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

 

Healthy vs unhealthy.

You already know that maintaining good oral hygiene is important for everyone — but when you're having orthodontic treatment, it's even more critical. Why? Because, while the appliances (such as braces or clear aligners) you may need to wear during treatment are very effective in correcting misaligned teeth, they can also trap food particles easily. Keeping your teeth (and your appliances) clean is a little harder — but you can do it! Here's a look at why good oral hygiene is so important during orthodontic treatment, and some tips on how you can keep it up.

The major enemy of oral health is plaque. Food that becomes trapped near tooth surfaces can lead to the formation of plaque — a thin coating of microorganisms and organic debris (biofilm) containing potentially harmful bacteria. Braces or other appliances make it harder to remove plaque. The bacteria in plaque digest the sugars in food, producing acids which may erode teeth and irritate gums. This can cause cavities, white spots on teeth, gum disease and bad breath.

Keeping plaque under control is one of the most effective means of maintaining strong, healthy teeth and gums. There are three general ways to do it: through diet, daily maintenance, and regular professional care. Taken all together, they're your teeth's best defense.

Diet and Decay

Controlling your diet involves avoiding foods that could increase your risk of developing tooth decay. That means cutting down or eliminating foods with an excess of sugar, like soda, sweets, and ice cream. It also means avoiding foods that could easily become stuck in your braces, like toffee, gum, licorice and caramels.

Foods that are very hard or extremely sticky can also cause physical damage to orthodontic appliances. Certainly braces or retainers with broken wires or loose brackets aren't working to straighten your teeth! You should avoid foods like hard candies or nuts, beef jerky and hard pizza crust. Keep eating healthy foods like carrots and apples — but cut them into bite-sized pieces first! And don't chew on ice, pencils, or your nails: these habits can cause damage to your appliances, and even result in chipped teeth!

Daily Maintenance

You know how important brushing and flossing are for keeping a healthy smile — especially now that you're in orthodontic treatment. But sometimes it's harder to clean your teeth effectively around an appliance's brackets and wires. Here are some tools and tips you can try for better tooth cleaning.

Either a soft-bristle or a bi-level toothbrush (one with longer bristles on the edges and shorter ones in the middle) can be effective in plaque removal — even with braces. An electric toothbrush can also be used, on a moderate setting. For hard-to-clean areas, try an interdental brush, or proxabrush. The small bristles of this special tooth-cleaning aid, which is shaped like a pipe cleaner, can get in between wires, brackets and teeth. With gentle and persistent effort, it's possible to reach into the smallest nooks and crannies, and control plaque buildup.

You should floss at least once a day during orthodontic treatment. While it's a little harder to do with braces, there are some special products available — including floss threaders and particular kinds of floss — that can help you get the floss between wires and gum line. The office staff will review proper brushing and flossing techniques with you when your braces are put on — but if you ever have questions, don't hesitate to ask!

Depending on your situation, an in-office or at-home supplemental fluoride treatment may be recommended to boost your cavity resistance. An antiseptic rinse may also be recommended, to ease minor gum inflammation or irritation.

If you have a retainer, it should be brushed daily, the same way you brush your teeth. A cleaning solution may be recommended — but never put hot water on your retainer, because it can distort the soft plastic and make it unusable! And always keep it in a case when it's not in your mouth.

Professional Care

During orthodontic treatment, it's as important as ever to make sure your teeth stay healthy with thorough examinations, cleanings and preventive care. Your orthodontic treatment is a team effort where everyone has an important role to play. And the team has just one goal: giving you a winning smile.

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