The impact of orthodontic appliances on eating - young people's views and experiences.

OBJECTIVES: Orthodontic appliances are known to cause patients difficulty with eating. Learning more about the issues patients face, while eating with orthodontic appliances in place, will allow us to create more informative and relevant patient information, thereby improving patient compliance and treatment success. This study aims to understand how orthodontic appliances impact on eating in the broader context and to explore adolescent patients' perceptions of eating with orthodontic appliances. METHODS: Purposive sampling was used and 19 participants currently undergoing orthodontic treatment and aged 11-14 years were selected for either a focus group or semi-structured interview to explore eating-related issues. Data collection and analysis were carried out as an iterative process broadly following principles of thematic analysis. Data collection ceased when no new themes emerged. RESULTS: Two main themes relating to eating problems emerged: restriction of food choice and problems associated with the eating process. Participants reported restricting food choice due to physical aspects of the appliance, advice given by their orthodontist, fear of breakage and also to minimize embarrassment. Participants also reported problems with the time taken to eat, chewing problems, taste change and being messy while eating. Additionally, time in treatment, the location of eating and relationship with those present during eating influenced emotions. Some participants indicated a positive impact of orthodontic appliances on their diet. CONCLUSIONS: These results can be used to further inform dietary advice offered to patients. Factors were identified which may not be considered in clinical practice but which could improve the value of dietary advice given to patients.

Can crown-root ratio predict premolar eruption?

INTRODUCTION: The purpose of this study was to establish a method to prospectively predict the eruption of mandibular second premolars with panoramic radiographs. This technique could be used clinically to optimize the timing of comprehensive treatment, detect abnormalities of development and eruption, or effectively estimate eruption timing and determine the need for early intervention because of caries or defects of the deciduous dentition. METHODS: Three hundred one white children from an orthodontic practice in Alaska between the ages of 6 and 16 years were examined and monitored with serial panoramic radiographs until all premolars had erupted. Eruption of the mandibular second premolar was predicted at the first examination based on the panoramic radiograph. When the mandibular second premolar erupted, a researcher measured the crown length to crown-plus-root length ratio on the radiograph using the Simpson and Kunos scale, and the prospectively predicted timing of eruption was compared with the actual timing. RESULTS AND CONCLUSIONS: The Simpson and Kunos scale allowed a rapid assessment for predicting the time of eruption of mandibular second premolars. The mean age of eruption of the mandibular second premolar in these children was 12.5 years.