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

 

Biting forces can loosen teeth as bone loss progresses.When you are a child, your first loose tooth can be cause for celebration; when you are an adult, it definitely is not. Biting and chewing with a tooth that is not securely attached in its socket can be difficult or even painful — and any tooth that becomes loose is at risk of needing to be removed or, at worst, falling out. It's often possible to prevent that from happening, but quick action is required.

Causes

The most common reason for tooth looseness is periodontal disease — a bacterial infection of the gum and/or bone tissues that surround and support your teeth. The infection results from bacterial plaque that sits on your teeth in the absence of effective oral hygiene. Over time, periodontal disease will cause gum tissue to detach from the teeth as plaque and tartar formation increases and tooth-supporting bone is lost. As more bone is lost, teeth gradually become loose and are unable to withstand normal biting forces. If severe periodontal disease remains untreated, loose teeth will eventually fall out.

Another common contributor to the loosening of teeth is a clenching or grinding habit that generates too much biting force. This force can stretch the periodontal ligaments that join the teeth to the supporting bone, making your teeth looser. These habits can accelerate bone loss and also cause jaw pain and excessive tooth wear.

Treatment

Just as the causes of loose teeth can be biological (disease) or mechanical (too much force) — or both — so, too, are the treatments. Let's first take a look at the biological approach.

To control gum disease, a dental professional must thoroughly clean the teeth of plaque and harder deposits (tartar or calculus) in which bacteria thrive; this includes the tooth-root surfaces beneath the gum line. At the same visit, you will be instructed on effective oral hygiene techniques and products to use at home. Often this type of deep cleaning, combined with improved oral hygiene, will reduce inflammation and heal the gums enough to cause some tightening of the teeth.

The mechanical approach involves modifying the forces that are applied to the teeth. This can be achieved in a number of ways. For example, an occlusal (bite) adjustment can be performed by carefully reshaping minute amounts of tooth surface enamel. This changes the way upper and lower teeth contact each other, redirecting and lessening the force. Replacing broken fillings and restoring worn teeth is also sometimes needed to create a more balanced bite, even when teeth are not loose.

Splinting teeth.It is also possible to reduce stresses on teeth by temporarily or permanently splinting them together like fence pickets so that any biting force is distributed among groups of teeth rather than individual loosened teeth. The splint is a very small metal bracket bonded to the backs of or tops of the teeth.

If clenching or grinding habits are a problem, a custom-made bite guard (also called an occlusal splint) can be worn when needed. Placed in the mouth at night or in times of stress, it can protect the teeth from the consequences of too much biting force. This can also be helpful in preventing excessive tooth wear, and sometimes in relieving jaw pain.

Loose teeth can be successfully treated with both biological and mechanical techniques. A thorough examination will be needed to determine the best approach. So if you are experiencing tooth looseness, don't wait — the sooner this problem is addressed, the more likely you are to keep your natural teeth.

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