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

 

Tooth Bonding - Step by Step.Firmly anchored in your jaw and protected by an outer coating of tough enamel, your teeth are remarkably strong — yet it's still possible for them to chip, crack, or even break. In fact, there is some evidence that today, our teeth are developing cracks at a record rate. This may be due to the fact that people are living longer (giving teeth more time to accumulate damage), or that our stress levels are increasing (which may cause teeth clenching and grinding).

Biting on hard objects, receiving a blow to the mouth, or having large cavities (or old amalgam fillings) that weaken the tooth's structure are also common causes of tooth fractures. But no matter of the cause, there are a number of symptoms that indicate a tooth may be cracked, and several treatments we can offer, depending on the severity of the injury.

Small chips on the edges or cusps of teeth often cause no symptoms, and can be treated by cosmetic bonding or other methods. Deeply fractured teeth, on the other hand, may be a serious problem. The sooner they are treated, the more likely it is that the affected tooth can be saved. Let's take a look closer look at the types of fractures teeth can develop, and the symptoms they may produce.

Minor Cracks (craze lines)
These tiny fissures in the outer enamel of the tooth often cause few or no symptoms; in fact, most don't require treatment. If you are having tooth pain, however, these cracks will need to be evaluated and possibly treated. That's because without a careful examination, there is no way to know for sure whether these cracks go into only the enamel, or if they penetrate into the dentin (inner body) of the tooth. While the tiniest craze lines don't show up on X-rays, they can often be detected by feel (using a small instrument called an explorer), by having you close down on a “bite stick,” or by using special dye stains or high-magnification instruments.

Vertical Cracks
Cracked tooth.This type of crack often starts at the chewing surface and extends toward the roots — but may it also begin in the root and continue toward the crown. Either way, it doesn't completely separate the tooth into two parts. Depending on the extent of the fracture, you may feel only minor discomfort that occurs in response to temperature changes (with hot or cold beverages, for example); or, it may produce sharp pain when you chew. In any case, you shouldn't ignore the symptoms, because cracked teeth require dental treatment quickly to keep them from progressing further. If the cracks continue to progress, tooth extraction may become necessary.

Deep Fractures or Split Teeth
When serious fractures occur, you'll know it: The distinct parts of the tooth can be separated from each other, and tooth's pulp is often inflamed and painful. This condition requires immediate treatment, and it's rarely possible to save the affected tooth.

Treatment for Cracked Teeth
What treatment is best for a cracked tooth depends on the extent and the severity of the damage. If a small crack is detected early enough, it's often possible to seal the fissure with restorative materials. For larger cracks that involve the pulp of the tooth, root canal treatment is generally required. Afterward, the visible structure of the tooth may be restored with a crown or “cap.” Sometimes, additional procedures may be recommended to try and save the tooth. In the most severe cases, however, the tooth will need to be extracted.

The preferred treatment for cracked teeth is — you guessed it — prevention! Wearing proper protective equipment (including a custom-fitted mouthguard) when playing sports, and staying alert to dangerous situations (like distracted or impaired driving) can help keep you safe. So can regular dental checkups, where your teeth are examined carefully for early signs of a problem. However, if you experience any symptoms that could indicate a cracked tooth, don't wait: The sooner it's treated, the better the chance that we can save it.

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