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

 

Cerec Same Day Crowns.A tooth that has been structurally damaged by decay or trauma sometimes needs to be crowned or “capped” so that it can look good and function properly again. A crown is a durable covering that is custom-made to fit over the entire tooth from the gum line up. Crown fabrication traditionally takes place in a dental laboratory. But these days, there's a much more convenient alternative: same-day crowns made in the dental office.

Advanced dental technology known as Computer-Aided Design/Computer-Aided Manufacturing, or CAD/CAM, makes it possible to fabricate laboratory-grade crowns and other dental restorations in minutes. It's an amazing innovation when you consider that traditionally, crowns take two or three visits and just as many weeks of waiting. Now you can have a restored tooth without the wait.

Best of all, studies have shown that CAD/CAM tooth restorations are just as successful as crowns made with traditional materials and techniques. And the amazingly lifelike appearance of a same-day crown means that no one will know your tooth has been restored.

How It Works

Scanning Wand.

The process of crowning a tooth starts out the same way, whether it's a same-day crown or traditional crown: with “preparation” of the tooth. This involves removing any decay that's present, and shaping the tooth with a dental drill so that it will fit perfectly inside the crown. But the similarities end there.

If you were getting a traditional crown, the next step would be to take an impression (mold) of your teeth with a putty-like material, and use it to construct a model on which to create the crown. With a same-day crown, your teeth are simply given a light dusting of reflective powder and then a small scanning wand attached to a computer is used to take digital pictures inside your mouth. In seconds, the computer will generate a highly accurate 3D model of your teeth. But it gets even better.

Milling Machine.

Dental Crowns.With the help of the CAD/CAM software, your crown will be designed while you wait. The software can even be used to create a mirror-image twin of the same tooth on the other side of your mouth, for the most natural-looking result possible. Then a block of dental ceramic material is chosen in the shade that most closely matches your own teeth. The computer's digital design is transmitted to a milling machine that carves the crown from the ceramic block in about five minutes.

Once the crown's fit has been verified, and any necessary aesthetic enhancements have been made to the crown's surface (staining and glazing, for example), the crown will be bonded to your tooth. With a traditional crown, you would have to wear a temporary restoration for several weeks while the permanent crown was being fabricated at the lab. With a same-day crown, you walk out with the real thing.

Caring for Your Same-Day Crown

Crowned teeth require the same conscientious care as your natural teeth. Be sure to brush and floss between all of your teeth — restored and natural — every day to reduce the build-up of dental plaque. When you have crowns, it is even more important to maintain your regular schedule of professional cleanings at the dental office. Avoid using your teeth as tools (to open packages, for example). If you have a grinding habit, wearing a nightguard would be a good idea to protect your teeth and your investment. A well-cared-for same-day crown will last for years to come.

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