The International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD) guidelines for prevention of traumatic dental injuries: Part 7: Orthodontics for the prevention of dental and oral trauma

Many factors play a role in the cause of traumatic dental injuries (TDI). It is important for dentists to advise patients and their parents about the predisposing risk factors associated with some malocclusions. The vast majority of TDI occur in the maxillary anterior (upper front) teeth in young girls and boys. Two major factors that increase the risk of such injuries are an increased overjet (protruding upper teeth) and lip incompetence (lips do not close easily). Children with other conditions such as severe underbite, open bites, and crossbites are also more susceptible to TDI.

Consideration of these predisposing factors leads to the obvious question of whether orthodontic intervention for people with these conditions will help to prevent injuries to their teeth. Orthodontic treatment at an early age through the use of various functional fixed (braces) or removable (plates) appliances can help to reposition the teeth so that they are in a more favorable position and less susceptible to dental injuries.

Several scientific reviews have discussed this question. A Cochrane review concluded that “providing early orthodontic treatment for children with prominent upper front teeth is more effective for reducing the incidence of incisal trauma than providing one course of orthodontic treatment in adolescence.” Analia and Liu concluded “that providing early orthodontic treatment/two stages for children with prominent upper front teeth is more effective for reducing the incidence of upper front teeth trauma (incisal trauma) than providing one course of orthodontic treatment in adolescence.” Cobourne et al. concluded that “although early treatment does not result in improved overall outcomes when compared to later treatment, some consideration should be given to starting early when it is thought that there is a real increased risk of dental trauma or a child is being teased because of their overjet.”

Hence, there is sound scientific evidence to support early intervention through orthodontic treatment to reduce the likelihood of dental trauma in children whose teeth are in unfavorable positions. However, many other factors must also be considered by the parents and the treating dental practitioners when deciding whether to initiate orthodontic treatment at a young age.

All authors contributed to the development of this paper and approved its final form.

No funding was received for the presented work.

The authors declare there are no competing interests for the above manuscript.

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