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Reviewed By: Rebecca Comstedt, RDH, BS

Date: March 30, 2018

Top three reasons for tooth loss?

  • Periodontal disease
  • Cavities
  • Trauma


Signs of a traumatic bite?

  • Recession
  • Abfractions
  • Cold Sensitivity
  • Clenching
  • Grinding
  • Teeth are shifting (crowding)
  • Packing food between teeth
  • Gingivitis
  • Decay
  • Deeper pockets around teeth


Benefits of aligned teeth:

  • Easier to clean (reduces risk of periodontal disease and cavities)
  • Reduced chance of losing teeth
  • May improve nighttime airway (less snoring)


Clear Aligner Therapy (such as Invisalign®) presents benefits over traditional Ortho.

  • Easier to clean teeth during active treatment
  • Bleach during the day while you wear trays (<10% bleach), remineralize your teeth at night while you sleep (MI Paste®)
  • Faster movement in many cases
  • Reduced risk of root resorption (no cases have been reported with Invisalign®)


Screening for Ortho (Occlusion is part of the D0180 CPE Code)

  • Molar relationship: Class 1, Class 2, Class 3
  • Deep Bite: Mild, Moderate, Severe
  • Spacing: Mild, Moderate, Severe
  • Crowding: Mild, Moderate, Severe
  • Overjet: Mild, Moderate, Severe
  • Crossbite: Anterior, Posterior (Left side/Right side)
  • Arch Width: Between 35-39  mm ideal (length of a cotton roll!)
  • Arch Shape: U, V, Box, Irregular

Checking occlusion with Shimstock

  • Shimstock should hold tight in the posterior and slide easily in the anterior


Best tool to clean around brackets?

  • Air Polishing with sodium bicarboncate


To address a compromised airway, some practitioners recommend early palatal intervention (around age 3-4). Companies such as The HealthyStart™ and MyoBrace® encourage early intervention.

Premolar extractions and head gear. In the “Airway” community, these procedures are highly discouraged as they make the oral cavity smaller, thereby increase the risk of a compromised airway.


Invisalign, MyoBrace® and HealthyStart™ all have educational material on their websites.

Book // “The Dental Diet,” 2018. By Dr. Steven Lin