a close up picture of the pediatric patient mentioned above. Notice how all of the bracketing hardware and wires are broken. Bacteria contamination and decalcification is already set into motion. The existence of a major occlusal and alignment treatment need is compounded with an uncontrolled bacteria growth.

This picture, and the one above, shows explicitly how expensive orthodontic treatments can fail and complicate future treatment needs that will incur more cost. In the end, it is the young patient who endures the severest of consequences. Parents only have to endure the repeated cost of starting all over again.

Zig Zag Crooked Lower Jaw Teeth
Pediatric Mandibular Treatment Failure
Paul Sussman, DMD

Gum tissue overgrowth for a young male. A combination of difficult and perhaps weak diligence in practicing good oral health habits. Wishful thinking, hope and benign neglect do not replace the real activities of keeping things clean and free of debris. Patients who anticipate problems or are already facing "gum tissue events" such as those pictured here are strongly recommended to use specialized rinses and irrigation instruments (WaterPik - HydroFloss) to possibly reverse or prevent the hyperplasia event.

Tissue changes otherwise will require the help of a gum tissue dentist or periodontist. In severe cases where overgrowth is abundant, the bracketing hardware can be removed temporarily to facilitate a straight forward modification of gingival tissues. The potential for relapse is strong however for those patients who don't become proactive in daily oral hygiene habits.

Gummy Orthodontics Male
Gum Tissue Overgrowth - Hyperplasia
Edward Brant, DDS, MS, Long Island, NY

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