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

 

Interdental cleaning.Almost everyone understands the importance of regular brushing and flossing to their oral health. You've heard it many times before, at office visits and checkups: Proper oral hygiene is your first line of defense against tooth decay and gum disease. Yet, while most of us brush regularly, many people don't floss as often as they should… or at all!

Why not? Sometimes, it's because we don't have the manual dexterity to handle the floss, or because braces or partial dentures get in the way; or, perhaps we just never got in the habit. Yet proper cleaning of the interdental areas (the small spaces between teeth) is crucial — and here's why:

Consistent brushing with fluoride toothpaste has been proven effective at removing dental plaque from the tooth's surfaces and making them more resistant to decay. But regular toothbrushes simply can't get into the small gaps between teeth, or the tiny crevices where teeth meet gums. Unfortunately for our oral health, that's exactly where tooth decay and gum disease starts — and that's where the tools called “interdental cleaners” can help.

There are several different types of interdental cleaners available, including special brushes and irrigation devices (commonly called “water picks”). None of them, by themselves, are a substitute for brushing and flossing. However, as part of a regular program of oral hygiene, they can be effective at fighting plaque and reducing the incidence of tooth decay and gum disease.

The Interdental Brush

Interdental brush.This specially designed toothbrush (sometimes called an interproximal brush or proxabrush) can be successfully utilized to clean the small gaps between teeth, as well as the gums and the areas around braces, wires, or other dental appliances. Because it has a handle not unlike a standard toothbrush, many people with limited dexterity find it easy to use. Plus, numerous clinical studies have demonstrated its effectiveness at reducing plaque and controlling gingivitis (gum inflammation).

The cleaning surface of an interdental brush is similar in shape to a small, conical pipe cleaner. Its short bristles radiate from a thin central wire, which is small enough to pass through a very tight space. The brushes are available with both coated and uncoated wire, and come in different widths to accommodate an individual's particular dental anatomy. When needed, they can also be used to apply antibacterial or desensitizing agents to certain areas of the teeth or gums.

Oral Irrigation Devices

Available to consumers for over 50 years, these devices (sometimes known as water jets or water picks) can also play a role in interdental hygiene. While their popularity has gone up and down over the decades, many studies have shown that they provide a safe and effective method of diluting the acids produced by plaque. Irrigation devices typically use pulsed or steady jets of pressurized water to remove food particles from the hard-to-clean interdental spaces, as well as in some subgingival (below the gum line) pockets.

Proper brushing and flossing is still generally considered the gold standard of at-home oral hygiene. But if you have trouble flossing regularly — or if you're at increased risk for developing dental or periodontal disease — then using these interdental cleaners might be right for you.

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