Anomalies of dental development: causes, symptoms and treatment

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.

Preventive measures

Specific methods for the prevention of tortoanomalies have not yet been developed. This is quite understandable, given their polyetiological nature and the impossibility of accurately predicting how teeth will behave during the process of eruption and growth.

You can help reduce the risk and consequences of an anomaly only by regular preventive visits to a doctor , which allow you to identify the development of disorders at the initial stage and take timely measures to prevent them.

The recommended frequency of visiting a doctor depends on the age of the child. In the period from the second to the fifth year (the period of growth and development of baby teeth), it is recommended to visit the dentist 3 times a year; in the future, you can reduce visits to 2 times a year.

It is also necessary to take into account the possibility of a hereditary predisposition to tortoanomaly; it should be the reason for genetic analysis.

Types of dental anomalies

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.).

Retention period

Tortoanomalies corrected with orthodontic appliances require a long period of retention as the periodontal and interdental ligaments strive to return the tooth to its previous abnormal position.

Retention methods are divided into orthodontic, surgical and physiotherapeutic:

• Orthodontic retention primarily involves the use of lingual retainers bonded to the inner surface of the teeth. The device used to correct the anomaly can also be used as a retainer.
• The surgical method of retention involves dissection of the interdental papillae with ligaments that tend to return the displaced unit to its previous position.
• The physiotherapeutic method consists of vibration stimulation of the rotated tooth with a frequency of up to 50 Hz. Vibrations are accompanied by repair of the bone tissue of the alveolar sockets, which helps maintain the tooth in a rotated position. Vibration stimulation sessions are carried out several times a week.

The retention time by orthodontic methods depends on the severity of the tortoanomaly and the correction method used, and can be several months.

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:

1. 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.
2. 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.
3. Distal (prognathic). Occurs due to disproportionately developed jaws (overdevelopment of the upper or underdevelopment of the lower).
4. Mesial: the lower row overlaps the upper segments.
5. 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.

What does polyodontia look like?

Quite often, extra teeth are almost indistinguishable from normal ones. It is not uncommon for them to grow in the form of a drop or a thorn. These dental elements can appear either individually or fused with permanent ones. They can form tooth-like formations and entire arrays of teeth.

Also in medical practice, there are cases where polyodontia was hidden and was detected only by radiography. There are many different cases of abnormal development of the number of teeth, and if you notice symptoms, you should definitely contact the dentist.

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.

General overview

Tortoanomaly is the most common violation of the position of individual teeth. According to various sources, it occurs in 10-20% of all diagnosed disorders.

The anomaly is a rotation of the tooth around a vertical axis, the magnitude of which can vary from several to 180°, that is, the position when the lingual (palatal) surface becomes vestibular.

The most common case is a rotation of approximately 45°. The maxillary lateral incisors are most often affected by tortoanomalies, and the lateral incisors of the mandible are somewhat less common.

But in principle, any element can, for one reason or another, be rotated relative to its longitudinal axis.

The most common reason why patients consult a doctor with a thoracic anomaly is dissatisfaction with the aesthetics of their smile. But when the anomaly is significant, functional problems arise along with aesthetic ones.

People begin to experience difficulty biting and chewing food, the tongue and mucous membrane of the cheeks are injured by the abnormally located unit, and they lose clarity of speech.

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.

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.

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.