Moderator:Summer is the peak of orthodontics again. Nowadays, many children have to go to the dental hospital to line up for braces in order to have a set of straight teeth, I would like to ask Director Li, is the rate of malocclusion higher than before? Li Song: According to the recent epidemiological survey results, the incidence of malocclusion is more than 60%, while the survey in the 1960s showed that the incidence of malocclusion at that time was less than 50%. Moderator: Is there a degree and type of malocclusion here? Li Song: Malocclusion is the growth and development process of children due to congenital or acquired factors caused by the abnormal alignment of teeth, misalignment of bite, as well as dental arch, jaws, craniofacial relationship is not adjusted. According to the Angell classification of malocclusion, more than half of the cases belong to Angell Class I malocclusion, while Angell Class II and Class III each account for about 20%. In layman’s terms, simple malocclusion accounts for the largest proportion of cases. “Diastema” is an An I III malocclusion and is much more prevalent in yellow than in white people. Anser type II refers to the upper teeth protruding forward, i.e. buck teeth, and “sky-bagging”. Moderator:What is the general cause of uneven teeth? Li Song:The imbalance of jawbone and tooth degeneration in modern people is an important reason. The jawbone of ancient people was much larger than that of modern people, and uneven teeth were rare. In the process of human evolution, due to changes in dietary habits, the masticatory organs have degenerated adaptively, and the degeneration of the jawbone is much greater than that of the teeth, so uneven teeth have appeared. Since the reform and opening up, people’s living standard has been improving, many parents pay attention to give their children some high nutrition food, but do not know that they should give their children some rough food with a certain degree of hardness to stimulate the chewing function to play, in order to facilitate the growth and development of the jaws. This simple “use in and waste out” is the reason why the number of children with misaligned teeth is increasing. Netizen: When can I see when my child has misaligned teeth? Li Song:Generally, it can be detected after all the baby teeth have erupted and the bite has been established. Moderator:Does that mean before the age of 3? Li Song:The time between 2 and 6 years old is called the period of the molars, during this period of time dental misalignment is relatively rare, even if there is misalignment generally do not need to correct. However, if the milk teeth appear “envelope” should be corrected, or the child has some bad habits, there are already some signs will occur misalignment should also be corrected, for example, the child after 4 years old and lip biting, finger sucking habits, should be promptly changed. And after weaning, you can give your child some coarse fiber, chewable food, to have a benign stimulation of his jaws. The host:The people also often say, eat something hard to make him grind his teeth. Li Song:Yes, it makes sense. Netizen: How can parents detect misalignment in their children at an early stage? Li Song:The easiest way is to see a dentist. Once a year, we should check the dentist because there are many problems that cannot be found by ourselves, such as abnormal occlusion or deep hidden caries, which are hard to find by ourselves. Moderator:So from the age of 4-5 years old, you need to see the dentist 1-2 times a year. Li Song:Yes, see regularly. Netizen:What is the age of oral malformation? Li Song: It can exist at any age, and will gradually manifest itself after tooth replacement, so the age of prevalence is around 10 years old, once it happens it will last a lifetime. The orthodontic treatment, 50% of patients need to extract teeth, brushing, persistence are very important Netizen: orthodontic treatment we know is usually wear braces, now there is no other way? Li Song: In fact, braces can be broadly divided into two categories of movable and fixed: the so-called movable braces is the patient can take off and wear the braces, fixed is only by the doctor to take off and wear, you can not take off the braces, 90% of patients are using fixed braces. Because the fixed braces treatment effect is better than the movable, movable only suitable for some simple malocclusion correction, such as the period of milk teeth correction generally do not use fixed braces. Netizen: Fixed braces are not very uncomfortable and painful to wear? Li Song: Generally speaking, the first week of wearing braces will be uncomfortable, there will be pain and bite discomfort, but after a week these symptoms will disappear. After wearing braces, eating will be a little affected, can not eat too hard food, and oral hygiene