Orthodontic diagnosis

Another factor that affects the timing of treatment is the patient's specific problem. If the problem involves excessively protruding teeth susceptible to traumatic injury, misaligned teeth that negatively affect a patient's self-image or desire to smile, or impacted or poorly erupting teeth, it is difficult to justify a delay in treatment. Early treatment might therefore be necessary for patients with these problems. The clinician must weigh the advantages and disadvantages of orthodontic treatment while giving equal consideration to the patient's psychological health and the total treatment time.

Figs 2-1 a to 2-1 d Adolescent girl, age 12 years, 2 months, presents with full permanent dentition including second molars. The patient is ready for treatment.

Figs 2-2a to 2-2d Adolescent boy, age 12 years, 5 months, demonstrates a mixed dentition with 8 primary teeth present. Consider a mandibular lingual arch, then recall in 6 months.

Fig 2-3 Late mixed dentition. The best time to initiate treatment is when all primary teeth except mandibular second molars have exfoliated. Having the option to use the "E space" in borderline cases can be helpful.

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