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

 

If you're like most people, you probably learned how to brush as a child… and chances are, you haven't thought about it much since then. That's understandable — but there may come a point when we find our oral hygiene techniques could use improvement. Here are a few tips on the proper way to brush your teeth… plus, a reminder of why we do it.

First, the reasons why: Brushing is an effective way to remove plaque — a sticky, bacteria-laden biofilm that clings stubbornly to your teeth. The bacteria in plaque produce acids, which erode the tooth's enamel and may lead to tooth decay. Plaque can also cause gum disease and bad breath. In fact, it's believed that over 90% of dental disease is caused by plaque accumulation alone.

Besides removing plaque, the fluoride in toothpaste strengthens tooth enamel and makes teeth more decay-resistant. Plus, brushing makes your mouth feel cleaner and your breath smell fresher. While there is no single “right” way to brush your teeth, there are a number of techniques that can help you get them squeaky-clean. So why wait — let's take a refresher course in brushing right now!

How to brush your teeth.

Proper Brushing Technique

  • To begin, select a small-headed, soft-bristled toothbrush, grasp it gently with your fingers (not your fist), and squeeze on a pea-sized dab of fluoride toothpaste.
  • Hold the bristles gently against the outside of your top teeth, near the gum line, at about a 45-degree angle upward.
  • Sweep the brush gently back and forth over teeth and gums in soft strokes — or, if you prefer, use an elliptical (circular) motion to clean the teeth.
  • Be sure to clean the spaces between teeth: You can use a sweeping motion to brush food particles away from the gums.
  • When you have done one brush-width, move to the adjacent area of your teeth and repeat. Keep going until you have finished cleaning the outside of the whole top row of teeth.
  • Move to the bottom teeth. Repeat the procedure, tilting the brush down toward the gum line at about 45 degrees. Finish cleaning the outside of the bottom teeth.
  • Go on to the inside of the top teeth. Tilting the bristles up toward the gums, clean the inside of the top teeth with gentle but thorough strokes.
  • Move to the inside of the bottom teeth. Tilt the brush down and repeat the procedure.
  • Now it's time for the chewing surfaces: Holding the bristles flat against the molars, clean the ridges and valleys of the back teeth. Do this for all the top and bottom teeth.
  • Finally, brush your tongue gently to remove bacteria and freshen breath.
 

Check Your Work

Tongue test.How good a brushing job did you do? One way to get an idea is by simply running your tongue over your teeth: If they feel slick and smooth, then chances are they're clean. If not, you should try again. To know for sure whether you're brushing effectively, you can use a “disclosing solution” — a special dye that highlights plaque and debris your brushing missed.

One common error is not brushing for long enough: two minutes is about the minimum time you need to do a thorough job. If you have music in the bathroom, you could try brushing along with a pop song; when the song's over, you're done! But no matter your musical taste, good brushing technique can go a long way toward maintaining tip-top oral hygiene.

Variations for Comfort

If you're having trouble with the two-finger method, here's another way to try flossing: Just tie the same amount of floss into a big loop, place all your fingers (but not thumbs) inside the loop, and work it around your teeth with index fingers and thumbs. All the other steps remain the same.

Once you've got the basics down, there are a few different types of flosses you can try, including flavored, waxed, and wider width. Some people find waxed floss slides more easily into tighter gaps between teeth or restorations — but it may not make that satisfying “squeak” as it's cleaning. Others prefer wide floss for cleaning around bridgework. But whichever way works best for you, the important thing is to keep it up!

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