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

 

Kids.Teeth can last a lifetime if you take care of them right — and the best time to start is just as soon as they begin appearing. By establishing good oral hygiene routines for your children right from the start, you'll give them the best chance of keeping their teeth healthy — forever.

Tooth decay, the major cause of dental trouble that can eventually lead to tooth loss, is actually an infectious disease caused by bacteria. If it takes hold, it can form a cavity in the enamel and then progress deeper into the tooth — causing discomfort, difficulty eating and speaking, and a need for fillings or root canal treatment. The good news is that tooth decay (also called caries) is completely preventable.

The primary route to good dental health is plaque removal. Plaque is the sticky, whitish film that builds up on teeth in the absence of effective oral hygiene. Decay-causing bacteria thrive in plaque, where they break down any sugar that lingers in the mouth. In the process, they produce acid byproducts that erode teeth. This is how a cavity begins. What are the most effective techniques for plaque removal and decay prevention? That depends on the age of your child.

Babies

Age one dental visit video

Babies can develop a form of tooth decay known as early childhood caries. This occurs when they are allowed to go to sleep with a bottle that's filled with anything but water. The sugars in formula, milk (even breast milk) and juice can pool around the teeth and feed decay-causing bacteria. When it comes to bedtime soothing, a pacifier or bottle filled with water is safer for developing teeth — that is, until about age 3. At that point, sucking habits should be gently discouraged to prevent orthodontic problems from developing later on.

Brush your baby's first teeth gently with a small, soft-bristled toothbrush, using just a thin smear of fluoride toothpaste, at least once a day at bedtime. Before a tooth is fully erupted, you can use a water-soaked gauze pad to clean around the tooth and gums.

Make sure your child has his or her first dental visit by age 1. There, you can learn proper hygiene techniques; have your youngster examined for signs of early decay; and get a recommendation for fluoride supplements if needed.

Children

Tooth tips for tots video

Starting at age 3, you can begin teaching your child to brush with a children's toothbrush and no more than a pea-sized amount of fluoride toothpaste. But remember, children will need help with this important task until about age 6, when they have the fine motor skills to do an effective job themselves.

It's also extremely important to start encouraging healthy dietary habits at this time. Your child will have less plaque buildup and decay if you place limits on soda and sugary snack consumption. As a parent, you can model this behavior to instill it in your child. After all, monkey see, monkey do! Any sugary treats that are allowed should come at mealtimes, not in between. This will ensure your child is not creating favorable conditions for oral bacteria to grow around the clock.

At your child's regular, twice-yearly dental checkups and cleanings, topical fluoride can be applied to strengthen tooth enamel and make it more resistant to erosion and decay. If necessary, dental sealants can be applied to the back teeth (molars) to prevent food particles and bacteria from building up in the tiny grooves where a toothbrush can't reach (View Dental Sealant Video).

Teens

At this point, your children have the primary responsibility for maintaining their day-to-day dental health — but you can continue to help them make good dietary and behavioral choices. These include drinking plenty of water and avoiding soda, sports drinks and energy drinks, all of which are highly acidic; avoiding tobacco and alcohol; and continuing to visit the dental office regularly for cleanings and exams. This is particularly important if your teen wears braces, which can make it more difficult to keep teeth clean.

Remember, it's never too soon to help your child develop good oral hygiene habits that will last a lifetime.

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