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

 

Implant supported fixed dentures vs removable dentures.

If you have lost an entire arch of teeth (top and/or bottom), or are soon to have your remaining teeth removed because they are too unhealthy to save, you may be able to replace them with fixed dentures supported by dental implants. Doctors and patients alike prefer fixed over removable dentures because they:

  • Look, feel and function just like natural teeth
  • Don't slip when you eat or talk
  • Prevent bone loss in the jaw
  • Last a lifetime

How It Works

Dental implants serve the same purpose as the roots of natural teeth: anchoring the replacement teeth to your jawbone. Just like natural tooth roots, they lie under the gum line and therefore are not visible in the mouth. Only the lifelike prosthetic teeth attached to them (the fixed denture) can be seen by you or anyone else. Because dental implants are made of titanium, a metal that has the unique ability to fuse to living bone, they are extremely stable and reliable. How many implants are needed? The number varies because each individual has unique conditions: Depending on the volume and density of the bone in your jaw, you will need as few as four implants or as many as six for your new teeth to function as well as a set of healthy, natural teeth.

What to Expect

All-on-Four.The surgery to place dental implants that support a fixed denture is a simple, routine procedure carried out in an office setting, under local anesthesia in most cases. (If you need to have failing teeth removed, that will be done first, often the same day your implants are placed). After numbing the area, the appropriate number of implants will be placed in your jaw at precisely planned angles and positions to maximize support and avoid anatomical structures such as nerves and sinuses. Depending on how many implants are needed, the surgery can take anywhere from one to three hours. Most people who have dental implants placed find that any post-operative discomfort can be managed with over-the-counter anti-inflammatory medication such as ibuprofen or acetaminophen. Some don't even need to take that.

What happens immediately after surgery will depend on what's best to promote healing in your individual situation. Sometimes a set of temporary teeth can be attached immediately, so that you can leave the office with new teeth. A few months later, your permanent replacement teeth with be installed. In other cases, the implants will be left to heal for several months before any teeth are attached. Sometimes that is the best way to insure that the implants remain undisturbed as they go through the process of fusing to your jawbone, which is known as osseointegration.

In either case, you will need to go easy on your newly placed implants during the crucial healing phase following surgery. You will be advised to eat a softer diet and avoid hard, chewy foods until the process of osseointegration is complete — about three months. While this may seem like a long time, keep in mind that people who wear removable dentures often avoid these foods permanently. The good news is that once your implants have fused to your jawbone and your new permanent teeth are attached, you will be able to eat anything you want. In fact, you are likely to forget you even have dental implants!

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