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

 

Mother and Child.Root canal treatment is a safe and effective way to stop many kinds of tooth pain, and to keep a tooth from being lost due to decay or injury. But if a root canal is recommended for your young child, you may wonder why: Isn't that baby tooth going to fall out in a few years anyway?

That's true — the primary (baby) teeth typically are shed between the ages of 6 and 12 years. Yet there are some good reasons for trying to save baby teeth for as long as possible with root canal treatment, rather than simply extracting any that are damaged by trauma or infection.

For one, primary teeth have the same functions as adult teeth — and a missing tooth at any age can cause problems with speech and eating. Baby teeth also have another important role: They serve as guides for the proper placement of the permanent teeth. Without primary teeth to guide them in, permanent teeth tend to emerge in a crooked fashion, often becoming tilted or crowded because of inadequate space. This can result in bite problems that may require extensive orthodontic treatment later.

Saving The Tooth Is Always Best

Root canal treatment for children.Unlike its hard outer surface, the soft pulp inside the tooth is rich in blood vessels and nerves. Problems in this area are often signaled by tooth sensitivity and pain. When these symptoms occur, radiographs (x-rays) are often necessary to confirm that the pulp is diseased, or dying. That's when treatment is needed, before an abscess or further infection can develop.

In severe cases, the tooth may need to be removed, and a space maintainer installed to fill the gap. But many times, space maintainers don't fully restore the tooth's functionality. Plus, they are susceptible to coming loose and must be monitored constantly. If possible, other treatment methods are preferred, such as:

  • Indirect pulp treatment. If pulp damage is minimal, it's possible to remove most of the decay (but not the pulp), apply an antibiotic, and then seal the tooth up again; that's referred to as an “indirect” treatment.
  • Pulpotomy. Alternatively, if decay is limited to the upper portion of the pulp, we may recommend a “pulpotomy.” This involves removing the damaged part of the pulp, stabilizing the remaining healthy portion, and then disinfecting and sealing the tooth. This “partial” root canal is a time-tested technique that's successful in many cases.
  • Pulpectomy. If pulp tissue is infected through the entire tooth structure, a pulpectomy may be needed, which requires the removal of all pulp tissue. The canals are then disinfected, shaped, then filled and sealed with inert material. Afterwards, the crown (visible part) of the tooth will be restored. This resembles traditional root canal therapy, with a crucial difference: The sealant we use in children is capable of being dissolved by the body. That way, when it's time for a permanent tooth to erupt, the baby tooth's roots can be naturally absorbed and tooth development can proceed normally.

Preparing for Your Child's Root Canal Treatment

As you probably already know, most of the legends you may have heard about root canal therapy simply aren't true. In fact, the procedure generally causes little discomfort, but is quite successful in relieving tooth pain! Dentists are adept at using anesthesia to block the sensation of pain, and are experienced in calming the fears of young ones. While it's understandable that you may be nervous, it will help if you don't let your child pick up on your own anxiety. A calming voice and a gentle touch can do much to relieve stress.

After a thorough examination, the best options for your child's treatment will be recommended. These procedures are routine and follow-up instructions will be provided. A root canal is nothing to fear: Think of it as a treatment that may save your child from some tooth pain now, and potentially a lot of corrective dental work later on.

Related Articles

Root Canal Treatment for Children - Dear Doctor Magazine

Root Canal Treatment for Children's Teeth You may think that if a baby tooth comes out prematurely, it's no great loss; after all, it was going to fall out anyway, right? Wrong! Primary (baby) teeth serve as important guides for the permanent teeth that will replace them. Losing baby teeth prematurely can allow bite problems to develop. Root canal treatment for children can prevent this. Learn what to look for in your child and what can be done to save baby teeth until they are ready to be lost naturally... 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