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

 

Teething.New parents sometimes anticipate their baby's first tooth with a mixture of excitement and worry. While reaching a new developmental milestone is always a cause for celebration, this particular one can come with considerable discomfort. However, teething is different for each baby, and need not be painful at all; plus, there are steps you can take to make the process easier for your baby — and yourself.

Teething refers to the process by which primary (baby) teeth emerge through the gums and become visible in the mouth. This usually begins between six and nine months of age, though it may start as early as three months or as late as one year. Usually, the lower front teeth erupt first, followed by the ones directly above. Most children have all 20 of their primary teeth by the age of 3 (View Tooth Eruption Chart).

Recognizing the Signs

Kids mouth anatomy.

Common signs that your baby is teething include:

  • Irritability
  • Biting and gnawing
  • Drooling
  • Chin rash (caused by excessive salivation)
  • Swollen gums
  • Ear rubbing
  • Decreased appetite
  • Disrupted sleep patterns

You are most likely to notice any of the above from about four days before the tooth breaks through the gums up until three days after the tooth appears.

A less common teething issue is the formation of an “eruption cyst,” a small bubble-like swelling filled with fluid that covers an erupting tooth. Eruption cysts usually do not require treatment as the tooth will simply pop the cyst when it comes through.

While there has been some disagreement as to whether diarrhea, rashes and fever are signs of teething, these are more likely to be associated with an unrelated illness and should be reported to your pediatrician.

How to Help

Teething babies get the most relief from cold and/or pressure on the affected area. This can be applied with:

  • Chilled teething rings
  • Cold, wet washcloths
  • Chilled pacifiers
  • Massaging baby's gums

Make sure not to actually freeze your baby's teething ring or pacifier because this could burn if left in the mouth for too long. The outmoded “remedy” of rubbing whiskey or other alcohol on the gums is neither effective nor appropriate. Over-the-counter medication may be helpful, but always check the correct dosage with your pediatrician or pharmacist. These, too, should not be rubbed on the gums because they can burn. Numbing agents shouldn't be used on babies under age 2 unless directed by a physician.

Remember, it's best to start dental visits by your child's first birthday to establish this lifelong health-promoting routine (View Age One Dental Visit Video).

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