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

 

Kid missing teeth.Your child's little baby teeth have some big responsibilities. Until the adolescent years, they will not only help your youngster bite and chew (i.e., get proper nutrition) and speak correctly but also help guide the permanent teeth underneath them into proper position. In fact, a major function of baby teeth is to hold space for the adult teeth that will eventually push them out.

At least that's how it's supposed to work; sometimes, however, injury or disease can cause a baby tooth to be lost prematurely. When that happens, the permanent teeth that are coming in on either side can actually drift into the space that was reserved for another tooth. This can cause teeth to erupt out of position or to be blocked entirely, and it may result in crowded or crooked teeth.

Fortunately, if your child loses a tooth prematurely, there's a dental appliance that can be used to hold the space open for the permanent tooth that is meant to fill it. The device is, not surprisingly, called a “space maintainer” or a “space maintenance appliance.” Made of metal and/or plastic, space maintainers can be fixed (cemented) or removable, but either way their purpose is the same: to help your child develop the best bite possible and hopefully avoid the need for braces later on.

Fixed appliances are cemented onto adjacent teeth. They are made in many different designs: One consists of a band that goes around a tooth and then a wire loop that extends out from the band to hold the space; another features a loop attached to a stainless steel crown, which goes over a nearby tooth. In either case, the loop extends just to the point where it touches the next tooth. Fixed space maintainers are often preferred with younger children, because they are less easy to fidget with, break, or misplace than appliances that can be removed.

Removable appliances look like the type of retainer that is worn at the end of orthodontic treatment. It can have a false tooth on it, which is particularly useful when the lost tooth was visible in the mouth. Older children can usually handle the responsibility of wearing this appliance and caring for it properly.

Whether fixed or removable, your child's space maintainer will be custom-made after we take impressions of his or her mouth. A child will wear a space maintainer until x-rays reveal that the tooth underneath is ready to erupt naturally. It is very important that anyone wearing a space maintainer keep up good oral hygiene at home and have regular professional dental cleanings.

Space maintainers are also useful when one or more permanent teeth are congenitally missing — in other words, they have never existed at all. In cases like this, which are not uncommon, permanent dental implant teeth are often recommended for adolescents or adults to replace a tooth they weren't born with. But timing is very important with dental implants — they can't be placed in a growing child. Therefore, it is very important to use a space maintainer with a false tooth on it until jaw growth is complete and an implant can be appropriately placed. It's a simple, non-invasive way we can avoid a malocclusion (bad bite) with some timely intervention.

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Baby Teeth - Dear Doctor Magazine

Early Loss of Baby Teeth If baby teeth are lost prematurely, other teeth can shift into the new space so that there is not enough room left for the permanent teeth to come in correctly; crowding or crooked teeth can result. Fortunately, a special oral appliance called a “space maintainer” has been designed to solve this problem... Read Article