Anterior bite plate is an orthodontic appliance used primarily to manage various dental issues, particularly those related to occlusion and alignment of the anterior teeth. It is a removable appliance that is placed in the mouth to help correct bite discrepancies, improve dental function, and protect the teeth from wear.

Indications for Use

1. Anterior Crossbite:

   • An anterior bite plate can help correct an anterior crossbite by repositioning the maxillary incisors in relation to the mandibular incisors.

2. Open Bite:

   • It can be used to help close an anterior open bite by providing a surface for the anterior teeth to occlude against, encouraging proper alignment.

3. Bruxism:

   • The appliance can protect the anterior teeth from wear caused by grinding or clenching, acting as a barrier between the upper and lower teeth.

4. Space Maintenance:

   • In cases where anterior teeth have been lost or extracted, an anterior bite plate can help maintain space for future dental work or the eruption of permanent teeth.

5. Facilitation of Orthodontic Treatment:

   • It can be used as part of a comprehensive orthodontic treatment plan to help achieve desired tooth movements and improve overall occlusion.

Design and Features

• Material: Anterior bite plates are typically made from acrylic or thermoplastic materials, which are durable and can be easily adjusted.
• Shape: The appliance is designed to cover the anterior teeth, providing a flat occlusal surface for the upper and lower teeth to meet.
• Retention: The bite plate is custom-fitted to the patient’s dental arch to ensure comfort and stability during use.

Mechanism of Action

• Repositioning Teeth: The anterior bite plate can help reposition the anterior teeth by providing a surface that encourages proper occlusion and alignment.
• Distributing Forces: It helps distribute occlusal forces evenly across the anterior teeth, reducing the risk of localized wear or damage.
• Encouraging Proper Function: By providing a stable occlusal surface, the bite plate encourages proper chewing and speaking functions.

Management and Care

• Patient Compliance: For the anterior bite plate to be effective, patients must wear it as prescribed by their orthodontist. This may involve wearing it during the day, at night, or both, depending on the specific treatment goals.
• Hygiene: Patients should maintain good oral hygiene and clean the bite plate regularly to prevent plaque buildup and maintain oral health.
• Regular Check-Ups: Follow-up appointments with the orthodontist are essential to monitor progress and make any necessary adjustments to the appliance.

Growth is the increase in size It may also be defined as the normal  change in the amount of living substance. eg. Growth is the quantitative aspect and measures in units of increase per unit of time.

Development

It is the progress towards maturity (Todd). Development may be defined as natural sequential series of events between fertilization of ovum and adult stage.

Maturation

It is a period of stabilization brought by growth and development.

CEPHALOCAUDAL GRADIENT OF GROWTH

This simply means that there is an axis of increased growth extending from the head towards feet. At about 3rd month of intrauterine life the head takes up about 50% of total body length. At this stage cranium is larger relative to face. In contrast the limbs are underdeveloped. 

By the time of birth limbs and trunk have grown faster than head and the entire proportion of the body to the head has increased. These processes of growth continue till adult.  

SCAMMON’S CURVE

In normal growth pattern all the tissue system of the body do not growth at the same rate. Scammon’s curve for growth shows 4 major tissue system of the body;

• Neural

• Lymphoid 

• General: Bone, viscera, muscle.

• Genital

The graph indicates the growth of the neural tissue is complete by 6-7 year of age. General body tissue show an “S” shaped curve with showing of rate during childhood and acceleration at puberty. Lymphoid tissues proliferate to its maximum in late childhood and undergo involution. At the same time growth of the genital tissue accelerate rapidly. 

Mouth Breathing

Mouth breathing is a condition where an individual breathes primarily through the mouth instead of the nose. This habit can lead to various dental, facial, and health issues, particularly in children. The etiology of mouth breathing is often related to nasal obstruction, and it can have significant clinical features and consequences.

Etiology

• Nasal Obstruction: Approximately 85% of mouth breathers suffer from some degree of nasal obstruction, which can be caused by:
  • Allergies: Allergic rhinitis can lead to inflammation and blockage of the nasal passages.
  • Enlarged Adenoids: Hypertrophy of the adenoids can obstruct airflow through the nasal passages.
  • Deviated Septum: A structural abnormality in the nasal septum can impede airflow.
  • Chronic Sinusitis: Inflammation of the sinuses can lead to nasal congestion and obstruction.

Clinical Features

1. Facial Characteristics:

   • Adenoid Facies: A characteristic appearance associated with chronic mouth breathing, including:
     • Long, narrow face.
     • Narrow nose and nasal passage.
     • Short upper lip.
     • Nose tipped superiorly.
     • Expressionless or "flat" facial appearance.

2. Dental Effects (Intraoral):

   • Protrusion of Maxillary Incisors: The anterior teeth may become protruded due to the altered position of the tongue and lips.
   • High Palatal Vault: The shape of the palate may be altered, leading to a high and narrow palatal vault.
   • Increased Incidence of Caries: Mouth breathers are more prone to dental caries due to dry oral conditions and reduced saliva flow.
   • Chronic Marginal Gingivitis: Inflammation of the gums can occur due to poor oral hygiene and dry mouth.

Management

1. Symptomatic Treatment:

   • Gingival Health: The gingiva of mouth breathers should be restored to normal health. Coating the gingiva with petroleum jelly can help maintain moisture and protect the tissues.
   • Addressing Obstruction: If nasal or pharyngeal obstruction has been diagnosed, surgical intervention may be necessary to remove the cause (e.g., adenoidectomy, septoplasty).

2. Elimination of the Cause:

   • Identifying and treating the underlying cause of nasal obstruction is crucial. This may involve medical management of allergies or surgical correction of anatomical issues.

3. Interception of the Habit:

   • Physical Exercise: Encouraging physical activity can help improve overall respiratory function and promote nasal breathing.
   • Lip Exercises: Exercises to strengthen the lip muscles can help encourage lip closure and discourage mouth breathing.
   • Oral Screen: An oral screen or similar appliance can be used to promote nasal breathing by preventing the mouth from remaining open.

• Types: Petit, Delaire
• Reverse pull headgear = Facemask
• Force direction: Downward & backward
• Hooks location: Canine-primary molar area
• Wear duration: 12 – 14 hrs/day
• Natural implants: Primary canines
• Relapse rate: 25 – 30%
• Successful RME activation: Midline diastema
• Force by RME: 10 – 20 lbs
• Force by slow expansion: 2 – 4 lbs
• Quadhelix skeletal:dental expansion: 1:2