By Chris Baker, RN, DMD F unny how dentists refer to the detailing the tooth align-ment and the bite as “finish-ing”. It’s funny because it all starts from diagnosis; actually, it starts at the initial examination: b Identifying the existing risks, discrepancies, malpositions and adverse trajectories of erupting or unerupted teeth is where finishing begins. b Making them part of your written treatment plan as information for the parent/ patient puts everyone on the same page, reducing surprises and disappointments later. b When you work up the treat-ment plan, you should discover, document and add any concerns, and review that with the parents/patient BEFORE you start. You will feel better, they will feel better, and even though the challenges are there for all of you, there is a better chance of working together with the realities. Think about the facts yielded by the patient’s medical history and status, dental history and status, and current findings; skeletal, dental, airway and function. Your level of awareness and utilization of these facts will help you from level and aligning to finishing stages of treatment. Here are three examples of finishing challenges that can become overwhelming, and how you can know of the facts and handle the challenges better from the start: Patient Miss A may need lengthy and difficult anterior bite closure; how do you know? (Figs. 1 & 2) b Signs and symptoms of airway and breathing limitations (bedwetting, ADD/ADHD, mouth breathing, snoring, bruxism/grinding, enlarged tonsils, enlarged adenoids, dense turbinates and more). b Vertical or dolichofacial growth and muscle patterns. 20 Summer 2018 JAOS
Journal of the American Orthodontic Society Summer 2018/Buyer's Guide: Page 20
