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

 

Periodontal Disease.It is not a given that we must lose teeth as we age. If we maintain good oral hygiene and have regular professional cleanings and oral examinations, chances are we can keep our natural teeth for life. That involves not only caring for the teeth themselves, but also the structures that surround them: the gums and tooth-supporting bone. Gum disease, which is a bacterial infection, threatens these supporting tissues. That is why dental professionals are always on the lookout for early signs that patients may not notice. When signs of trouble become apparent, periodontal therapy may be suggested.

Periodontal therapy can take various forms, but the goal is always to restore diseased tissues to health. Gum (periodontal) disease can spread from the gums to the bone that supports the teeth, and may even cause tooth loss in the most severe cases. There are very effective therapies to combat this, ranging from scalings (deep cleanings) that remove plaque and calculus (tartar) from beneath the gum line, to surgical repair of lost gum and bone tissue.

Periodontal Therapy Procedures

Periodontal therapy includes both surgical and non-surgical techniques to restore health to the tissues that support the teeth (gums and bone) and prevent tooth loss. They include:

  • Scaling and Root Planing. These deep-cleaning techniques are the best starting point to control gum disease. Plaque and calculus (tartar) are removed from beneath the gum tissues, using hand scalers and/or ultrasonic instruments.
  • Gum Grafting. Sometimes it's necessary to replace areas of lost gum tissue so that tooth roots are adequately protected. This can be accomplished by taking healthy gum tissue from one area of the mouth and moving it to where it is needed, or by using laboratory-processed donor tissue.
  • Periodontal Plastic Surgery. When used to describe surgery, the word “plastic” refers to any reshaping procedure that creates a more pleasing appearance of the gum tissues.
  • Periodontal Laser Treatment. Removing diseased gum tissue with lasers can offer significant advantages over conventional surgery, such as less discomfort and gum shrinkage.
  • Crown Lengthening Surgery. This is a surgical procedure in which tooth structure that is covered by gum and bone tissue may need to be exposed either for cosmetic reasons (too make the teeth look longer and the smile less gummy) or to aid in securing a new dental crown.
  • Dental Implants. Today's preferred method of tooth replacement is a titanium dental implant, which is placed beneath the gum line and into the jawbone during a minor surgical procedure. The implant is then attached to a realistic-looking dental crown that is visible above the gum line and indistinguishable from a natural tooth.

Your Role in Periodontal Health

Dental plaque is the main cause of periodontal disease, so it's essential to remove it every day with effective brushing and flossing. This doesn't mean scrubbing, which can actually cause your gums to recede. Proper techniques can be demonstrated for you, if you have any questions.

Of course, there are some areas of the mouth that a toothbrush and floss just can't reach, which is why it's so important to have regular professional cleanings at the dental office. Your regular dental exam is also a time when early signs of gum disease can be detected — before they become apparent even to you.

Eating a nutritious diet low in sugar, and staying away from tobacco in all forms, will also increase your periodontal health — and your chances of keeping your teeth for life.

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