Types of occlusal problem to refer in the deciduous dentition:
- Individuals with cleft lip and/or palate, or other craniofacial anomalies
- Severe maxillary/mandibular disproportion (but only if the parents are concerned, otherwise wait until the mixed dentition stage)
Types of occlusal problem to refer in the mixed dentition:
- Anterior or posterior crossbites with associated mandibular displacement
- Class III in the mixed dentition
- Class II/I malocclusion where there is an underlying skeletal II pattern. Most functional appliances are easiest to wear when the upper first premolars are fully erupted. Such a patient entering his or her pubertal growth spurt should be seen without delay
- Asymmetry in the pattern of tooth eruption (especially upper central incisors)
- Severely hypoplastic/carious first molars of poor long-term prognosis
- Lack of palpable canine bulges buccally at 10-12 years of age indicating palatal impaction
- Hypodontia (missing teeth); supernumerary teeth
- Submerged deciduous molars; impacted first permanent molars
- Periodontal problems caused by severely ectopic tooth position
- Severe crowding of incisors
Types of occlusal problem to refer in the permanent dentition: