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

 

If you have been told you need root canal treatment, you may be feeling a bit nervous. Not to worry — treating root canal problems is a routine part of dentistry that can relieve certain kinds of tooth pain and help your teeth last longer. As you learn more about this beneficial procedure, you will understand why it's needed — and how it will leave you in far better shape than you were. Here are some answers to frequently asked questions.

Tooth after root canal treatment.

What is a root canal?

Dentists use the term “root canal” in referring to the tiny, narrow passageways that branch from a central, hollow space in your tooth (called the pulp chamber) down to the ends of the tooth roots. The term can also be used as a shorthand for “root canal treatment” — that is, the procedure used to save the tooth if the soft tissue deep inside of it (called pulp) becomes acutely inflamed or infected.

Why do I need root canal treatment?

If tooth pulp becomes acutely inflamed or infected because of decay or injury, the tissue will need to be removed in order to save the tooth and stop the infection from spreading. As an adult, you don't actually need the pulp — its primary use is to aid in tooth development during childhood.

Is there an alternative?

You could have the whole tooth extracted, but it's always better to try to save it — especially since root canal treatment is routine and has a very high success rate (over 90%). Saving the tooth can prevent other troubles from occurring later on; these could include bite problems from teeth shifting position, difficulty eating, and loss of jawbone volume and density.

Is root canal treatment painful?

The procedure normally causes no more discomfort that a filling would. Root canal treatment may have a bad reputation, but it is undeserved; in this case it's the disease that's to blame and not the cure. In other words, the infections that make the treatment necessary in the first place are often painful because they are inflaming tissue that has lots of nerves and therefore is very sensitive. Root canal treatment actually relieves this pain!

What will happen during the procedure?

After numbing the area, a tiny hole in the crown (top) of your tooth is made to access the pulp chamber and canals. The diseased tissue is removed, and the pulp chamber and the canal(s) are disinfected all the way to the root end(s). Teeth in the front of the mouth have one root and generally one canal; back teeth have two or three roots and generally three or four canals. Those canals and the pulp chamber are filled with an inert, biocompatible material, and sealed with adhesive cement. The access hole will receive a temporary filling.

What will happen afterwards?

Your tooth may feel sensitive for a few days, but any discomfort can usually be relieved with over-the-counter pain medication or anti-inflammatories like ibuprofen. You will be instructed to avoid chewing on that tooth until it receives its permanent filling, which can be placed a few days later. Depending on how damaged the tooth was to begin with, it may need a full-coverage crown. Those options will be discussed with you.

How can I avoid the need for root canal treatment in the future?

Keep your teeth decay-free by brushing and flossing every day. Eat a healthy diet low in sugar and avoid acidic beverages such as soda. Have regular professional cleanings and exams. And if you're active in sports, consider ordering a custom-made mouthguard to protect your teeth from injury.

Related Articles

Root Canal Treatment - Dear Doctor Magazine

Common Concerns About Root Canal Treatment The term “root canal” can send shivers down many a spine. However, preconceived notions that root canal treatment is filled with pain and discomfort are nothing more than outdated myths. In fact, root canal treatment doesn't cause pain but actually relieves it... Read Article

Root Canal - Dear Doctor Magazine

“I'd Rather Have a Root Canal...” We've all heard that expression, but how true is it? Is root canal treatment really something to be feared, or does it actually offer relief? In this article, a common misconception is demystified. Get the real story about this much maligned procedure that eases pain, rather than causes it... Read Article

Tooth Pain - Dear Doctor Magazine

Tooth Pain? Don't Wait! Pain is a protective response that informs the body that something is wrong. Tooth pain, specifically, is caused by a reaction of the nerves inside a tooth's pulp chamber, with the severity dependent upon the type and degree of the stimulus. This article gives some examples of pain symptoms and their possible causes... Read Article