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

 

Tongue Ring.At the present time, oral piercings such as tongue bolts, cheek studs, and lip rings seem to be in vogue among a certain number of young people. Whether you find these bodily adornments appealing or repulsive is a matter of personal taste — but whichever side of the fashion divide you're on, there are a few things you should know about the impact they can have on your oral health.

According to the Journal of the American Dental Association, the tongue and lips are the most common sites for intraoral piercings. In either location, the ornament is likely to come into contact with teeth, gum tissue, and other anatomical structures in the mouth. And that's where the trouble may start.

The Anatomy of a Problem

The tongue, composed primarily of muscle tissue, is rich in blood supply and nerve endings; that's why a cut on the tongue is often painful and bloody. In a tongue piercing, a metal stud is inserted through a hole made in the tongue. The possibility of infection or the transmission of a blood-borne disease like hepatitis B exists in this situation. Rarely, the piercing may also cause immediate and severe facial pain. It's the long-term effects of an oral piercing, however, which give the most reason for concern.

As teeth regularly come into contact with the metal parts of the ornament, increased tooth sensitivity and pain may become a problem. Chipping or fracture of the teeth can also occur, which may require tooth restoration. Teeth that have already been restored (with crowns, for example) may be even more prone to damage. Plus, wherever it's located, jewelry in the mouth can trigger excessive saliva flow, impede speech, and cause problems with chewing and swallowing.

Periodontal (gum) disease can also result from wearing an oral piercing. This may first show up as injury to the soft gum tissue, and later as gum recession. It's important to understand that before the gums can recede, some of the underlying bone in the jaw must be lost. Following bone loss, inflammation and infection of the gums may occur.

When gums recede, tooth roots become exposed; this makes tooth decay more likely, since roots lack the protective enamel covering of the tooth's crown. Some studies have even shown that, over time, this condition makes gum disease more likely — primarily because it's more difficult to practice good oral hygiene with an irregular gum line. Besides causing problems in the mouth, advanced gum disease can have a potentially negative effect on your general (systemic) health.

It's Your Health — and Your Choice

If you're old enough to get an oral piercing, you're old enough to take an active part in maintaining your own oral health. If you are thinking about having a tongue bolt, lip ring, cheek stud, or other ornament placed in your mouth, talk to a dental professional about it first. Due to the increased potential for dental or periodontal problems, you will likely need to have more frequent checkups, and pay special attention to your oral hygiene.

And if the time comes when you decide that the piercing you got on an impulse isn't what you want any more, take heart: Removing it will immediately reduce your disease risk, and thus instantly improve your oral health!

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