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

 

Child with mouthguard.Kids who take part in athletic activities — whether they're playing on organized sports teams, bicycling, or just kicking a ball around — gain a host of well-documented health benefits. Yet inevitably, along with all the fun, the sense of achievement, and the character-building features of athletics, the possibility of injury exists. Does this mean your kids shouldn't play sports? Of course not! But it makes sense to learn about the risks involved, and to take appropriate precautions.

How prevalent are sports-related dental injuries? In 2012, the National Youth Sports Safety Foundation forecast that more than 3 million teeth would be knocked out in youth sporting events that year! Among all the dental injuries we treat in children, it is estimated that over 25% are sports-related, and the majority of these involve the top front teeth.

Besides the immediate trauma, sports-related injuries can result in time lost from school and work, and substantial cost — up to $20,000 over a lifetime to treat a missing permanent tooth. Yet there's a simple and relatively inexpensive way to reduce the chance of dental injury in children: A properly-fitted, comfortable mouthguard, worn whenever playing sports where the possibility of orofacial injury exists.

Use the Right Equipment

Athletic mouthguards.

You wouldn't let your child play football without a helmet and protective padding, right? Yet it might surprise you to know that kids playing basketball are 15 times more likely to sustain injuries to the mouth or face than football players! Mandatory mouthguards are one reason for that: More American kids wear mouth protection for football than any other sport, which has resulted in a dramatic drop in injuries.

Mouthguards are required in only four school-based sports: football, ice hockey, lacrosse, and field hockey. Yet basketball and baseball are associated with the largest number of dental injuries. Other sports for which the American Dental Association (ADA) recommends wearing a mouthguard include bicycling, soccer, skateboarding, wrestling and volleyball. Do mouthguards work? The ADA estimates that athletes who don't wear mouthguards are 60 times more likely to suffer dental injury than those who do.

What Type of Mouthguard Is Best?

The best mouthguard for your child is the one he or she actually wears, both at practice and on game day. There are several different types of mouthguards on the market, which generally fall into three categories:

  • An “off-the-shelf” mouthguard. Available at many sporting goods stores, this type comes in a limited range of sizes, and varies widely in quality. The least expensive option, it offers a minimal level of protection that's probably better than nothing. It generally must be clenched in the mouth, which can make wearing it uncomfortable and cause trouble breathing and speaking.
  • The “boil and bite” mouthguard. These are designed to be immersed in hot water, and then formed in the mouth using finger, tongue and bite pressure. When they can be made to fit adequately, they generally offer better protection than the first type—but they may still be uncomfortable, and usually fail to offer full coverage of the teeth.
  • A custom-made mouthguard. This is a piece of quality sports equipment that is custom fabricated for your child's mouth. How? Molds or impressions of your child's teeth will be made and then tough, resilient, high quality materials are perfectly fitted to that impression. This type of mouthguard offers your child maximum protection and a superior level of comfort — and its cost is quite reasonable.

At the present time, when top-quality sports equipment for kids can run in the hundreds of dollars, it makes more sense than ever to invest in the proven protection of a professionally made, custom-fitted mouthguard.

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