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279
Several cases of speech defects which were thought to be
associated with malocclusion of the jaws have, following orthodontic
treatment, improved considerably This evidence appears to support
the recommendation that all cases referred for speech training at
the speech defects class should be first examined by a dental officer
to ascertain if the defect is in any way connected with dental
deformity.
An orthodontic scheme deals firstly with prevention, secondly
with early treatment, and finally with the correction of deformities
by special appliances.
As regards prevention, this is chiefly medical, but the dental
officers when they visit the child welfare centres are provided with
an opportunity to assist in this very necessary part of prophylactic
instruction. Advice would cover, among other items, the question
of suitable diet for the child, the education of the parent in the
dangers of bad habits, such as thumb, finger and toe sucking, and
the art of correct breathing and sleeping.
The early treatment of deformities includes the correction, by
suitable exercises, of the perverted action of the mouth muscles,
the judicious removal of temporary teeth which are likely to cause
mal-position of the permanent teeth, and the use of special
apparatus such as oral screens and lip exercisers to stop mouth
breathing.
With regard to orthodontic treatment the age for treatment
varies, but, as a general rule, if the deformity is severe it is not
desirable to attempt treatment after 11 years of age. Some cases
of mal-position of the teeth can be treated quite successfully at a
later age; in fact, many cases of close bite cannot be treated effectively
until all the premolar teeth have erupted. The stage of
development of the child is the factor upon which the time for
commencing or postponing treatment is based.
A survey of the incidence of malocclusion was taken during the
year, and it was found that out of 15,067 children examined 578
had definite dental deformities, i.e., 3.7 per cent. of those children
inspected. It is, of course, impossible for all these cases to be
treated each year, and only those of very marked deformity, in
which it was felt that the child would suffer aesthetically, and
those in whom the risk of danger to the general health could not
be overruled, were selected for treatment.