Dental anomalies are various types of deviations of teeth from the norm (in number, size, shape, structure, etc.), usually congenital or acquired disorders of the functioning of the dental system. According to dental practice, various dental anomalies are observed in 40-50% of children and adolescents and 30-40% of adults. Despite the fact that dental anomalies sometimes require long-term and multi-stage treatment (orthodontic, orthopedic, therapeutic, surgical, etc.), many prefer to turn a blind eye to the presence of problems, some even try to make a feature out of a problem (as in the case of diastema , despite the charm and charm of some public representatives of the fair sex, this is in any case an anomaly).
Examples of dental anomalies from the YuliSTOM dental practice
Anomalies of the dental system can be divided into the following groups:
- anomalies of individual teeth (size, shape, number, position);
- dental anomalies;
- malocclusion;
Below we will look at each group separately.
Description and causes of the disease
Both children and adults are susceptible to pathology. Depending on the etiological reasons, acquired and congenital anomalies of dental development are distinguished. The first appear throughout life as a result of various external and internal factors affecting the dental system. Congenital are formed due to the presence of unfavorable heredity, or a violation of the embryonic development of the fetus.
Main reasons:
- genetic predisposition;
- teratogenic effects of various substances on the embryo during the formation of organs and systems;
- hormonal imbalance (hypothyroidism, hypocortisolism), vitamin deficiency during pregnancy;
- infections that cause genetic mutations in the fetus (herpes, rubella, HIV, syphilis, toxoplasmosis, cytomegalovirus, etc.);
- fetal hypoxia;
- toxicosis of a pregnant woman;
- bad habits of childhood: prolonged use of a pacifier, bottle feeding, finger sucking, etc.;
- difficult childbirth, birth injuries of the jaw;
- infectious diseases, rickets, hypovitaminosis in the first three years of life, leading to impaired development of segments.
Various factors can provoke abnormalities in the development of teeth in children: alcohol, drugs used by the expectant mother before and during pregnancy, unbalanced nutrition, sudden climate change, radiation, lack of fluoride, calcium, etc.
Types of dental anomalies
View | Characteristic |
Size pathology | Macrodentia. The crown is significantly enlarged. The developmental anomaly is associated with the fusion of several rudiments into one due to hormonal imbalance. Defective units are more often located in the upper row of the smile zone. Microdentia. Excessively small units. Pathogenesis is associated with genetic predisposition. The violation affects the incisors, mainly the upper ones. |
Anomalies of dental structure | Hyperplasia. “Pearls” are formed on the crown - formations of enamel of various shapes, 1.5 - 3.5 mm in diameter. Droplets are most often localized near the neck of the segment, or in the bifurcation zone of the root. Dysplasia. The surface of the unit is heterogeneous, thinned in places, and gray spots are present. There are many serrations on the incisors. Chipping and increased sensitivity may occur. Hypoplasia. The enamel layer is sharply thinned, sometimes absent (aplasia). Leads to premature development of inflammatory diseases of hard tissues (caries, pulpitis). Dentinogenesis imperfecta. Units are amber in color, opalescent. Enamel and dentin are fragile, susceptible to abrasion and destruction. Insufficient amelogenesis. It manifests itself as thinning of the enamel, the appearance of brown spots, and hyperesthesia to stress factors. |
Form defect | Spine-shaped (in the form of a thorn or awl). The segments are wide at the base and sharply taper towards the periphery. Possible combination with microdentia. The surface is uneven and spotty. The pathology is characteristic of segments of the smile zone. Barrel-shaped (Hutchinson's teeth). The neck is thickened, the cutting surface has a recess in the center of which there is no enamel layer. Molar segments with a shortened surface and enamel hypoplasia, etc. |
Growth disorder | Anomalies in tooth growth are associated with their abnormal spatial arrangement: vestibular displacement (outward); oral (inside); high or low localization; trema, diastema (gaps between units); tortoanomaly (rotation of a segment around an axis); crowding; transposition (change of place). |
Pathology of numbers | Supernumerary (hyperdentia). Extra units. Hypodentia (insufficient quantity). Adentia (complete absence of units in the mouth). |
Impaired eruption | Retention (retention of a unit in the jaw or alveolar process). Late eruption of incisors. Impaired eruption of paired segments. Premature eruption. |
Abnormalities of tooth roots | Characterized by a change in the number of roots (downwards or upwards), their curvature |
Common symptoms that occur with most developmental anomalies are: discomfort in the mouth (sometimes soreness), problems with chewing food, and speech defects. Such pathologies are often accompanied by other genetic defects (cleft palate, lips, etc.).
