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Article: Volume 42 Number 2 Page 131 - March 2015

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  Dent Update 2015; 42: 131-140

Orthodontics:  Emergencies in Orthodontics Part 1: Management of General Orthodontic Problems as well as Common Problems with Fixed Appliances

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Abstract: Fixed appliance treatment is a popular treatment modality with a burgeoning increase in the numbers of children and adults realizing the benefits that can be gained. Appliance breakage is an unavoidable nuisance which is at best inconvenient, and at worst may result in significant pain or discomfort for the patient. General dental practitioners (GDPs) should have the practical knowledge of how to provide timely and appropriate orthodontic ‘emergency treatment’. This will significantly reduce the sometimes considerable inconvenience and discomfort for both the patient and his/her parents, and the inevitable frustration for the clinician providing ongoing care. This first paper will deal with general orthodontic problems that commonly present, as well as some issues specific to fixed appliances. The second paper will deal with the other orthodontic appliances that may be encountered by GDPs in their daily practice.

Clinical relevance: Appropriate handling of an orthodontic ‘emergency’ by the general practitioner will, on many occasions, provide immediate relief of pain and distress for the patient. This will in turn allow treatment to continue moving in the right direction, thus allowing more efficient and effective use of valuable resources.

Author notes: Paul Dowsing, BDS, DGDP(UK), FDS RCPS, MOrth, FDS(Orth) RCPS, MPhil Orth, Consultant Orthodontist, The Princess Royal Hospital, Telford, Alison Murray, BDS, MSc, FDS RCPS, MOrth RCS, Consultant Orthodontist, Royal Derby Hospital and Jonathan Sandler, BDS(Hons), MSc, PhD, FDS RCPS, MOrth RCS, Professor and Consultant Orthodontist, Chesterfield Royal Hospital, Chesterfield, Derbyshire, UK.

Objective: To recognize and diagnose orthodontic ‘emergencies’ and to prescribe the appropriate treatment for the most common problems.