to pay attention to, after all, wearing braces will have an impact on oral hygiene, to pay attention to brush teeth. Moderator:Is there a high technical requirement for orthodontics? Li Song: each doctor’s clinical experience, technology will be different. There is also a special situation, although orthodontics is done by dentists, but not every dentist will do orthodontics. The orthodontic cycle is very long, usually two years, so our dentists learn orthodontics when they go to school rarely, and have not experienced the full cycle of treating a patient, so dentists who have just graduated from medical school usually do not do orthodontics. Like most of the doctors in our section are graduate students, to go through 3-6 years of postgraduate training, specializing in orthodontics, so orthodontists are specialists abroad. So you must find someone to do orthodontics to find a specialist trained orthodontist. Netizen: can I still insist on orthodontic treatment if my gums are bleeding during orthodontic treatment? Li Song: If the gum bleeding is mild, it does not affect the orthodontic treatment. If there is a serious gum redness, we must go to the periodontal treatment, you can first remove the wire, go to the periodontal department to do treatment, the gum situation improved before continuing orthodontics. Netizen: Why do all teeth have to be extracted when doing orthodontics? The main reason is that the jawbone development has degenerated and cannot accommodate so many teeth, so the number of teeth can only be reduced. Moderator: Where are the four teeth extracted? Li Song: the most common is the first premolar behind the tiger’s teeth, the purpose of extraction is to align the misaligned teeth; secondly, in order to collect the convex teeth, some people do orthodontic purposes is not good-looking teeth protruding; third is to adjust the upper and lower teeth bite relationship, sometimes also through the extraction of teeth to solve. Moderator: malformation correction generally speaking to last two years, what is the scientific reasoning? Li Song: two years is not absolute. To move the teeth in line with the physiological laws, generally every month to review, each time the doctor will adjust, add a little strength, generally need to review about 20 times to achieve results, a count down is almost two years, there are some simple malocclusion treatment can end in six months, a year. More serious malocclusion, or the patient’s lack of cooperation, will also lead to a longer course of treatment. Moderator: Why is the patient uncooperative? Li Song: Because orthodontics only once a month to the hospital, sometimes some treatment means such as hanging leather band traction is to be worn by the patient, some patients go back to the leather band a throw simply do not change, then the month will be delayed. Moderator: What kind of problems are most likely to occur when children do orthodontics? Li Song: the most common is the enamel demineralization, is not properly brushed teeth caused by bacteria corrosion of the tooth surface, this situation after the braces are removed in the tooth surface will remain discolored, so that later became a mouthful of neat rotten teeth, brush your teeth, maintain good oral hygiene can avoid this situation. Netizen: Is there any good way to make the child persevere during the orthodontic period. Li Song: or to encourage the main, we usually contact the patient 99% of the children can adhere to. Netizen: How to brush teeth correctly during the orthodontic period? Li Song: The so-called correct brushing is to brush the teeth clean, we used to teach children to brush their teeth vertically, but the orthodontic period can not brush vertically, so we need to choose a smaller brush head, softer bristles toothbrush, you can choose the children’s toothbrush, you can also choose the orthodontic toothbrush, mainly to brush around the braces, the braces around the place where food is easily retained. Toothbrush should be changed regularly, because the orthodontic period is particularly expensive toothbrush, it is recommended to change the toothbrush once a month or two. The use of flush is also a better way, it is through the high-pressure water column, the brush can not be clean, orthodontic use of such things is also better, the gums also play a massage effect. The braces are removed does not mean that the job is done, you still need to wear retainers to consolidate. The host: after the orthodontic treatment, will there still be misalignment? Li Song: After orthodontic treatment, you need to wear retainers to maintain the effect of treatment. Netizen: Will orthodontic teeth loosen easily when they get older? Li Song: This is a question that almost every patient asks. No, the physiological structure of the teeth decides that it can move, even