Symptom relief
Most often, in adults, extra teeth erupt without any symptoms, but for children this can become a problem that needs to be addressed.
Supernumerary teeth erupt with the same symptoms as regular teeth, so the treatment for them is the same.
- To lower the temperature, it is recommended to give your baby Paracetamol or Ibuprofen. If the child is very small, these drugs can be used in the form of suspensions or rectal suppositories. In addition to lowering the temperature, these medications do an excellent job of treating pain and inflammation.
- To relieve gum pain, local anesthetics are used - ointments and gels (for example, Kalgel, Dentinox, Solokoseryl). These remedies cope well with painful sensations and slightly relieve inflammation.
- Adults and children over 2 years of age can be treated with folk remedies: propolis, honey, decoctions of calendula, chamomile and lemon balm. Some decoctions help reduce pain and relieve inflammation. Traditional methods of treatment should be used only after consultation with your doctor.
- If primary supernumerary teeth have partially erupted, stimulation of eruption is prescribed. For this purpose, vibration and electrical stimulation, as well as special massage, are used.
Types and classification of malocclusions
Bite is the position of the segments at the moment of tight closure of the jaw bones. Occlusion is assessed in 3 planes:
- by crown height (vertical);
- lateral arrangement of segments relative to the jaws (transvesial);
- ratio of the length of the row and the jaw (sagittal plane).
Malocclusion can be of 2 types: skeletal and dental. In the first case, the cause of pathological closure of the elements is the non-standard size of the jaws or their position in the mouth. Dental abnormal bite is formed due to dental defects (number, size, shape, etc.).
Classification of dental malocclusions:
- Open: the segments of the top and bottom rows do not meet each other vertically. The mouth remains slightly open. Due to the defect, speech, breathing, and chewing are impaired.
- Deep. The lower crowns are significantly (more than ½ covered by the upper ones). The face takes on a flattened shape. Often leads to injuries to the mucous membrane, rapid abrasion of teeth, and defects of the temporomandibular joint.
- Distal (prognathic). Occurs due to disproportionately developed jaws (overdevelopment of the upper or underdevelopment of the lower).
- Mesial: the lower row overlaps the upper segments.
- Crossed: on one side of the jaw, the teeth are located without pathology, and on the other, the lower crowns protrude above the upper ones.
Diagnostics
Examining supernumerary teeth during an x-ray is not as easy as it seems. They can be superimposed along the contour onto the permanent ones and remain invisible. In such cases, patients are recommended to undergo a computed tomography scan, which shows a more accurate picture of the disease.
If the extra dental elements have already erupted, the dentist can easily detect them. In practice, the patients themselves find the erupted supernumerary teeth and already at the initial appointment with the dentist they complain about the pathology.
Possible consequences
Improper development of teeth and abnormal bite cause uneven distribution of chewing load. This leads to the development of various complications:
- rapid abrasion of closing teeth;
- caries, pulpitis;
- gingivitis, periodontitis;
- bleeding of the mucous membrane;
- displacement of the articular head of the temporomandibular joint.
