ortho

Question 1

A case requires intervention with an IOTN of what?

Answer 1

4/5
OR
3 with an aesthetic component of 6+

Question 2

MOCDO rule

Answer 2

Missing - hypodontia, impacted, unerupted.
Overjet
Crossbite
Displacement (crowding)
Overbite
(Buccal occlusion can be included last)

Question 3

4 factors included in a problem list:

Answer 3

1. pathology
2. skeletal
3. dental (overbite / overjet / crowding)
4. soft tissue (be specific: increased / decreased overjet / impacted UR canine etc.)

Question 4

Urgent Orthodontic Referral

Answer 4

• trauma or dental injury
• impacted or ectopic teeth (root resorption / pain / infection damaging adjacent teeth)
• cleft lip / palate
• sever functional issues (traumatic occlusion)

Question 5

Hospital Orthodontic Referral

Answer 5

• supernumerary, impacted, transposed, submerged teeth
• > 1 tooth missing in quadrant
• severe skeletal discrepancies
• cleft / other dento-facial anomaly
• complicated MH / special needs
• MDT approach

Question 6

Specialist Ortho Practice Referral

Answer 6

• impacted canine
• mild hypodontia
• mild-moderate skeletal discrepancies
• crowding

Question 7

Routine Orthodontic Referral

Answer 7

• malocclusion
• aesthetic concerns
• interceptive treatment
• conditions benefiting from later interventions

Question 8

When should orthognathic surgery be undertaken?

Answer 8

once growth has completed -
don’t want to outgrow changes.

Question 9

At what age should a child have headgear?

Answer 9

8 years old

Question 10

orthodontic emergencies

pain from appliance after bonding or adjustment.

Answer 10

• normal 3-5 days after
• take painkillers as you would for a headache
• wax can cover sharp edges

Question 11

orthodontic emergencies

trauma from appliance.

Answer 11

• wax over sharp edges
• salty water rinses
• can also see dentist to have the wire trimmed (distal edge cutters)

Question 12

orthodontic emergencies

broken brace.

Answer 12

• debonded bracket: locate if possible to rule out ingestion/inhalation.
• make appt with orthodontist asap.

Question 13

orthodontic emergencies

hypersensitivity / allergy.

Answer 13

• NiTi, CoCr, Beta-Ti, unpolymerised monomer
• sings - gingival hyperplasia, burning mouth, angular chelitis, altered sensation, swelling.
• stop wearing removal appliances or immediate referral to ortho to discuss alternatives.

Question 14

orthodontic emergencies

aspiration (asymptomatic / symptomatic)

Answer 14

asymtpmatic
- referral to A+E for x-ray, provide example of inhaled item.

symptomatic
- partial obstruction = choking protocol,
- complete obstruction = call ambulance

Question 15

orthodontic emergencies

ingestion of component.

Answer 15

asymptomatic
- elastics then reassure
- metallic then ref to A+E

symptomatic
- immediate pain = refer to A+E
- delayed pain = call ambulance as could be GIT perforation