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

 

Nutrition and oral health.You probably already realize that maintaining a balanced diet offers a host of benefits to your overall health. But did you know diet also directly affects the health of your teeth and gums? It all starts before birth, as a baby's teeth begin forming in the sixth week of pregnancy and mineralizing in the third or fourth month. During this time, an expectant mother needs to take in lots of calcium (the major component of teeth) along with vitamin D, phosphorous and protein. Dairy products including milk, cheese, and yogurt have all of these. Broccoli and kale also have calcium, while meats are good sources of protein and phosphorous. These foods are also important for children, whose teeth continue to develop and mineralize through the teen years.

Throughout life, oral tissues are constantly recycling; they need a variety of nutrients to support this process. It's equally important to recognize that nutritional deficiencies — a particular concern among older adults who have lost teeth — can reduce resistance to disease and hinder your ability to fight infection. Studies have consistently found that a high intake of fruits and vegetables reduces the risk for oral cancer — as well as other types of cancer. That's why eating a nutritious diet is important for oral health — as well as general health — at any age.

Eating Healthy

What's the best diet for you? That depends mainly on your age, gender, height, weight and level of physical activity. But in general, a health-promoting diet is based on the concepts of:

  • Variety. No single food can meet all of the daily nutrient requirements. Eating lots of different foods also makes meals more interesting.
  • Balance. We need to eat the recommended amounts of foods from specific categories on a daily basis. Find out what your specific needs are at www.choosemyplate.gov
  • Moderation. Don't supersize it. Foods and beverages should be consumed in serving sizes that are appropriate to meet energy needs while controlling calories, fat, cholesterol, sodium, and — particularly important in the dental arena — sugar.

Protecting Your Teeth

Your diet (which includes what you drink) plays a major role in tooth decay and enamel erosion. Your mouth is naturally hospitable to all kinds of bacteria. Some of these microorganisms are helpful and some are harmful, and many of the harmful ones thrive on a steady supply of sugar. As they process sugar from your diet, these bacteria produce acids that can eat into the enamel of your teeth, forming small holes called cavities. If left untreated, tooth decay can worsen, become quite painful, and threaten the survival of teeth.

Soda and tooth erosion.That's why it is important to avoid food and drinks with added sugar. If you have a sugar craving (and we all do from time to time), choose fresh fruit or yogurt instead of a donut or candy bar. Fortunately, there is no evidence that sugars in whole grain foods, whole fruits and vegetables, and in starch-rich staple foods like bread, rice and potatoes are harmful to teeth.

Soft drinks, however, are a double whammy for teeth; many not only contain lots of sugar — up to 10 teaspoons per 12-ounce can — but they are also highly acidic. This means they erode teeth on contact, even before the bacteria in your mouth have processed the sugar these drinks contain. But even if they are sugar-free, the acid can still harm your teeth. So it might be best to avoid soda, sports drinks, energy drinks and canned iced tea. If you do occasionally have a soda, swish some water in your mouth afterwards — but don't brush your teeth for at least an hour! Doing so could make it easy for tooth enamel, already softened up by acid, to be eroded away by brushing.

Drinking lots of water can help you maintain a healthy supply of saliva, which protects teeth by neutralizing acid. You can also neutralize the acid in your mouth after a sugary snack by following it up with a piece of cheese.

Finally, remember that it's not just what you eat that affects the level of acidity in your mouth — it's also when. Snacking throughout the day, especially on chips, crackers, cookies or candy, means that your saliva never gets the chance to neutralize the harmful acids being produced. So if you eat sweets, do it only at mealtimes. As an added incentive, you may find this helps you maintain a healthy weight, too!

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