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Chapter: Medical Surgical Nursing: Management of Patients With Oral and Esophageal Disorders

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Malocclusion - Disorders of the Teeth

Malocclusion is a misalignment of the teeth of the upper and lower dental arcs when the jaws are closed.

MALOCCLUSION

 

Malocclusion is a misalignment of the teeth of the upper and lower dental arcs when the jaws are closed. Malocclusion can be inher-ited or acquired (from thumb-sucking, trauma, or some medical conditions). Malocclusion makes the teeth difficult to clean and can lead to decay, gum disease, and excess wear on supporting bone and gum tissues. About 50% of the population has some form of malocclusion. Correction of malocclusion requires an orthodontist with special training, a patient who is motivated and cooperative, and adequate time. Most treatments begin when the patient has shed the last primary tooth and the last permanent successor has erupted, usually at about 12 or 13 years of age, but treatment may occur in adulthood. Preventive orthodontics may be started at age 5 years if malocclusion is diagnosed early. The need for teeth straightening in adolescence is reduced if preventive orthodontics is started with the primary teeth.

 

Management

 

People with malocclusion have an obviously misaligned bite or crooked, crowded, widely spaced, or protruding teeth. To re-align the teeth, the orthodontist gradually forces the teeth into a new location by using wires or plastic bands (braces). These devices may be unattractive, but this psychological burden must be overcome if good results are to be achieved. In the final phase of treatment, a retaining device is worn for several hours each day to support the tissues as they adjust to the new alignment of the teeth.

Nursing Management

 

The patient must practice meticulous oral hygiene, and the nurse encourages the patient to persist in this important part of the treatment. An adolescent undergoing orthodontic correction who is admitted to the hospital for some other problem may have to be reminded to continue wearing the retainer (if it does not interfere with the problem requiring hospitalization).

 

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