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By Dai Roberts-Harry, Jonathan Sandy, British Dental Association

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The use of dental wax over the bracket may help to reduce trauma and discomfort, (Fig. 10) as may rubber bumper sleeving on the unsupported archwire (Fig. 11). BRITISH DENTAL JOURNAL VOLUME 196 NO. qxd 12/12/2003 12:28 Page 75 PRACTICE bow must incorporate a safety feature. Failure to observe safety guidelines on the use of headgear is medico-legally indefensible. Fig. 10 Dental wax placed over a bracket can ease the pain of ulceration in the lip and mucosa EXTRA-ORAL RISKS Allergy Allergy to nickel is more common in extra-oral settings, most usually the headgear face bow or head strap.

Patient assessment and examination I 3. Patient assessment and examination II 4. Treatment planning 5. Appliance choices 6. Risks in orthodontic treatment 7. Fact and fantasy in orthodontics 8. Extractions in orthodontics 9. Anchorage control and distal movement 10. Impacted teeth 11. Orthodontic tooth movement 12. Combined orthodontic treatment 1Senior Specialist Registrar in Orthodontics; 3Professor of Orthodontics, Division of Child Dental Health, University of Bristol Dental School, Lower Maudlin Street, Bristol BS1 2LY; 2*Consultant Orthodontist, Orthodontic Department, Leeds Dental Institute, Clarendon Way, Leeds LS2 9LU *Correspondence to: D.

Dilacerated teeth should be carefully assessed to see if crown alignment is achievable. Often extraction of these teeth is the only option. Macrodont teeth, geminated or fused, need careful consideration (Fig. 1). The aesthetics are often poor but extraction can result in an excess amount of space, which may prolong orthodontic treatment. Where supplemental teeth are present, extraction may result in spontaneous correction of any crowding (Fig. 2). BRITISH DENTAL JOURNAL VOLUME 196 NO. qxd 27/01/2004 10:09 Page 197 PRACTICE EASE OF EXTRACTION, AND THE PRESENCE OF IMPACTED TEETH The extraction of teeth is a potentially traumatic experience.

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