CE: Permission To Intercept by Dr. Michael K. DeLuke

Short course description
This course contrasts the current symptom-driven approach to interceptive orthodontic treatment with a new approach that focuses on diagnosing and treating the etiology of the malocclusion. The presented clinical case study demonstrates the results that can be achieved with an etiologybased approach to the interceptive treatment of preadolescent patients.

Synopsis
For more than 100 years, orthodontists have debated the value of interceptive treatment, especially as it pertains to the management of crowding in preadolescent patients who present in the early mixed dentition. The existing, antiquated paradigm is one that focuses on treating the symptom, but it is time to shift that paradigm to one that is more proactive and less reactive—one that focuses on the diagnosis and treatment of the etiology of the malocclusion.

From an evolutionary perspective, dental crowding is a relatively new phenomenon that has largely emerged over the past 300 years. The dramatic increase in the prevalence and severity of dental crowding in preadolescent patients is the result not of increases in tooth size but the narrowing of the dental arches, secondary to environmental factors such as airway obstruction and a soft diet. As such, when we focus solely on addressing the crowding, we are incorrectly taking a symptom-based approach to treatment. Instead, we must first determine the underlying etiology of the malocclusion and then develop a treatment plan to address it. When we do, we can have a profound, life-changing impact on the physical and psychological health and well-being of our patients.

Learning objectives
At the end of this course, you should be able to:

1. Recognize the paradigm shift occurring in the diagnosis and treatment of malocclusion in preadolescent patients.
2. Describe the interconnectivity of the structures of the craniofacial complex as it pertains to the development of malocclusion.
3. Correctly identify the etiology of dental crowding in preadolescent patients.
4. Explain how airway obstruction can contribute to the development of malocclusion.
5. Recognize the clinical signs of airway obstruction in preadolescent patients.
6. Develop an etiology-based treatment plan for a preadolescent patient who presents with dental crowding in the early mixed dentition.

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