The American Association of Orthodontists recommends that all children see an orthodontist by at least age seven and sooner if something is obviously wrong before age seven. Fortunately, most young patients don't need anything more than observation while the permanent teeth are growing into place.

Many young patients have problems, which will not, or should not wait. Most orthodontic problems are inherited and cannot be totally prevented; however something can usually be done before these problems become more difficult and more expensive to manage.

It is advisable to consult with an orthodontist prior to having your dentist remove any baby teeth or permanent teeth. To ensure the best overall dental and facial development, all patients should have an orthodontic consultation sometime between the ages of four and seven.

Dr. Bock offers early examinations and observation consultations. Contact us to schedule a complimentary consultation.

Classifications of Teeth

The classification of bites is divided into three main categories: Class I, II, and III. This classification refers to the position of the first molars, and how they fit together.

Class I
Class I is a normal relationship between the upper teeth, lower teeth and jaws or balanced bite.


Class I normal



Class I crowding

 

Class I spacing
 

 

Class II
Class II is where the lower first molar is posterior (or more towards the back of the mouth) than the upper first molar. In this abnormal relationship, the upper front teeth and jaw project further forward than the lower teeth and jaw. There is a convex appearance in profile with a receding chin and lower lip. Class II problems can be due to insufficient growth of the lower jaw, an over growth of the upper jaw or a combination of the two. In many cases, Class II problems are genetically inherited and can be aggravated by environmental factors such as finger sucking. Class II problems are treated via growth redirection to bring the upper teeth, lower teeth and jaws into harmony.

 

 
Class II division 1

 
 
Class II division 2

 

 

Class III
Class III is where the lower first molar is anterior (or more towards the front of the mouth) than the upper first molar. In this abnormal relationship, the lower teeth and jaw project further forward than the upper teeth and jaws. There is a concave appearance in profile with a prominent chin. Class III problems are usually due to an overgrowth in the lower jaw, undergrowth of the upper jaw or a combination of the two. Like Class II problems, they can be genetically inherited. Class III problems are usually treated via surgical correction of one or both jaws.

 
Class III functional or dental

 
 
Class III skeletal

 

 

Orthodontic Problems

 
Overjet
Upper front teeth protrude


 
 
Deep bite
Upper front teeth cover lower front teeth too much

 
 
Underbite
Lower front teeth protrude


 
 
Open bite
Back teeth are together with space between the front teeth


 

Crowding
Upper and/or lower teeth are crowded


 

Excess Spacing
There is excess space between teeth


 

Mid-Line Misalignment
Mid-lines of upper and lower arches do not line up

 

Crossbite
Upper back teeth fit inside lower teeth

Phases of Treatment

Phase I: Treatment usually takes 12 to 18 months and is done between the ages of 7-9. A variety of appliances may be used to correct specific problems.

Maintenance / Recall Phase: During the time between the first and second phase the patient will be seen every few months per year. This is to monitor the eruption of the permanent teeth and exfoliation of primary teeth.

Phase II (if required): During the first phase of treatment Dr. Bock has no control over 16 unerupted permanent teeth. If they grow in and problems still exist, further treatment, known as Phase II, will be required. A separate fee will be quoted at that time. Treatment usually takes 12-24 months.

Full Treatment: If you decide to wait, treatment will be started when all permanent teeth have erupted. Full treatment usually takes 18-30 months. The length of treatment depends on the severity of malocclusion and orthodontic problems.

Proper Braces Care and Brushing Techniques

Brushing and flossing your teeth can be challenging when wearing braces but it is extremely important that you do both consistently and thoroughly.

 
 
 


Foods to Avoid During Treatment: Eating proper foods and minimizing sugar intake are essential during orthodontic treatment. Your braces can be damaged by eating hard, sticky, and chewy foods.

  • Hard foods : Nuts, Candy, Hard Pretzels
  • Crunchy foods : Popcorn, Ice, Chips, etc.
  • Sticky foods : Gum, Chewy Candy (Skittles, Taffy, Gummy Bears, Caramel, etc.)
  • Chewy foods : Bagels, Hard Rolls, etc.
  • Foods you have to bite into : Corn on the Cob, Apples, Carrots (cut these foods up into smaller pieces and chew on back teeth)
  • Chewing on Hard Objects (for example, pens, pencils or fingernails) can damage the braces. Damaged braces will cause treatment to take longer.

Hard Foods

 

Soft Foods

 

Patient Rights

  • You have a right to choose your own dentist and schedule an appointment in a timely manner.
  • You have a right to know the education and training of your dentist and the dental care team.
  • You have a right to arrange to see the dentist every time you receive dental treatment, subject to any state law exceptions.
  • You have a right to adequate time to ask questions and receive answers regarding your dental condition and treatment plan for your care.
  • You have a right to know what the dental team feels is the optimal treatment plan as well as the right to ask for alternative treatment options.
  • You have a right to an explanation of the purpose, probably (short and long term) results, alternatives and risks involved before consenting to a proposed treatment plan.
  • You have a right to be informed of continuing health care needs.
  • You have a right to know in advance the expected cost of treatment.
  • You have a right to accept, defer or decline any part of your treatment recommendations.
  • You have a right to reasonable arrangements for dental care and emergency treatment.
  • You have a right to receive considerate, respectful and confidential treatment by your dentist and dental team.
  • You have a right to expect the dental team members to use appropriate infection and sterilization controls.
  • You have a right to inquire about the availability of processes to mediate disputes about your treatment.

(Adopted by the American Dental Association in 2009)

Your Responsibilities as a Patient

  • You have the responsibility to provide, to the best of your ability, accurate, honest and complete information about your medical history and current health status.
  • You have the responsibility to report changes in your medical status and provide feedback about your needs and expectations.
  • You have the responsibility to participate in your health care decisions and ask questions if you are uncertain about your dental treatment or plan.
  • You have the responsibility to inquire about your treatment options and acknowledge the benefits and limitations of any treatment that you choose.
  • You have the responsibilityfor consequences resulting from declining treatment or from not following the agreed upon treatment plan.
  • You have the responsibilityto keep your scheduled appointments.
  • You have the responsibilityto be available for treatment upon reasonable notice.
  • You have the responsibilityto adhere to regular home oral health care recommendations.
  • You have the responsibilityto assure that your financial obligations for health care received are fulfilled.

(Adopted by the American Dental Association in 2009)

American Dental Association Leads Fight for Patient Rights

The American Dental Association has supported legislation that will set a few basic rules to promote high-quality care and protect patients in an increasingly bottom line-driven health care system.

ADA member dentists have been instrumental in moving the patients' rights issue into the national spotlight. The nation appears closer than ever to finally seeing a comprehensive patients' bill of rights passed into law.

While Congress debates various versions of patient rights legislation, the insurance and managed care industries have long supported legislation that would fail to protect all privately insured Americans against unfair delays and denials of coverage by their health plans, according to the ADA. Some ill-fated bills left out critical protections, such as guaranteeing people the option of choosing their own doctors or creating mechanisms to address patients' grievances against health plans. One proposal even omitted freestanding dental plans, which could have left more than 120 million dental patients without these vital protections.

The American Dental Association continues to lobby for the enactment of bipartisan legislation to help ensure that health plans treat patients fairly and do not discriminate against dentists. Here are some of the key issues identified by the ADA:

  • Coverage for freestanding dental plans, which account for the vast majority of Americans who have dental coverage.
  • Patient choice, by guaranteeing access to at least one plan with a point-of-service option that allows patients the opportunity to choose their own doctors.
  • Health plan accountability, through the availability of impartial, external review and by holding plans accountable when their decisions to delay or deny care harm patients.