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

 

Fluoride Toothpaste.Fluoride is a mineral that is naturally present to some degree in both fresh and salt water sources. Its major dental benefit is that it is readily incorporated into the teeth's mineral structure, thereby making them stronger and more decay-resistant. Fluoride can even reverse tiny cavities that are starting to form. Less tooth decay means you have a better chance of avoiding significant dental treatments — and keeping your natural teeth for life.

The great majority of toothpastes sold today contain fluoride, because it's an effective, easy and inexpensive way to prevent tooth decay and promote oral health. Because of its proven health benefits, fluoride is often added to municipal water supplies to bring them to the current recommended level of 0.70 parts per million. In fact, the federal Centers for Disease Control and Prevention recently named community water fluoridation as one of the most significant public health achievements of the 20th century.

Making Fluoride Available to the Teeth

Fluoride can be delivered to teeth in two ways: topically (on the surface) and systemically (through the body). The first method helps people of all ages; the latter is only beneficial in childhood while the permanent teeth are forming beneath the gum line — up to about age 9.

Fluoride ingested in drinking water can reach teeth both ways. When swallowed, it travels through the body and becomes incorporated into developing teeth; it also stays in the mouth throughout the day in a very low concentration. Toothpaste and mouthwashes provide higher concentrations over shorter periods of time. Fluoride can also be applied directly to the teeth at the dental office; children who get their water from unfluoridated sources may be prescribed a fluoride supplement in the form of pills or drops.

How Much Do You Need?

Tooth Caries Balance.

The amount of fluoride you need varies according to your particular risk for decay, which is determined by many factors: your body's own biochemistry, your diet, the amount of fluoride you come into contact with daily, and the effort you put into your own oral hygiene. If you maintain an effective daily routine of brushing and flossing, and avoid sugary and/or acidic foods and beverages, your decay risk will likely be low. If you are lax about oral hygiene, drink soda and snack throughout the day, your risk will be much higher.

Poor oral hygiene and constant intake of sweets make an ideal environment for decay-causing bacteria, which need sugar to thrive. In the process of digesting that sugar, they create tooth-eroding acids as a byproduct. And if you drink beverages that are already acidic — soda, sports drinks, energy drinks, even some fruit juices — you are applying those tooth-destroying acids directly to your teeth without using bacteria as a middleman. In that case, you might benefit from fluoride treatments at the dental office and/or regular use of a fluoride mouthrinse.

Fluorosis.However, there is such a thing as too much fluoride — particularly when it comes to children. If developing teeth absorb too much fluoride, they can become permanently stained or even pitted — a condition referred to as enamel fluorosis. It is not dangerous, but may require cosmetic dental work. That's why young children should not be allowed to swallow fluoride toothpaste. Adults who take in excessive fluoride throughout their lifetimes may become more prone to bone fractures or tenderness, a condition known as skeletal fluorosis. Severe forms of enamel or skeletal fluorosis are not common in the United States. Still, given that excessive doses of fluoride could cause problems, it's best to consult a dental professional on the most appropriate products for you and your child to use.

Related Articles

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