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

 

When dental emergencies and pain occur, our attention is often focused on diseases and injuries related to the teeth. However, it's important to remember that the soft tissues of the mouth — the gums, tongue, lips and cheek lining — may also be affected. While they are tough enough to stand up to the oral environment, these tissues can be damaged by accidental bites, falls, sports injuries, and scalding liquids. They may also suffer injury from foreign bodies that become lodged below the gum line, and they can develop painful and potentially serious abscesses.

First Aid for Soft Tissues

Soft tissue injuries in the mouth don't usually bleed excessively — although blood mixing with saliva may make any bleeding appear worse than it actually is. To assist someone with this type of injury, you should first try to rinse the mouth with a dilute salt water solution. If a wound is visible, it can be cleaned with mild soap and water; if that isn't possible, try to remove any foreign material by hand, and rinse again.

Bleeding can usually be controlled by pressing damp gauze (or, if unavailable, another clean material) directly to the site of the injury, and keeping it there for 10-15 minutes. If the bleeding doesn't stop, immediate medical attention will be needed. Try to see a dentist within 6 hours of the injury for evaluation and treatment. This usually involves determining the extent of the damage, performing initial restorative procedures, and occasionally suturing (stitching) the wound. An antibiotic and/or tetanus shot may also be given.

Foreign Bodies

Occasionally, foreign objects may become lodged in the space between teeth and gums, causing irritation and the potential for infection. There are a few foods (such as popcorn husks) that seem especially prone to doing this, but other items placed in the mouth — like wood splinters from toothpicks or bits of fingernail, for example — can cause this problem as well.

If you feel something stuck under the gum, you can try using dental floss to remove it: Gently work the floss up and down below the gum line to try and dislodge the object. Light pressure from a toothpick may also help work it free — but avoid pressing too hard or pushing the object in deeper. If that doesn't work, see a dentist as soon as possible. Special tools may be needed to find and remove the object, and you may be given medication to prevent infection.

Periodontal (Gum) Abscesses

Gum abscess.Sometimes called a gum boil, a periodontal abscess is a pus-filled sac that may form between teeth and gums. It is caused by an infection, which may have come from food or other objects trapped beneath the gum line, or from uncontrolled periodontal disease. Because pressure builds up quickly inside them, abscesses are generally quite painful. Symptoms may include a throbbing toothache which comes on suddenly, tenderness and swelling of the gums or face, and sometimes fever. Occasionally, pus draining into the mouth through an opening in the sac relieves the pressure and pain, but may cause a strange taste.

If left untreated, abscesses can persist for months and cause serious health problems, including infections that spread to other parts of the body. That's why it is important to see a dentist right away if you experience symptoms. He or she will find the location of the abscess and treat it appropriately. Treatment usually involves draining the pus and fluid, thoroughly cleaning the affected area, and controlling the infection.

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