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

 

Toothbrush unable to clean grooves in teeth.The most likely location for a cavity to develop in your child's mouth is on the chewing surfaces of the back teeth. Run your tongue over this area in your mouth, and you will feel the reason why: These surfaces are not smooth, as other areas of your teeth are. Instead, they are filled with tiny grooves referred to as “pits and fissures,” which trap bacteria and food particles. The bristles on a toothbrush can't always reach all the way into these dark, moist little crevices. This creates the perfect conditions for tooth decay.

What's more, a child's newly erupted permanent teeth are not as resistant to decay as adult teeth are. The hard enamel coating that protects the teeth changes as it ages to become stronger. Fluoride, which is found in toothpaste and some drinking water — and in treatments provided at the dental office — can strengthen enamel, but, again, it's hard to get fluoride into those pits and fissures on a regular basis. Fortunately, there is a good solution to this problem: dental sealants.

Dental sealants are invisible plastic resin coatings that smooth out the chewing surfaces of the back teeth, making them resistant to decay. A sealed tooth is far less likely to develop a cavity, require more expensive dental treatment later on, or, most importantly, cause your child pain.

How Sealants Are Placed

Dental Sealants - Step by Step.

You can think of a sealant as a mini plastic filling, though please reassure your child that it doesn't “count” as having a cavity filled. Because tooth enamel does not contain any nerves, placing a sealant is painless and does not routinely require numbing shots. First, the tooth or teeth to be sealed are examined, and if any minimal decay is found, it will be gently removed. The tooth will then be cleaned and dried. Then a solution that will slightly roughen or “etch” the surface is applied, to make the sealing material adhere better. The tooth is then rinsed and dried again. The sealant is then painted on the tooth in liquid form and hardens in about a minute, sometimes with the help of a special curing light. That's all there is to it!

A note about BPA: A 2012 study that received wide press coverage raised concerns that trace amounts of the chemical bisphenol-A (BPA) found in some (but not all) dental resins might contribute to behavioral problems in children. The study authors noted that while they had found an association, they had not actually proven that BPA in dental sealants causes these problems. In fact, BPA is far more prevalent in food and beverage packaging than in dental restorative materials. The American Academy of Pediatric Dentistry and the American Dental Association have since reaffirmed their support for the use of sealants.

Taking Care of Sealants

Sealed teeth require the same conscientious dental hygiene as unsealed teeth. Your child should continue to brush and floss his or her teeth daily and have regular professional cleanings. Checking for wear and tear on the sealants is important, though they should last for up to 10 years. During this time, your child will benefit from a preventive treatment proven to reduce decay by more than 70 percent.

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