Bad distal shoes
Let’s talk distal shoes!
*This distal shoe was placed by an outside provider.
CC: “My child says his gums hurt.”
Dx: over-retained and poorly placed distal shoe
Tx: replace distal shoe with band and loop or lower lingual holding arch
🔑: Distal shoes aren’t for everyone. If poorly done and left unsupervised, they can damage the developing tooth bud and/or interfere with its eruption. Here’s a few tips to mitigate the risks.
Take a post-operative film prior to cementation to ensure position and angulation of the blade is clinically acceptable. Note in this case the blade of the distal shoe (marked red) ends too anteriorly toward the path of the permanent second premolar. A more ideal position and angulation is marked in green.
Ensure the blade reaches below the height of contour of the permanent molar (marked by the yellow star along the yellow curve). This allows the molar to “ride up” the blade of the distal shoe into a favorable position. If the tip of the blade lies above the height of contour and the permanent molar’s path of eruption takes it more mesial than predicted, the permanent molar may get stuck underneath the blade (almost like the permanent second premolar in the picture).
Patient needs to be reliable with follow-up appointments. Prolonged placement of the distal shoe appliance is not ideal and it should be replaced with a band and loop or lower lingual holding arch as soon as possible (when the permanent molar erupts into the oral cavity).
#notjustbabyteeth #pedodontics #pediatricdentistry #pediatricdentist #dentalhealth #dentalstudents #dentalschool #dentallife #dentistlife #dentalcare #dentalwork #futuredentist #dentalphoto #dentalphotography #dentalart #odontogram #dentistrylove #instadentist #aestheticdentistry #estheticdentistry #orthodontics #endodontics #endodontist #oralpathology #oralsurgery #omfs #dentalsurgery