without orthodontics teeth position is changing, orthodontics is the use of this principle, correction of malocclusion is beneficial to the long-term health of the teeth. Netizen: I hope you can give me a more complete answer about what I should pay attention to during orthodontic treatment. Li Song: The first food to pay attention to, not to bite particularly hard things, do not use the front teeth to chew things. Secondly, we should pay special attention to oral hygiene and brush our teeth after meals. Thirdly, after wearing orthodontic braces, most patients will experience varying degrees of discomfort such as soreness and swelling of the teeth or feel that the teeth are “soft” and cannot bite hard objects. In general, the pain or discomfort usually appears 2-3 hours after replacing the arch wire or adding force, reaches a peak within 1-3 days, and starts to gradually reduce after 4-5 days, and generally disappears after a week. You can take some methods to relieve the pain, such as gargling warm salt water and eating soft, easy-to-chew food. Netizen: Will the correction affect pronunciation? How to solve it? Li Song: It will not affect the pronunciation. Generally, braces are worn on the outer side of the teeth and will not affect the tongue. However, there is a way to wear braces on the inner side, because some people want to pursue aesthetics, which will affect the pronunciation. If you do not want to affect the pronunciation, this lingual orthodontic technique is not recommended. Moderator: The lingual orthodontic technique is mainly better looking, is it also costly? Li Song: Yes, mainly for some adults with special requirements, its operation is much more complicated than some ordinary orthodontic techniques, so its fees are three or four times higher than the general orthodontic. Children are not recommended to do lingual orthodontics. Netizen: The effect of correction is ideal, but this ideal effect needs to be consolidated? Li Song: This is also an important issue, not braces removed is a great success, for children at least two years to wear retainers to consolidate. The doctor will put a retainer on the patient on the day the braces are removed, and the patient can take it off and put it on himself. For the first six months, the retainer should be worn during the day and night as much as possible, and after six months, it can be worn every other day. Periodontal disease patients require lifelong maintenance after orthodontic treatment, otherwise it is easy to relapse. The host: wear this at night on the sleep is not affected? Li Song: no effect. Netizen: Adult teeth were very good, but slowly become uneven as they get older, what is the reason for this? Li Song: periodontal disease is a common cause, because of periodontal tissue disease, tooth loosening, uneven teeth, gaps in the teeth, etc. Moderator:What are the requirements for adults to be orthodontic? Li Song:Adult orthodontics is more complicated than children because of the oral environment, for example, there may be caries, periodontal problems, missing teeth, etc. For example, many patients with periodontal disease will have fan-shaped protrusion of the front teeth, so adult orthodontics is more complicated than children. The most healthy teeth are neatly arranged, a little yellowish in white, and with opposite cusps and sockets. Li Song: Severe malocclusion can lead to malocclusion and affect digestive function. There is also an impact on pronunciation, and individual sounds may not be pronounced properly. It also has an impact on the child’s self-confidence, which is important for the child’s life. Moderator:How can we prevent children from having bad teeth in the future? Li Song: It is very important to protect the milk teeth, don’t think that the milk teeth will not be protected when the teeth are changed in the future, many children don’t brush their teeth and go to sleep after eating milk, so it is easy to form caries, serious caries will cause the milk teeth to fall off prematurely, which will cause the teeth to be uneven after the teeth are changed, so it is very important to protect the milk teeth. Therefore, it is very important to protect the baby teeth. Also, proper chewing will stimulate the jaw bone and help to reduce the malocclusion in the future. We should also pay attention to whether the child has bad habits, some bad habits can cause serious malocclusion, and should be corrected as soon as they are found. Moderator: Time is up, please ask Director Li to conclude today’s topic. Li Song: Misalignment is actually not simply a problem of aesthetics, but also a modern disease that affects oral health, general health and psychology. I hope parents and children will pay attention to this problem, go to the hospital regularly for checkups, detect the problem in time and treat it early.