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

 

Malocclusions are fairly common in children (as well as adults). While some malocclusions are so minor that no treatment would provide a demonstrable benefit, serious malocclusions may require intervention in the form of appliances such as braces.

For this reason, regular dental checkups are critical because they provide an opportunity for a dental professional to spot small problems before they become big ones. During a routine exam, your dentist may be able to determine if the child's jaws are growing properly and at the same rate.

If your child has any of the following symptoms, a more detailed orthodontic exam may be called for:
  • "Loose" jaws that can be easily shifted around or make popping noises when opening or closing
  • Abnormal bite relationship (teeth that don?t match up well when biting)
  • Baby teeth that are lost too early or too late
  • Biting the cheek or roof of the mouth
  • Breathing through the mouth excessively (instead of through the nose)
  • Disproportionate teeth or jaws
  • Problems with biting down or chewing food
  • Teeth that have become crowded, knocked out or in the wrong place
  • Thumb-sucking or finger-sucking
Benefits of early treatment in children

Here are just some of the benefits of catching problems early:
  • Avoiding impacted teeth
  • Avoiding more costly and lengthy orthodontic treatments in later life
  • Avoiding soft tissue and palate injuries from protruding teeth
  • Bad habits like thumb- or finger- sucking can be corrected
  • Correcting breathing, speaking, swallowing or eating problems
  • Creating space for newly erupting or future erupting teeth
  • Erupting teeth and jaws can be gently glided into their correct positions
About early extractions

Extracting a tooth (either primary of permanent) before its time can sometimes do more harm than good.

There are reasonable instances, and good cause, however, for extracting teeth early in a child.

Common justifications for an early tooth extraction include preserving space for other incoming teeth to avoid crowding and possible impacted teeth later on, or to clear an obstructed tooth that is preventing a jaw from forming correctly.

As your child grows

Orthodontists employ a wide variety of "growth modification" techniques to help nature correct problems as your child grows.

Orthodontic appliances can do wonders as your child develops. For example, an appliance may stave off problems with an upper or lower jaw that isn't growing at the same rate as the other, or correct problems that are creating difficulties with chewing or swallowing.

Whatever the cause, orthodontic treatment during your child's development will reap substantial dividends in adult life, including avoidance of possible surgery, improved oral health and improved self-esteem.

Typically, children between the ages of 10 (usually girls) and 12 (usually boys) benefit greatly from procedures designed to correct jaw length and width problems.

Keep in mind that orthodontic treatment involves a firm commitment from the child, as well as the parent. The kinds of changes such treatment is designed for sometimes take years to fully realize their benefit. Also bear in mind that even the most dedicated commitment is no guarantee of permanent results. Nature sometimes has a way of taking over, and in limited cases, relapses can occur later on.