Too much lattice in the mouth
Tooth braces have almost become an obligation among young people: on average every second person is treated orthodontically. But must that be? Ursula Hirschfelder, President of the German Society of Orthodontics, explains when parents should choose a brace for their children .
Stuttgart – Ms. Hirschfelder, as a parent you have the impression that now almost every child is missing a . Is it really only medically necessary measures or does it have only cosmetic reasons?
That today more children wear a than before, is often assumed. However, the data of the German National Health Association does not provide any evidence for this. Accordingly, the number of treatment cases settled by the health insurance funds from 1995 to 2014 remained largely constant. The settlement volume for orthodontic orthodontics has hardly changed since 1995. In addition, considering the expenditures of the health insurance funds for all dental treatments, the orthodontic treatment of the orthodontists is only slightly reduced. In 2013 it was below eight percent. The statistics do not therefore suggest that more children have a clasp and that orthodontists deserve a golden nose. The parents are now more enlightened and more critical. This is why there is more talk about orthodontic treatments.
Sometimes preschool children even wear a . Can this be useful?
Overall, orthodontic treatments are rarely used in the dairy bite. However, there are marked shortcomings in which they are indicated, because growth inhibitions are threatening and the prognosis is bad. This may be the case, for example, in a milk-bitten progeny, ie, a reverse overbite of the incisors.
Often the treatment extends over years. Could it be harnessed?
“Raffen” is by no means in any case sensible, but could be “stiffened”. Orthodontists should develop a detailed treatment plan, including a chronological classification, and enlighten patients and their parents. They need to what’s coming to them. We depend on the patient’s cooperation. If a removable not worn often enough, the treatment can be extended. In such a case you have to talk again with the parents and possibly change the treatment plan. In the long term, it would be important to update the plan in the meantime.
The health insurance companies pay only in more urgent cases. Sometimes, however, orthodontists recommend a clasp. This can be irritating for parents. What do you advise?
This is difficult for the parents. We have a high social standard in Germany, the health insurance companies pay much. However, the rasters in the classification, on which the cost take over depends, are rough. Many things that would be needed fall out. Not necessarily necessary is added. There may be instances where the funds do not pay, even though the treatment would make sense. This is conceivable, for example, with an open bite, the extent of which is too small to meet the criteria. I am clarifying the parents in such a case exactly. In addition, there is a wide range of additional orthodontics, ranging from additional caries prophylaxis to ceramic brackets.
Are there any threats to health if you do not do anything wrong?
The damage to health can be quite relevant for a long time. The digestion finally begins in the oral cavity and thus indirectly depends on the functional integrity of the chewing organ. Mouth health has a great impact on overall health.
Is it true that back problems can be related to misalignment?
That may be. The temporomandibular joint is a very complex organ, because many connections are conceivable. Otherwise you should leave the church in the village. Sometimes such statements are also embarrassing responses from orthopaedists who no longer .
Critics say that the medical benefits of many orthodontic treatments scientifically insufficient.
The critics demand studies with comparative groups. To find participants with exactly the same prerequisites is, however, very difficult. In addition, there are ethical concerns, because a group should be deprived of treatment. Such studies are hardly possible in orthodontics. The critics have also failed to tackle the matter and make it better. This makes them unbelievable. In the orthodontic literature there are excellent effective publications that can be used for the daily practice. In addition to this, orthodontists are doing quite well in this regard: our society is involved in the network of dental care research in order to demonstrate the benefits of orthodontic treatments for oral health even better.
Do you often have patients who are concerned with aesthetics?
Often not, but sometimes girls come in puberty who want to do something for their appearance.However, purely aesthetic orthodontic treatments must not be borne by the health insurance companies, which must be paid for themselves. For us, medical benefit must come first.