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

 

Tooth wear.Teeth grinding and clenching are common habits, but that doesn't mean they are harmless. Stresses from the powerful forces generated by grinding and clenching (also known as “bruxing”) can wear down teeth or even loosen them. Teeth that have enamel worn away or scraped off from this repeated rubbing action may become sensitive to hot or cold. And dental work such as crowns and fillings may get damaged. Bruxism can also lead to jaw pain and/or headaches.

Even if you have experienced some of these signs and symptoms, you may not realize you are a bruxer — particularly if your habit is nocturnal, as is often the case. Yet the evidence of tooth damage may become obvious during your regular checkup and cleaning. Dentists can also help you break the habit, relieve any pain you are experiencing, and repair any damage to your teeth or dental work.

Why do we grind or clench our teeth?

The most common reason for grinding/clenching habits is stress, which can affect our health in various ways. Some people experience stomach pain or skin breakouts; bruxing is yet another manifestation. Sometimes people grind their teeth because of misaligned teeth or other bite problems. Using stimulating substances such as caffeine, alcohol, tobacco and illegal drugs can also put you at risk. Additionally, teeth grinding is believed to be an uncommon side effect of certain medications.

What can be done?

Sometimes simply becoming aware of the habit can help you to get it under control. If stress is the issue, try to find healthy ways of managing it: exercise, meditation, listening to relaxing music, or a warm bath may help. Your teeth will be monitored over time at the dental office to make sure the problem is not worsening.

Custom nightguard.If damage to your teeth or existing dental work is evident, we may recommend a custom-made nightguard, also known as an “occlusal guard,” may be recommended. It resembles an athletic mouthguard. Made of comfortable plastic, the guard is worn at night to keep your teeth from actually contacting each other. It also helps protect your jaw joints from excessive force.

If a bite problem exists where some teeth are hitting before the others (all of your teeth should hit at the same time), it can sometimes be treated by removing a tiny bit of enamel from an individual tooth that is sticking up a bit (and therefore receiving too much force) to bring it in line with the others. This is known as a bite adjustment. If your malocclusion (bad bite) is more serious, orthodontics might be recommended. Replacing any teeth that are missing can also help stabilize your bite by inhibiting the shifting of teeth that occurs when extra space is left open by missing teeth.

A word about kids: Teeth grinding is very common in children, especially when they are shedding their baby teeth. Since they often outgrow it, treatment is not usually recommended.

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