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

 

Child drinking water.Fluoride, a naturally occurring mineral, is essential for proper tooth development and the prevention of tooth decay. In communities throughout the United States, tooth decay may still be a significant problem — but it is far less prevalent than it would have been, if not for the fluoridation of public water supplies. That's why the major associations of pediatric dentists and doctors support water fluoridation to the current recommended levels of 0.70 parts per million (ppm). It's also why the federal Centers for Disease Control and Prevention (CDC) has called fluoridated water one of the most significant health achievements of the 20th century.

Of course, not everyone has access to fluoridated water. That's one reason why a fluoride supplement is often recommended for your child and/or the use of toothpastes and other products that contain this important mineral. Because it is possible for children to get too much fluoride, it is best to seek professional advice on the use of any fluoride-containing product.

How Fluoride Helps

The protective outer layer of teeth, called enamel, is often subject to attacks from acids. These can come directly from acidic foods and beverages, such as sodas and citrus fruits — or sometimes through a middleman: the decay-causing bacteria already in the mouth that create acid from sugar. These bacteria congregate in dental plaque and feed on sugar that is not cleansed from your child's mouth. In metabolizing (breaking down) sugar, the bacteria produce acids that can eat through tooth enamel. This is how cavities are formed. When fluoride is present, it becomes part of the crystalline structure of tooth enamel, hardening it and making it more resistant to acid attack. Fluoride can even help repair small cavities that are already forming.

Delivering Fluoride to the Teeth

Correct amount of toothpaste for children.

Fluoride ingested by children in drinking water or supplements can be taken up by their developing permanent teeth. Once a tooth has erupted, it can be strengthened by fluoride topically (on the surface). Using a fluoride-containing toothpaste is one way to make sure your children's teeth receive helpful fluoride exposure daily. We recommend using only a pea-sized amount for children ages 2-6 and just a tiny smear for kids under two. Fluoride should not be used on children younger than six months. A very beneficial way to deliver fluoride to the teeth is with topical fluoride applications painted right onto your child's teeth and allowed to sit for a few minutes for maximum effectiveness.

How Much Is Too Much?

Teeth that are over-exposed to fluoride as they are forming beneath the gum line can develop a condition called enamel fluorosis, which is characterized by a streaked or mottled appearance. Mild fluorosis takes the form of white spots that are hard to see. In more severe cases (which are rare), the discoloration can be darker, with a pitted texture. The condition is not harmful, but may eventually require cosmetic dental treatment. Tooth decay, on the other hand, is harmful to your child's health and can also be quite painful in severe cases.

The risk for fluorosis ends by the time a child is about 9 and all the permanent teeth have fully formed. Since fluoride use is cumulative, all the sources your child comes in contact with — including powdered infant formula mixed with fluoridated tap water — need to be evaluated. While caution is advised, however, it would be a mistake to forgo the benefits that this important mineral can bring to your child's teeth — and his or her overall health.

Related Articles

   
Fluoride - Dear Doctor Magazine

Fluoride and Fluoridation in Dentistry The Center for Disease Control says that water fluoridation is “One of the ten most important public health measures of the 20th century.” Extensive systematic reviews of the evidence conclusively show that water fluoridation and fluoride toothpastes both substantially reduce dental decay. Learn why through the amazing fluoride story... Read Article

   
Topical Fluoride - Dear Doctor Magazine

Topical Flouride Fluoride has a unique ability to strengthen tooth enamel and make it more resistant to decay. That's why dentists often apply it directly to the surfaces of children's teeth after routine dental cleanings. This surface (topical) application can continue to leach fluoride into the tooth surface for a month or more... Read Article

   
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