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

 

Normal Anatomy and Function. Obstructive Sleep Apnea.

You know it instinctively: A good night's sleep is essential for good health. It makes you feel rested and ready to take on the world. Yet many people don't get the sleep they need. Sometimes this is related to sleep-related breathing disorders (SRBD) — their own, or those experienced by their sleeping partners.

SRBD is characterized by recurrent episodes of reduced or interrupted respiratory airflow. This is caused by soft tissues near the back of the throat collapsing during sleep so that they partially close off the windpipe. These tissues — the tongue, for example — can vibrate as air passes by, causing snoring. Snoring is often worsened sleeping on one's back because this encourages the lower jaw to slip back, which in turn pushes the tongue in front of the airway.

Loud snoring often disturbs the person in the bed who isn't the one doing it, robbing him or her of vital sleep. The snorer, on the other hand, may seem to be slumbering peacefully, but this might not actually be the case. Chronic loud snoring is a common symptom of Obstructive Sleep Apnea (OSA; “a” – without; “pnea” – breath), which occurs when the upper airway is blocked to the point of causing significant airflow disruption, or even no airflow whatsoever for 10 seconds or more. This can be dangerous as reduced airflow into the lungs lowers blood-oxygen levels.

A person with sleep apnea may wake 50 or more times per hour — that's almost once a minute! — without having any memory of it. These awakenings, called micro-arousals, last just long enough to restore muscle tone to the airway so the individual can breathe. Unfortunately, all those micro-arousals preclude deep and restful sleep.

What to Look Out For

Sleep Related Breathing Disorders.

Obstructive Sleep Apnea is a serious matter as it can lead to heart problems and other health issues. It's possible you may have OSA if you snore and also suffer from any of the following:

  • Excessive daytime sleepiness
  • Irritability
  • Poor memory/confusion
  • Accident proneness
  • Night sweats
  • Morning headaches
  • High blood pressure
  • Obesity

How Dentistry Can Help

Oral Appliance Therapy.By now you're probably wondering: What does my dentist have to do with all this? Here's the connection: Snoring or sleep apnea can sometimes be treated with an oral appliance available at the dental office that's designed to hold the lower jaw forward during sleep. This repositioning of the jaw moves the tongue away from the back of the throat, reducing the potential for obstruction. This treatment is backed by a great deal of scientific evidence; it's a good remedy to try before moving on to more complicated breathing devices or surgery to remove excess tissues in the throat.

Only a dentist can fabricate, fit, adjust, monitor, and treat complications associated with Oral Appliance Therapy used in managing SRBD. So if you or a loved one is experiencing any combination of the signs and symptoms mentioned above, a consultation with a dental professional is a good idea.

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Sleep Disorders & Dentistry If my partner snores loudly, should I be concerned and what can be done to alleviate the problem? Why does my sleeping partner have lapses in breathing while sleeping and is it dangerous? Why do I wake up exhausted even though I get up to 10 hours of sleep at night? The answers to these and other questions — and how dentistry can help — are all revealed within... Read Article

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Snoring & Sleep Apnea Snoring is annoying to those who have to listen to it, but it can also signal a serious health condition called Obstructive Sleep Apnea (OSA). Individuals with OSA experience significant airflow disruption during sleep, which in turn can cause a variety of health problems. Learn what to look for and how your dentist can help... Read Article