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.You probably know that many physical and emotional changes you will experience during pregnancy result from an increase in the levels of certain hormones — the chemicals that regulate many important processes in the body. But what you may not realize is that these hormonal variations can affect your oral health — and usually not for the better. In fact, surges in the female hormones estrogen and progesterone can dilate (expand) the tiny blood vessels in your gums, increasing blood flow. This makes gums more sensitive to the bacteria (and associated toxins) found in the sticky dental plaque that accumulates on teeth every day.

Pregnant women commonly notice that their gums may become red and swollen, and even bleed when they floss or brush their teeth, a condition known as “pregnancy gingivitis.” Similar gum inflammation can result from taking birth control pills that contain a type of synthetic progesterone, or even from the normal hormonal fluctuations of the menstrual cycle.

Another, less common effect of pregnancy hormones on the gums is an overgrowth of gum tissue or small, berry-colored lumps at the gum line or between teeth. These growths are called “pregnancy tumors,” though they are completely benign.

All of the above conditions usually clear up within a few months after giving birth. Still, if you experience gum inflammation, it's a sign that you need to take extra conscientious care of your teeth and gums during pregnancy.

Why It Matters

Pregnancy hormones don't cause gingivitis by themselves — the irritants in plaque need to be present first. So if you experience the signs and symptoms mentioned above, you'll want to redouble your oral hygiene efforts, both for your sake and your baby's. Untreated gingivitis can progress to a more serious form of gum disease called periodontitis — a bacterial infection that attacks not just the gums but also the tooth-supporting bone beneath. It can eventually cause bone loss, loose teeth and even tooth loss. Some research has even indicated a link between periodontal (gum) diseases and other serious health conditions, such as cardiovascular disease and diabetes.

Pregnant women should also be aware that studies have suggested a link between periodontal (gum) disease and preterm delivery. Although the exact mechanism by which this happens is unclear, evidence suggests that the bacteria in dental plaque can reach the placenta and trigger inflammatory responses. This causes substances to be released into the bloodstream that may in turn start labor prematurely. Preeclampsia, a form of high blood pressure specific to pregnancy, may also be associated with periodontal disease.

What You Can Do

  • Eat right. Even if pregnancy cravings are driving you to seek out sugar, try to go easy on the sweets. While they offer you and your developing baby virtually nothing in the way of nutrients, they're the favorite food of disease-causing oral bacteria. If you find you can't resist sweets, try to eat them only at mealtimes and make sure to brush your teeth afterwards.
  • Stick to a good oral hygiene routine. Make sure to floss every day and to brush your teeth at least twice per day. If morning (or afternoon or evening) sickness is a problem, don't brush immediately after throwing up. That's because the enamel on your teeth, which has been temporarily softened by the acid coming up from your stomach, can now be easily removed. Instead, rinse with a teaspoon of baking soda dissolved in a cup of water (or even plain water) to neutralize the acid. Wait a full hour before brushing your teeth.
  • Have a dental cleaning and exam. Not only are professional cleanings safe during pregnancy, they're highly recommended. So if you haven't been to the dentist in a while, now is a great time to make an appointment. And don't forget to share the happy news! You teeth can certainly be cleaned and examined — but for other non-emergency dental procedures, it's probably best to wait.

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