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 contouring and reshaping.Sometimes little defects in teeth can attract more than their fair share of attention. The eye often seems drawn to the tiny chip in a front tooth; the slight mismatch in tooth size among adjacent teeth; the extra-pointy canine. If you find yourself staring at these subtle yet distracting features in your own smile, help is available — often with a minimally invasive, relatively inexpensive procedure known as tooth contouring (reshaping).

Tooth contouring involves removing a tiny amount of tooth enamel with a drill to sculpt a more pleasing shape and make the tooth fit in better with its neighbors. The tooth is then polished for a smooth finish. The procedure is most often used on the upper front incisors and canines, which are your most visible teeth.

Cosmetic problems that can be corrected with tooth contouring include: small chips, uneven tooth length, slight overlaps, and tooth edges that are too flattened or pointy. It can even be used to correct minor bite problems from teeth touching unevenly during contact. Conversely, your teeth should not be reshaped if any bite imbalances could result from it. In that case, one of several other highly effective cosmetic dental procedures would be recommended. Tooth contouring can also be used to give teeth a more feminine or masculine shape, simply by rounding or squaring the edges.

What to Expect
The first step in the contouring procedure is to examine your teeth and diagnose how the reshaping will accomplish your goal of smile enhancement or correct a bite problem if you have one. This will ensure that the teeth being reshaped will not only look better but also will be healthy. Sometimes a reshaping of the root surfaces is required to protect you from gum disease. In that case, an x-ray may be necessary to isolate and protect the sensitive inner tissue (the pulp). However, most often tooth contouring only involves the removal of a bit of enamel — the hard outer covering of the tooth. Because enamel is not living and contains no nerves, you will likely not need even a local anesthetic.

You will probably feel some vibration as your tooth is gently sculpted, and then polished smooth. Reshaping one tooth usually takes less than half an hour — and the results will be obvious as soon as you look in the mirror! Sometimes reshaped teeth can be a little sensitive to hot or cold after the procedure, but this should last no more than a day or two.

Tooth contouring can be combined with whitening for a dramatically younger-looking smile. It's also often used in conjunction with cosmetic bonding or dental veneers — both of which can be used to reshape teeth with larger imperfections.

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