By Kristy Menage Bernie, RDH, BS, RYT
There is very little published with respect to the role of the dental hygienist regarding the unique challenges and opportunities presented by the orthodontic patient. Most research and related articles date back to the 1970s and yet, orthodontics as a science has evolved dramatically over the past 20 years. From bio-adaptive minimally invasive treatment to "invisible" aligner technology, tooth movement has become an important health and cosmetic option for most patients, regardless of age or occlusal status. Dental hygienists have an important role in patient identification, treatment options, the dental hygiene process of care from orthodontic pre-therapy through post-orthodontic therapy, as well as the daily adjuncts necessary to maintain optimal oral health during orthodontic therapy.While fixed appliances have been readily available for decades, the use of appliances with lighter forces that work in natural harmony with the body--or bio-adaptive therapy--is growing in popularity. It has been well understood and accepted that light forces will effectively and quickly move teeth.(1)The challenge has been to develop a fixed appliance that will allow light force action with minimal friction and moderate force as seen when arch wires are ligated to fixed appliances. The premise of bio-adaptive therapy, as defined and facilitated through the Damon System of brackets, arch wires and treatment philosophy from Ormco Corp. (Orange, CA), takes into account this opportunity to achieve ideal tooth position and facial harmony while keeping vascular integrity of the alveolar cortical plate. “Optimum force levels for orthodontic tooth movements should be just high enough to stimulate cellular activity without completely occluding blood vessels in the periodontal ligament.”(2) Bio-adaptive therapy utilizes forces 100 times less than traditional mechanics while maximizing availability of oxygen for periodontal remodeling. The presence of oxygen is the trigger on the periododontium and thus tooth movement.(3)When forces exceed a certain threshold, it results in occlusion of the blood vessels, which forms a hyalinized avascular necrotic area. This area must "heal" or revascularize before teeth start to move, a process that is slower in adults than adolescents. A review article on the effects of orthodontic therapy on periodontal health in adults confirms that when forces are kept within biologic limits gingival inflammation is avoided and further, that light forces are recommended to avoid root resorption for the periodontally healthy adult patient. Additionally, some cases, studies demonstrated that orthodontic treatment might enhance the possibilities of saving and restoring periodontal health.(4)
There is very little published with respect to the role of the dental hygienist regarding the unique challenges and opportunities presented by the orthodontic patient. Most research and related articles date back to the 1970s and yet, orthodontics as a science has evolved dramatically over the past 20 years. From bio-adaptive minimally invasive treatment to "invisible" aligner technology, tooth movement has become an important health and cosmetic option for most patients, regardless of age or occlusal status. Dental hygienists have an important role in patient identification, treatment options, the dental hygiene process of care from orthodontic pre-therapy through post-orthodontic therapy, as well as the daily adjuncts necessary to maintain optimal oral health during orthodontic therapy.While fixed appliances have been readily available for decades, the use of appliances with lighter forces that work in natural harmony with the body--or bio-adaptive therapy--is growing in popularity. It has been well understood and accepted that light forces will effectively and quickly move teeth.(1)The challenge has been to develop a fixed appliance that will allow light force action with minimal friction and moderate force as seen when arch wires are ligated to fixed appliances. The premise of bio-adaptive therapy, as defined and facilitated through the Damon System of brackets, arch wires and treatment philosophy from Ormco Corp. (Orange, CA), takes into account this opportunity to achieve ideal tooth position and facial harmony while keeping vascular integrity of the alveolar cortical plate. “Optimum force levels for orthodontic tooth movements should be just high enough to stimulate cellular activity without completely occluding blood vessels in the periodontal ligament.”