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

 

Tooth Pain.At one time or another, almost everyone has probably experienced some degree of tooth pain, from minor aches and sensitivity to acute distress. In general, the sensation of pain is a protective response that tells the body something is wrong. But when it affects your teeth, the exact source of the pain can be difficult to pinpoint; it may also come and go in response to other stimuli, like eating hot foods. So what is tooth pain signaling, and what should you do about it?

The most common cause of dental pain is tooth decay, a bacterial infection that can spread through many parts of the tooth, and even into the gum tissue. Traumatic damage and gum disease can also result in tooth pain.

The only sure way to know what's causing tooth pain is to see a dentist, who will ask detailed questions about what you're feeling and perform diagnostic tests, such as x-rays, to try and identify the exact source of the pain. However, there are some general ways to describe the sensations you may be experiencing — and their potential cause.

Severe Pain/Root Canal Emergencies

Tooth Infection.Constant, severe pain and pressure, swelling of the gums, and sensitivity to touch indicate an infection in the tooth, possibly accompanied by an abscess (inflamed, pus-filled sac) in the surrounding gum and bone tissue. In this case, it's important to see a dentist or endodontist right away — not only to relieve the pain, but also to save the tooth while it's still possible. Treatment may include a root canal to remove diseased or dying pulp tissue, and/or periodontal procedures to drain the abscess and stop the infection.

Lingering pain after eating hot or cold foods usually indicates disease in the pulp tissue deep inside the tooth. Deep decay or physical trauma to the tooth may have allowed bacteria to infect the pulp tissue or compromise the pulp vitality. As nerves inside the pulp tissue die, the pain may go away, but the infection won't — in fact, it can spread and cause significant damage. Make an appointment to see a dental professional as soon as possible; a root canal may be needed to ease the pain and preserve the tooth.

Sharp pain when biting down on food can be caused by severe tooth decay, a loose filling, a crack in the tooth, or possibly by damaged pulp tissue inside the tooth. It should be evaluated by a dentist as soon as possible. Depending on the cause, treatment may involve filling, bonding, root canal therapy, or other procedures.

Toothache

Tooth Decay.Occasional or momentary sensitivity to hot or cold foods may be caused by a tiny area of decay, a loose filling, or a small amount of gum recession that has exposed the roots of the teeth. To alleviate the symptoms, you can try using a soft brush and toothpaste formulated for sensitive teeth, for a couple of weeks. If that doesn't help, call the dental office to schedule and appointment. Dental treatment itself sometimes causes temporary sensitivity, which can often be relieved by the same methods. If pain persists or grows worse, however, be sure to seek treatment.

A severe sinus headache or congestion from colds or flu may cause you to experience symptoms such as a dull ache or pressure in the upper teeth and jaw. When the illness goes away, the dental distress should cease too. Tooth clenching or grinding (bruxism) has also been known to cause this type of discomfort. If you have these habits, you may want to have a nightguard made at the dental office to protect your teeth and jaws from too much force.

No matter what type of tooth pain or discomfort you are experiencing, it is important to seek treatment if it persists.

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