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

 

Endodontics is the dental specialty that deals with tissues and structures located inside the tooth. One of the most common endodontic treatments is root canal therapy, a procedure which effectively eases the pain associated with a bacterial infection deep within the pulp of the tooth. Of course, root canal treatment doesn't just relieve pain — it also stops the infection by removing dead and dying tissue from the tooth's pulp. Plus, it helps to save the tooth, which is in danger of being lost if left untreated.

Yet root canal therapy isn't the only treatment endodontics offers. This field also deals with cases of dental trauma, performs microsurgery on the tips of the tooth's roots, and even helps figure out what's going on when tooth pain seems to come and go intermittently, or when the pain isn't localized at one tooth. So when it comes to preserving your natural teeth, endodontics has plenty of ways to help.

The Inside Story

Healthy Tooth.What's inside your teeth? Behind the tough, shiny enamel of the tooth's visible crown lies the sturdy inner tissue called dentin. Dentin is also found behind the cementum that forms the outer layer of the tooth's roots — in fact, it makes up the bulk of the tooth's structure. Similar in many ways to bone tissue, dentin is composed of many tiny tubules which can transmit sensations to nerve cells when it is stimulated.

At the core of the tooth, inside small, branching chambers called the root canals, we find the soft pulp tissue. This consists of nerves, connective tissues and blood vessels which extend into the center of the tooth and exit through canals near the apex (tip) of the tooth's roots. When problems (such as infection and inflammation) develop in the pulp tissue, your first indication of trouble may be tooth sensitivity — or intense pain. In time, as the nerves die, the pain may go away… but the problem won't. In fact, if left untreated, the end result may be tooth loss.

The “Root” of the Problem

Root canal treatment.What could cause the pulp tissue to become diseased and lead to root canal problems? One potential source of infection is untreated tooth decay, which can allow bacteria from the tooth's surface to work its way deep inside. A crack or fracture in a tooth could offer another pathway for microorganisms to infect the pulp.

Dental trauma — from a sports injury, for example — may also damage dentin or pulp, or expose it to infection. Extensive dental procedures (such as multiple fillings or restorations on the same tooth) may cause trouble; occasionally, even routine procedures like orthodontics may eventually lead to root canal problems.

Endodontic Treatment

The old gag line “I'd rather have a root canal” may still get a laugh — but root canal problems are no joke. It's important to remember that root canal treatment doesn't cause pain; it relieves pain. A typical root canal procedure is performed with local anesthetics, and doesn't cause any more discomfort than having a filling. Here's what to expect:

First, you will receive anesthesia (usually a numbing shot) — and for many patients, the worst is now over. Next, a small opening is made in the tooth surface to give access to the pulp chamber and root canals. Then, tiny instruments are used — often with the aid of a microscope — to remove dead and dying tissue from inside the narrow passages. These passages are then cleaned, disinfected, and filled with a safe, inert material. Finally, the opening in the tooth is sealed to prevent contamination.

Other endodontic treatments may be recommended for removing sources of infection and preventing future problems. Following an endodontic procedure, it may be necessary to have a restoration (such as a crown) placed on the tooth to restore it to full function and aesthetic appearance. After that, with proper care the restored tooth should last for many years.

Related Articles

Root Canal Treatment - Dear Doctor Magazine

Common Concerns About Root Canal Treatment The term “root canal” can send shivers down many a spine. However, preconceived notions that root canal treatment is filled with pain and discomfort are nothing more than outdated myths. In fact, root canal treatment doesn't cause pain but actually relieves it... Read Article

Root Canal Treatment for Children - Dear Doctor Magazine

Root Canal Treatment for Children's Teeth You may think that if a baby tooth comes out prematurely, it's no great loss; after all, it was going to fall out anyway, right? Wrong! Primary (baby) teeth serve as important guides for the permanent teeth that will replace them. Losing baby teeth prematurely can allow bite problems to develop. Root canal treatment for children can prevent this. Learn what to look for in your child and what can be done to save baby teeth until they are ready to be lost naturally... Read Article

Tooth Pain - Dear Doctor Magazine

Tooth Pain? Don't Wait! Pain is a protective response that informs the body that something is wrong. Tooth pain, specifically, is caused by a reaction of the nerves inside a tooth's pulp chamber, with the severity dependent upon the type and degree of the stimulus. This article gives some examples of pain symptoms and their possible causes... Read Article