(2) Bio-adaptive therapy utilizes forces 100 times less than traditional mechanics while maximizing availability of oxygen for periodontal remodeling. The presence of oxygen is the trigger on the periododontium and thus tooth movement.(3)When forces exceed a certain threshold, it results in occlusion of the blood vessels, which forms a hyalinized avascular necrotic area. This area must "heal" or revascularize before teeth start to move, a process that is slower in adults than adolescents. A review article on the effects of orthodontic therapy on periodontal health in adults confirms that when forces are kept within biologic limits gingival inflammation is avoided and further, that light forces are recommended to avoid root resorption for the periodontally healthy adult patient. Additionally, some cases, studies demonstrated that orthodontic treatment might enhance the possibilities of saving and restoring periodontal health.(4)
There are three components to the Damon System: 1) Damon passive self-ligating braces that eliminate the need for elastic or metal "ties." With Damon tie-less braces you can experience treatment without tightening. 2) Light high-technology shape-memory wires that move teeth faster and require fewer adjustments. 3) A new clinically proven treatment approach that aligns your teeth and enhances your facial aesthetics—usually without extractions or rapid palatal expanders.Additionally, passive self-ligating brackets like those used as part of the Damon System lend to better patient comfort, improves the ability to minimize plaque biofilm accumulations around brackets because there are no elastic "o" rings or wire ligatures and arch wires are easily removed for hygiene appointments. Both adolescents and adult populations are appropriate for bio-adaptive orthodontic therapy.(5)
Damon System orthodontists are specially trained in bio-adaptive therapy, which assures optimal treatment planning and success. Regardless of the treatment option, it is imperative to refer clients to those whose education and experience will lend the most appropriate treatment regime taking into account the numerous factors associated with the correction of malocclusion. Visit www.DamonBraces.com for more information and to locate a Damon orthodontist in your area.References
1. Rygh, P. (1986) Periodontal response to tooth-moving force: Is trauma necessary? In L.W. Graber (Ed). Orthodontics: State of the Art, Essence of Science. (pp. 100-115). St. Louis, MO: C.V. Mosby.2. Profitt, W.R., & Fields, H.W. (1993). The biologic basis of orthodontic therapy. Contemporary Orthodontics. (pp 266-288). St. Louis, MO: C.V. Mosby.3. Tuncay, O.C. (1994). Oxygen tension regulates osteoblast function. American Journal of Orthodontics and Dentofacial Orthopedics, 105, 457-463. 4. Ong, M.A., & Wang, H. (2002). Periodontic and orthodontic treatment in adults. American Journal of Orthodontics and Dentofacial Orthopedics, 122(4), 420–428.5. Damon, D.H. (1998).The Damon low-friction bracket: A biologically compatible straight-wire system. Journal of Clinical Orthodontics 32(11), Vol. 32, 670-680.To read another article written by Kristy Menage Bernie for RDH eVillage FOCUS, go to article.
1. Rygh, P. (1986) Periodontal response to tooth-moving force: Is trauma necessary? In L.W. Graber (Ed). Orthodontics: State of the Art, Essence of Science. (pp. 100-115). St. Louis, MO: C.V. Mosby.2. Profitt, W.R., & Fields, H.W. (1993). The biologic basis of orthodontic therapy. Contemporary Orthodontics. (pp 266-288). St. Louis, MO: C.V. Mosby.3. Tuncay, O.C. (1994). Oxygen tension regulates osteoblast function. American Journal of Orthodontics and Dentofacial Orthopedics, 105, 457-463. 4. Ong, M.A., & Wang, H. (2002). Periodontic and orthodontic treatment in adults. American Journal of Orthodontics and Dentofacial Orthopedics, 122(4), 420–428.5. Damon, D.H. (1998).The Damon low-friction bracket: A biologically compatible straight-wire system. Journal of Clinical Orthodontics 32(11), Vol. 32, 670-680.To read another article written by Kristy Menage Bernie for RDH eVillage FOCUS, go to article.
Kristy Menage Bernie, RDH, BS, RYT, is the owner and director of Educational Designs, an international speaker, author and registered yoga teacher. She can be reached at [email protected].
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