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

 

Dentist taking blood pressure.Before prescribing any medications — even lifesaving ones, such as those used to reduce blood pressure or prevent epileptic seizures — your health care professionals carefully weigh the benefits a drug offers against the possible risks of taking it, including its potential side effects. In most cases, the side effects are relatively slight: for example, drowsiness, an upset stomach, or minor aches. But in some individuals, particular drugs may produce side effects that are more troublesome.

This is sometimes the case with a class of drugs called calcium channel blockers (CCBs), which are commonly used to treat high blood pressure (hypertension) and certain other heart conditions. Some people who take these medications experience a condition called gingival hyperplasia, or an overgrowth of gum tissue. This effect has also been seen in some epileptics who take an anti-seizure medication called phenytoin.

Possible Side Effects

CCBs work by dilating (widening) the blood vessels, which makes it easier for the heart to pump blood. But in a small percentage of people, they also cause changes in the gums. Gum tissue may become thick and lumpy, and it may sometimes extend abnormally and start to cover the teeth. This change in appearance can cause social embarrassment, as well as discomfort and difficulty in chewing.

The overgrowth of gum tissue also makes it difficult or impossible to clean the spaces between teeth. This can cause a rapid deterioration in oral hygiene that may lead to full-blown gum disease if not treated promptly. And since poor oral hygiene is itself a contributing factor in gum overgrowth, the condition can easily spiral out of control.

In addition, some CCBs also reduce saliva flow. This may not only cause the mouth to feel dry, but may also severely reduce saliva's protective effects on the teeth and gums.

What To Do About Gum Overgrowth

Gum Overgrowth.It's always a good idea to tell your health care providers about any side effects you may be experiencing as soon as you notice them. However, even though gum tissue overgrowth may be a worrisome issue, it doesn't mean you should stop taking your blood pressure medication! There are several options for controlling this condition, which should be discussed with all members of your medical team.

With your doctor's consent, it may be possible for you to change your dosage or switch to a different blood pressure medication that produces fewer side effects. It can take a few months for your gums to return to normal after the change, while you are maintaining good oral hygiene at home. But even if it's not possible for you to change your medication, there are a number of in-office treatments that can be used to help alleviate the problem.

Non-surgical treatments like scaling and root planing (a type of deep cleaning) are sometimes the first step to controlling gum overgrowth. These relatively minor procedures can dramatically improve your overall oral hygiene. If necessary, they may be followed by surgical treatments to remove overgrown tissue and eliminate periodontitis — a serious condition which, if left untreated, could result in tooth loss.

In addition to regular dental cleanings, you will need to be extra vigilant at home: proper brushing technique and the use of interdental cleaners (such as floss) are needed to clean the spaces between teeth is a must. Your progress will be monitored at follow-up dental visits as needed.

While gum tissue overgrowth may seem a daunting problem, experience has shown that it can be successfully controlled by initial periodontal therapy, good at-home care, and frequent follow-up visits. Meanwhile, you should continue to follow all of your doctors' recommendations for maintaining a healthy blood pressure.

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Blood Pressure Medications An important class of drugs used for treating high blood pressure can sometimes cause an overgrowth of gum tissue. This in turn can affect your appearance, and your ability to clean your teeth. Your dentist can help you get the situation under control... Read Article