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

 

Pregnant woman eating.Your baby's teeth will not be visible at birth. But believe it or not, they already exist beneath the gums. Children's primary teeth begin forming at about the sixth week of pregnancy, and start mineralizing — building the bonelike inner tooth layer (called dentin) and the super-hard enamel layer that covers it — around the third or fourth month of pregnancy. So if you're pregnant, it's not too early to start thinking about how to make sure your child's teeth are as healthy as possible!

Like everything else having to do with your baby's physical development before birth, much depends on how well you take care of yourself. Developing teeth need certain nutrients to grow properly; if you don't get them through your diet, your baby won't receive them either. Likewise, you'll have to watch your intake of substances that could harm your teeth in utero, such as certain antibiotics. Here's a brief summary of what to seek and what to avoid.

Eat Right

Certain nutrients are particularly important for prenatal tooth development:

  • Calcium, a mineral, is the main component of teeth. If there is not enough calcium coming from your diet to support fetal development, your body will actually take this mineral from your bones (but not your teeth) and use it to meet your developing baby's needs. Good for your baby, not so good for you. The best sources of dietary calcium are dairy foods such as milk, cheese and yogurt. It can also be found in broccoli and kale.
  • Phosphorous, another mineral, also accounts for the hardness of teeth. It is found in every one of the body's cells, and also in many foods — especially high protein sources such as meat and milk, but also cereals. Of all the nutrients your baby's teeth need, this is the easiest to get.
  • Vitamin D helps the body absorb and retain calcium and phosphorous. Very few foods contain it naturally — oily fish like salmon and tuna are exceptions; that's why it is added to milk and some other beverages and foods (check labels to find out which ones). It is also produced in the body naturally when skin is directly exposed to sunlight. Concerns about the negative effects of sun exposure may prevent you from getting all the vitamin D your body requires this way, so you may be advised to take a supplement.
  • Protein is the most plentiful substance in your body after water. It is responsible for building, maintaining and replacing the body's tissues. Interestingly, it is the action of a single protein that causes calcium-phosphate crystals to form tooth enamel rather than bone. All proteins are made of amino acids, but some amino acids cannot be manufactured by the body and must come from foods. Meats and dairy products are the most protein-rich. It is possible to get all the different proteins your body requires with a vegetarian diet, but you will need to pay closer attention to what combinations of foods will provide all the essential amino acids.

Seek Guidance on Dietary Supplementation & Medications

If you feel your diet is inadequate in some nutrients during your pregnancy, it's best to seek professional medical advice on what supplements you may need. While it's unlikely you will ever receive too much of any given nutrient from your diet, you can overdo certain vitamins and minerals in pill form (vitamin D and calcium, for example).

When you know you're pregnant (or if you may be pregnant), please share the news with all of your healthcare professionals who see you. That way, medications that should not be prescribed will be avoided at this time. For example, if you need antibiotics to combat an infection, some are much safer for developing babies than others. Tetracycline, for example, can permanently stain teeth in utero. Fluoride supplementation at this time is not recommended either, as there are too many unanswered questions about its use during pregnancy.

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