The Importance Of An Accurate Health History
Dr. Allen Garai, a Diplomate of the American Board of Orthodontics with over 15 years of experiance and practicing in Vienna and Great Falls, VA, asks every patient to fill out a comprehensive health history form, including allergies and current medications. You may wonder why this is necessary in an orthodontic office.
In fact, in dentistry as well as in orthodontics, there are numerous health conditions and medications that can have a significant impact on the success of treatment. For example, diabetes is a common systemic disease among adults and children that is well documented in scientific literature as a possible cause of the loss of bone that supports the teeth, leading to gum disease, loosening of the teeth and possible tooth loss. It is extremely important to know if a patient has been diagnosed with diabetes before any orthodontic treatment begins, or if diabetes is diagnosed during treatment. Patients must receive close monitoring by their physician to assure that the diabetes is under control. An orthodontic treatment plan will be chosen to minimize any possible effects of diabetes.
Another disease that may not seem relevant to orthodontic treatment is rheumatoid arthritis. This disease affects the joints and can have effects in the jaw joint (temporomandibular joint) as well. In both adults and children with rheumatoid arthritis, there can be a gradual or rapid destruction of bone in the condylar process of the lower jaw (the part of the lower jaw which is attached to the skull, in the area in front of the ears). Loss of bone in this area can cause the lower jaw to appear shorter as it drops back and down, causing an appearance of a recessive lower jaw, or overbite, as the lower jaw rotates downward and backward. This process adversely affects the bite (the relationship between the upper and lower teeth in chewing or when the mouth is closed) and also changes the apparent skeletal pattern and the appearance of the face. This process can continue to progress, or it may stop and then recur later. Occasionally, these symptoms are among the first to develop during the onset of rheumatoid arthritis. Obviously, it is very important to tell the orthodontist about any history of rheumatoid arthritis.
Dr. Garai will also ask about any history of allergies. An increasing problem today is sensitivity to latex, which is commonly used in the gloves that are used to protect patients from any possibility of cross contamination. Latex is also used in the manufacture of most orthodontic rubber bands, which are needed in the treatment of many patients. In the case of latex allergy, our office will use non-latex gloves and special non-latex rubber bands in order to avoid any problems for our patients.
An accurate list of current medications is also essential, because some medications may interfere with treatment. For example, some of our adult patients may be taking medications for treatment of osteoporosis, such as Fosamax or Actonel. These medications treat osteoporosis by slowing the loss of bone. However, the same process that slows the loss of bone will also greatly slow or even prevent the changes that need to occur in the bone around the teeth in order for the teeth to move during orthodontic treatment. As a result, a patient taking these medications (bisphosphonates) may respond very poorly to orthodontic tooth movement.
So, in order to provide the best treatment possible for all of our patients, Dr. Garai will request a complete and accurate health history, as well as requesting updates on any changes in our patients’ health or medications during orthodontic treatment. Your well-being is the focus of our practice and we strive to do everything possible to promote your orthodontic health.