Orthodontic
problems are becoming more prevalent in our dogs and cats mostly
due to selective breeding. They can occur in any breed and in mixed
breed dogs as well. Most orthodontic problems that effect the size
of the jaw are considered genetic, and the affected animals should
not be used for breeding. At this time, defects of tooth location
only are considered non-genetic, and may be treated. This may change
as more studies are done. The standards of the AVMA and ACVD are
that all animals are entitled to a healthy mouth, but not a perfect
mouth. Aesthetics are not considered important in our pet's teeth,
unless they are used in the show ring. If this is the case, then
the mouth is usually being corrected to win shows. The ultimate
goal to breed the patient for profit. Thus, the defect is passed
on to a new generation. This is why the standards are written,
and to correct them is to harm our patients. This means that a
malocclusion that is not causing any health problems should not
be fixed, as most orthodontic corrections are long term and require
numerous anaesthetic procedures. Which is not in the patient's
best interest. If orthodontic correction of a genetic problem is
elected, then the patient should be spayed or neutered.
This
being said there are times that orthodontic correction is in our
patient's best interest.
The
most common orthodontic problems that are treated are retained
deciduous teeth, base narrow, crossbite, overshot and undershot,
and wry bite.
The
most common orthodontic problem in small animal patients is retained
deciduous teeth. This is especially common in small breed dogs
(Maltese, Yorkshire terriers, and poodles). One of the many reasons
the baby teeth exfoliate is that the adult tooth puts pressure
on the base of the baby tooth and causes resorbtion of the root
structure. In these cases, the adult tooth does not line up correctly
with the deciduous tooth; therefore there is no pressure for the
baby tooth to come out. This will cause the adult tooth to be deviated
to the side, and have two teeth there. This is a problem for several
reasons. First, the adult tooth can erupt into an area that will
cause either soft tissue or tooth trauma. Second, it can cause
an increase in periodontal disease in the area. This is due to
the loss of the normal separation between teeth, as well as the
fact that the periodontium is not allowed to form correctly. The
malformed periodontium will occur very early (days) after the adult
tooth erupts. This does not mean full eruption, jut that the adult
tooth can be seen above the gumline. This will cause build up of
plaque and calculus in the area. Finally, the adult tooth may become
impacted. This condition is treated by interceptive
orthodontics (extraction of the deciduous tooth). This should
be done as soon as the adult tooth is seen erupting to avoid as
many of the problems as possible.
Another
common problem is base narrow lower canines. This can be due to
a tooth or jaw problem. The tooth variety can be caused by retained
deciduous lower canines. This is due to the fact that the adult
canines erupt lingual (or inside) the deciduous canines. The deciduous
tooth will cause the adult canines to deviate inwards. If there
are retained deciduous canines or the patient is base narrow with
its deciduous dentition, interceptive orthodontics should be performed
as soon as possible to hopefully avoid the problem. The lingual
deviation of the adult canines will usually cause palatine trauma
and patient discomfort. The jaw variety is due to a genetically
narrow jaw. There are two ways to treat this condition. If the
malocclusion is slight (usually a tooth problem), then an incline
plane or other orthodontic correction can push out the teeth.
If the problem is moderate to severe, or there is interlock with
the upper canines, then crown amputation
and pulp capping is usually the best choice. A wry bite, where
the two halves of a jaw don't grow at the same rate can also cause
this problem, and crown amputation is
indicated to relieve soft tissue trauma. Our experience has been
very unrewarding in treating wry bite orthodontically.
Undershot
(longer lower jaw) and overshot (longer upper jaw) are common problems
as well. Undershot jaws can be "Normal" for certain breeds
(Persian cats, Lhasa Apso, bull dogs, etc. These conditions can
cause problems by allowing for soft tissue trauma by the canines
not being in the proper alignment. Overshot jaws can cause the
lower canines to strike the upper canine or palate. Severe undershot
jaws can cause lip trauma. If the defect is mild and caught early
enough, the problem may be avoided. Sometimes, the jaw discrepancy
will only be temporary, and the jaws will want to correct over
time. However, the dental interlock will not allow the jaw to move.
For this reason, if this is discovered early enough, interceptive
orthodontics can be performed by extracting the deciduous teeth.
This will allow the jaws to move if they want to, but will not
make them do so. If the patient already has its permanent dentition
orthodontic treatment is difficult to impossible. If the teeth
are causing oral trauma, then crown amputation
and pulp capping is the treatment of choice.
Rostrally
displaced upper canines (Lance Effect) can be caused by a
retained deciduous upper canine or can be genetic in nature.
This is mostly seen in Shetland sheepdogs. This can cause periodontal
disease, as well as tooth attrition from striking the lower teeth.
This can be corrected by extraction of
the tooth, amputation and pulp capping,
or by orthodontic bands. If this
is genetic, the patient should be neutered prior to performing
orthodontic correction.
Crowded
and/or rotated teeth are commonly seen in small breed dogs, especially
the bracheocephalic breeds. The major problem they cause is that
they greatly increase periodontal disease in the area. These are
generally not orthodonticly treated, Posterior cross bite is where
the upper fourth premolar is inside the lower first molar. This
is most common in collies. Correction of this defect is very difficult
and is usually not necessary as the teeth function properly in
their new alignment.however extracting them
can improve the overall periodontal health of the animal.
Anterior
crossbite is where the upper incisors erupt behind the lower incisors.
This is usually not a problem for the patient, as it is usually
a "reverse scissors"
and comfortable. This can be corrected by orthodontic
appliance if it is due to a tooth problem. If it is a jaw problem,
this will be much more difficult and the patient should be neutered
prior to this lengthy process.
Posterior
cross bite is where the upper fourth premolar is inside the lower
first molar. This is most common in collies. Correction of this
defect is very difficult and is usually not necessary as the teeth
function properly in their new alignment.