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

 

Full or partial tooth loss, if left untreated, doesn't just affect a person's self-image — it can also increase the risk of developing nutritional problems and other systemic health disorders. Fortunately, there's a reliable and time-tested method for treating this condition: full or partial dentures.

Normal facial contours restored with dentures.

Dentures are just one option for replacing missing teeth; some of the others include fixed bridgework and dental implants. Each method has its particular pluses and minuses, which should be carefully considered. There are also several varieties of dentures available to address specific issues, from partial dentures to implant-supported overdentures. The best option for you will depend on your individual situation.

How Do Removable Dentures Work?

Full or partial dentures consist of a gum-colored base made of plastic resin, which fits over the remaining alveolar (bone) ridge that formerly held the teeth. The prosthetic teeth projecting from the base are designed to look and function just like your natural teeth. Dentures are held in place primarily by the suctioning effect of their close fit against the alveolar ridges — that's why it's so important that they are fitted properly. The upper denture also gets extra support from the large surface area of the roof of the mouth (palate), which generally makes it extremely stable.

At first, wearing dentures may require some getting used to in terms of talking and eating, as the dentures become “balanced” in the space formerly occupied by the teeth. But over time, the muscles, nerves and ligaments of the mouth learn to work in new ways, which allows these functions to occur normally. Dentures also help support the facial skeleton and the soft tissues of the lips and cheeks, which can help create a more youthful appearance.

Types of Full Dentures

Removable denture types.Immediate Dentures: These are usually a temporary means of helping you transition to successful denture wearing. Because of the muscular readjustment required, as well as the natural shrinkage of gums, the dentures which are placed immediately after tooth extraction won't fit as well as permanent dentures made when the healing is complete. They do, however, provide you with new teeth right away, and give you time to adjust.

Conventional Full Dentures: After a period of time, permanent dentures that conform to your mouth with near-perfect accuracy can be fabricated. These are carefully crafted to look as much like your own natural teeth as possible, and are able to function properly in your mouth for a long time.

Implant-Supported Overdentures: To increase the stability of a lower or upper denture, it's possible for it to be securely anchored using two or more dental implants. The upper jaw requires more implants (generally three or more) than the lower jaw due to a lesser bone density. Many people find this option offers a great balance of comfort, functionality and value.

Types of Partial Dentures

Transitional Partial Dentures: These relatively inexpensive removable plastic dentures serve as a temporary tooth replacement and space maintainer as you wait for your mouth to heal from tooth extraction, for example. Once the healing process is complete, dental implants can be placed.

Removable Partial Dentures (RPDs): Usually made of cast vitallium, these well-constructed, metal-based removable partial dentures are much lighter and less obtrusive than those made of plastic. They are a little more expensive than plastic dentures but will fit better. They are, however, much less expensive than implants or fixed bridgework.

How Dentures Are Made and Fitted

Lab making denture.Making quality dentures is a blend of science and art. First, an accurate impression (mold) is made of the alveolar ridges on the top and bottom of your mouth. The base of the denture is made from this mold in a dental laboratory. Working together, the dentist and lab technician choose from among many different sizes and shapes of prosthetic teeth to re-create a natural-looking smile. When everyone is satisfied with the result, the temporary dentures are made in permanent form.

To enable normal speech and eating, it's crucial to balance your bite. This means that the upper and lower dentures come together and properly stabilize each other. The form and function of the dentures are carefully checked to ensure that they are working and fitting properly.

What to Expect After You Get Dentures

If you've recently lost your teeth and received an immediate denture, it's normal to find some tissue shrinkage and bone loss occurring. Therefore, in several months you may find that your immediate dentures no longer fit well. You will have two choices at this point: You can have your immediate (temporary) dentures re-lined. This means that material is added under the denture's base to better conform to the new contours of your alveolar ridge. A better option is to move to a set of conventional full dentures, which will last longer and fit better. With proper care, dentures offer a functional, aesthetic and economical solution to the problem of tooth loss.

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