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

 

Consequences of Tooth Loss.If you have lost any of your teeth, you no doubt realize there are consequences to living without them: Your smile may not look the way you want it to; eating, speaking and intimacy may be more difficult; and your self-confidence may fade. Though serious, these are not the only impacts. There are hidden consequences of losing teeth that affect not only your appearance but also your health.

Importantly, a loss of jawbone inevitably follows tooth loss. Bone needs stimulation to maintain its form and density. In the case of the jawbone, that stimulation comes from the teeth, which make hundreds of fleeting contacts with each other throughout the day. The small stresses produced by these contacts are transmitted to the bone, prompting it to regenerate constantly. When a tooth is lost, the stimulation it provided disappears. In just the first year of tooth loss, there is a 25% decrease in bone width. This is followed over the next few years by an overall 4 millimeters decrease in height. If enough teeth are lost, and as bone loss continues, the distance from nose to chin can decrease and the lower third of the face partially collapses. With a lack of structural support, the lips sag; that's why toothless people often appear unhappy. Also, extreme loss of bone can make an individual more prone to jaw fractures.

You may also find that some of your remaining teeth actually shift into the spaces left open by your missing teeth. This in turn can cause additional bite problems and even jaw joint (TMJ) pain. Finally, compromised nutrition and poor general health can result if eating healthy foods like raw fruits and vegetables becomes too difficult without teeth.

Now here's the good news: Dental implants — the state-of-the-art tooth-replacement method preferred by dentists — can prevent all this.

How Dental Implants Prevent Bone Loss

Dental Implants 101.Besides helping a person without teeth look and feel great again, dental implants actually prevent bone loss. That's because they are made of titanium, which has a unique ability to fuse to living bone. By actually becoming a permanent part of the jawbone, dental implants stabilize and stimulate the bone to maintain its volume and density.

Dental implants are placed during a minor surgical procedure using local anesthetic and then, after a healing period, topped with a lifelike dental crown. Together, these precision components look, feel and function exactly like your natural teeth. Dental implant success rates exceed 95% — the highest of any tooth-replacement option.

Other Options for Tooth Replacement

Other than dental implants, your tooth-replacement options include fixed bridgework that incorporates or uses the adjacent teeth, and removable dentures. You should be aware, however, that the disadvantage of both of these options is that they may damage the anatomical structures on which they rest. For example, fixed bridges rely on support from two adjacent, possibly healthy teeth, which must be filed down and capped; this can make them susceptible to decay and root canal problems. Removable partial dentures hook onto existing teeth, which may become loose over time. And full dentures press on the bony ridges that used to support the teeth, accelerating the bone loss that began when the teeth were lost in the first place.

The above tooth-replacement options are all less expensive than dental implants, but only when viewed in the short term. Since bridgework and dentures may cause new problems and will likely need replacement themselves, they don't offer the same long-term value. When viewed as an enduring investment in your comfort, health and well-being, implants offer the best return by far.

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