When bite deviations occur, problems arise with oral hygiene and microcirculation in the periodontal tissues is disrupted. Ultimately, cellular nutrition, gas exchange, and metabolism are disrupted. A complex of pathological processes leads to early destruction of dentin, periodontal ligaments and tooth loss. Timely consultation with a doctor will help prevent adverse consequences. In Moscow, jaw bite correction is carried out by the Center for Aesthetic Dentistry near the Otradnoye metro station.
Symptoms of hyperdontia in adults
Polyodontia affects permanent teeth more often than baby teeth. An adult usually develops dystopic and impacted supernumerary teeth.
Dystopic teeth are those that appear outside the dental arch. Most often they erupt on the lingual surface of the gums and in the palate. With this form of the disease, the patient typically:
- poor pronunciation of sounds;
- noticeable malocclusion;
- change in the usual arrangement of teeth: curvature of the angle at which they grow, as well as their rotation
- around its axis;
- frequent injury to the oral mucosa and, as a result, its inflammation;
- disruption of chewing processes, resulting in digestive problems.
Among other things, dystopic teeth often cause psychological problems. Due to a non-aesthetic, and sometimes completely unattractive smile, the patient becomes withdrawn and uncommunicative. Psychological problems, in turn, cause chronic diseases of the endocrine, digestive and nervous systems.
Impacted supernumerary teeth are teeth that do not erupt, but continue to remain in the bone tissue of the human jaw. Often they hardly make themselves felt until complications begin. Dentists diagnose this anomaly during a routine examination of the patient.
This abnormality in the number of teeth is accompanied by the following symptoms:
- normal teeth begin to loosen (the condition is considered pathological);
- the bone begins to protrude (if the impacted tooth is too close to the edge of the jaw);
- Aching pains appear periodically.
One of the most difficult situations is when extra teeth grow in place of impacted third molars. Wisdom teeth cannot grow and begin to negatively affect the roots of other teeth, which in turn can lead to serious complications.
Methods for correction and treatment of anomalies
Treatment depends on the clinical situation and is determined by the doctor after a comprehensive dental examination. Correction of dental abnormalities may include:
- surgical removal of wisdom teeth or supernumerary units;
- prosthetics: for adentia, hypodentia;
- orthopedic correction with a crown, veneer, lumineer: for size anomalies;
- restoration with crowns, composite materials, veneers: for non-standard shapes;
- if the structure of enamel and dentin is damaged, complex therapeutic, orthodontic, orthopedic treatment, enamel mineralization, and drug therapy are prescribed;
- eruption disorders: physiotherapy, massage. Sometimes orthopedic treatment (plates, aligners), removal of a baby tooth (if a permanent tooth has formed underneath it), surgical care (for impacted segments), or orthodontic preparation (system braces) may be required in order to create conditions for stretching the segment retained in the gum.
Malocclusions are most often corrected with fixed orthodontic structures (braces, aligners) in adults. Children are mostly fitted with removable devices.
What are mouth guards in orthodontics?
Mouth guards are special designs used to correct malocclusion and dental defects. Unlike braces, they are outwardly invisible and do not interfere with diction.
Features and advantages of mouth guards:
- have a transparent plastic or silicone base;
- you can remove it yourself and carry out thorough hygienic care;
- soft structure that does not injure the oral cavity and does not damage tooth enamel;
- aesthetic designs ensure a tight fit to the teeth;
- do not create discomfort for the patient;
- do not require restrictions on food intake.
The only disadvantages of orthodontic aligners include their higher cost compared to braces, as well as a longer treatment period.
Indications for wearing mouth guards:
- slight curvature of teeth;
- rotation, crooked teeth;
- large gaps between crowns;
- elongation or shortening of dental alveoli;
- abnormal position of the upper canines;
- crossbite (effectively handled by McNamara mouthguard
).
Orthodontics
considers other indications for wearing a mouthguard. Such designs have an undeniable mass of advantages, are easy to maintain and completely invisible to others. They are made in dental laboratories individually for each patient using a dental impression. Installing the aligners takes only a few minutes.
Orthodontic aligners are also used to consolidate the results after wearing braces.