The initial examination serves to classify the malposition and to estimate the need for treatment as well as the time of treatment. It takes place in several steps. You will then be advised on the results of the examination.
During the initial examination, the anamnesis (medical history) is taken, i.e. an attempt is made to determine the causes of the tooth and jaw malposition. To do this, you fill out a medical history sheet, on which you will be asked about previous illnesses, among other things. For example, it is recorded whether inherited malpositions occur in the family, whether the child has unfavourable habits such as thumb sucking or whether milk teeth were missing at an early stage. In the case of adults, the questions asked include whether the teeth have shifted again after a correction in childhood or which correction was carried out. We will then discuss your details with you.
2. stage of development (children)
For the success of orthodontic treatment in children, it is important that the child is motivated to wear their braces for a sufficient period of time. Therefore the physical and mental maturity of the child is determined. Occasionally, a further examination by a paediatrician is advisable.
3. extraoral examination
The extraoral examination is about the appearance of the face. It is the appearance of the face that is judged:
Shape of skull and face
The shape of the skull and face allows initial conclusions to be drawn about a possible malposition and treatment options. For example, a narrow face can be accompanied by a narrow jaw.
Facial asymmetries – effects on nose, chin, lips
Many misalignments affect the shape of the face. For example, in the case of a prebite (mandibular prognathism), the chin is often too prominent. The face can appear severe. In a cross bite, the growth of one half of the lower jaw can be inhibited. This results in asymmetry: the face does not appear uniform. The shape of the nose and lips is also aesthetically influenced by the position of the jaw and teeth.
4. intraoral examination
During the intraoral examination, the structures in the mouth and the general oral health are examined:
Teeth and jaw bone (alveolar process)
The teeth and the tooth supporting part of the jawbone, the alveolar process, are carefully examined:
- Which milk teeth are still present in children, which permanent teeth have already come out? Are there fillings? In adults, it is examined whether all permanent teeth have been preserved and whether dental restorations, e.g. crowns or bridges, have been fitted.
- The tooth surfaceWhat does the surface of the teeth look like? Does the enamel show any damage (e.g. cracks) or discoloration?
- CariesIs there a caries disease? And how far has it progressed? It is checked whether only the enamel or even deeper areas of the tooth are affected.
- If a child still has milk teeth, it is tested whether and to what extent they are already wobbling. A teeth loosening test is performed on adults if they suffer from periodontitis (inflammation of the periodontium) or if the tooth has been damaged by overloading or an accident.
- Oral hygiene Oral hygiene plays a major role in the success of orthodontic therapy. After all, teeth should not only stand straight but also remain healthy. Therefore, the care of the teeth and interdental spaces is controlled and, if necessary, optimized.
The gums are individually different. It can be thick and insensitive or thin and sensitive. This can play a role in orthodontic therapy because very dense, thick gums, for example, can hinder tooth penetration.
In addition, it is checked whether gum inflammation is present. It usually occurs when bacterial plaque is not sufficiently removed. Before the therapy, you or your child will be shown how to improve dental hygiene. If adults have periodontitis, an inflammation of the tooth supporting tissue, it must first be treated by a dentist.
Asymmetries occur, among other things, when the halves of the palate develop at different speeds. This can be caused, for example, by a crossbite or displaced teeth. Displaced teeth can also often be detected during the examination of the palate, e.g. as protrusions in the area of the upper canines.
In the case of children, the almonds are also checked. If they are very large, they can make nasal breathing very difficult. In this case, a further examination by an ENT specialist is advisable.
If the frenulum of the lips is too deep, it can lead to a gap between the middle incisors in the upper jaw (diastema). In this case it is usually necessary to cut the ligament.
Among other things, the size, the position in the mouth and the mobility of the tongue are examined. If the tongue is more immobile than usual, this is often because the frenulum of the tongue is too far forward. It may need to be severed.