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CE Showcase Orthodontics Supporting Your Practice

CE Showcase ASM 2017: Orthodontic Assessment: Where There is Smoke, There is Fire!


I had a real pleasure speaking with Dr. Tim Agapas, who will be speaking at ASM 2017 in May. Tim shared some slides from his upcoming presentation and promised to come back to show us some of his very interesting cases. 

Chiraz Guessaier, CDA Oasis Manager


This presentation covers diagnostic information pointing to growth, occlusal and dental problems prior to becoming complicated orthodontic treatment concerns.

Orthodontic and occlusal issues can usually be identified and diagnosed at an early age. If the patient and parent are informed at an appropriate age, future orthodontic treatment can usually be optimized and significant orthodontic treatment avoided.

Current research advocates intervention whenever possible to interrupt undesirable occlusal and orthodontic relationships to promote optimal growth and occlusal function.

Learning Objectives

  • Identify facial, skeletal and dental criteria that will enable diagnosis of developing orthodontic and occlusal concerns
  • Outline potential treatment options to address occlusal and orthodontic problems based on the underlying ethology
  • Suggest referral and treatment timing to provide intervention for optimal results

Tim’s session runs on May 4th 2:00 – 4:30 pm




  1. Mark Antosz March 29, 2017

    I feel that crossbites (especially anterior or unilateral posterior) should be evaluated and probably treated in the primary dentition. The barometer I use is that if they can handle a prophy and fluoride, then they can handle the simple expansion and maxillary protraction that is required to manage their problems. Of all things we do in ortho, this can be the biggest bang for the buck. Even for the Class IIIs. It’s amazing what you can accomplish (and no, they won’t just grow out of it. Ever).
    Speaking of “smoke and fire” is being aware of dental compensations, especially in Class IIIs. If there is no anterior crossbite, but the upper incisors are proclined and/ or the lowers are retroclined, they could be camouflaging a skeletal Class III. Often these get missed unless you have a keen diagnostic eye, and then the growth spurt comes and “Oops. Guess you need jaw surgery.” You HAVE to manage Class IIIs properly in the mixed dentition otherwise you’ve missed the boat completely. And with this comes a good diagnostic eye. If you just thing about what the occlusion would look like if the teeth were a normal inclination, then you’ll be able to see past the compensations, get the early treatment and avoid unpleasant circumstances in the future. THAT is truly seeing the smoke…

  2. B. Günay April 15, 2017

    I completely agree with Mark Antosz. I believe other then crossbites, the age for first ortho consultation should be around 7, and 4-5 for crossbites.

    Unfortunately I am seeing a lot of wait and see with the young patients I refer.


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