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

 

In the future, could small cavities be detected early and filled without anesthesia, and with only the minimum removal of tooth material? Will routine dental procedures be performed with patients noticing no vibration or pressure? Will the piercing whine of a dental drill be a sound that's heard in dental offices no more? The answer may well be yes — in fact, it's happening right now with air abrasion technology.

The air abrasion instrument is a hand-held tool that dentists use for a variety of purposes. A bit like a mini-sandblaster, it uses compressed air (or another gas) to produce a fine stream of abrasive particles that can be precisely aimed. The small, high-speed particles (often silica or aluminum oxide) remove tiny bits of material in the decayed portion of the tooth; the debris is then whisked away through a suction tube.

Sound futuristic? It is, but it's not exactly new: Air abrasion instruments were first developed in the 1940's, but recent advances in high-volume suction and improved dental restoration materials have given the process a renewed appeal. Some of the uses for air abrasion tools include: removing dental caries (cavities) and filling them with composite (tooth-colored) material; preparing teeth for bonding, veneering or other procedures; and removing stains or even repairing small defects in teeth.

How It Works

The tiny abrasive particles (.002” or less in diameter) remove only minute amounts of tooth structure, making a drill seem coarse by comparison. The air pressure, flow rate, nozzle diameter, and other settings on the instrument can be accurately controlled to produce the precise amount of abrasion needed. The result is a minimally-invasive method of removing decayed or unwanted tooth material.

Even though powerful suction is used to remove spent abrasive and debris, it's still necessary for everyone to wear protective eyewear as a precaution. A rubber dam (shield) is also generally used to keep abrasive particles from affecting other teeth or getting into areas of the mouth where they don't belong. Nearby teeth and gums can also be coated with a protective resin if needed.

Advantages of Air Abrasion

Because it doesn't require a whirring drill, air abrasion generates no pressure or vibration, and makes very little noise. It can eliminate the need for anesthesia, especially if the cavity isn't deep. It reduces the chance of damaging the tooth during a procedure, and it leaves more healthy tooth material behind. This makes it ideal for children, or others who are sensitive to dental discomfort. In fact, it's perfect for treating tiny cavities that have been detected by laser diagnosis (cavities that aren't big enough to be seen on an X-ray), and sealing them up before they become bigger problems.

Minimally-invasive procedures are where air abrasion truly shines. Because it's a relatively fine-scale instrument, it isn't suitable for treating deep cavities or removing old metal fillings. However, as a high-tech tool for performing many preventive and restorative dental procedures, it offers some unique benefits to both dentist and patient. And some day, it just might make the dental drill obsolete.

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