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

 

Traumatic dental injury.Traumatic dental injuries can occur in people of all ages and activity levels. The cause might be a car accident, a fall down the stairs, or an elbow to the face during a basketball game. As with most types of dental treatment, the primary goal when treating a traumatic dental injury is to save teeth at risk of being lost, and restore them to full function and normal appearance. In many cases, the difference between saving and losing a tooth depends on taking the proper action in the immediate aftermath of an injury. Here are some guidelines on how to prevent sports-related dental injuries and what to do after a dental injury occurs.

Sports-Related Dental Injuries

Americans of all ages love playing sports — so much so that participation in high school sports has been increasing for 24 consecutive years, according to one survey. Yet to gain the very real benefits that sports offer, it's necessary to accept — and prepare for — the risk of injury.

Athletic mouthguards video

Dental trauma accounts for a significant portion of all sports injuries, yet so many of these injuries are preventable. How? With a high-quality mouthguard. When you consider that the lifetime cost of replacing a permanent tooth has been estimated to exceed $20,000, a good mouthguard is one of the best investments you can make in sports equipment: It has been shown to reduce the risk of sports-related dental injury by 60 times.

The best kind of mouthguard is one that comes from your dentist's office. It's custom-made from a model of your own teeth, so it's strong, lightweight, and perfectly fitted. If you (or your child) are active in sports, ask about this indispensable piece of safety gear. And continue reading below to find out what to do in the case of specific types of dental injuries.

Chipped or Broken Teeth

Chipped tooth.Chipped teeth are the most common dental injury, according to the American Association of Endodontists. If teeth have been chipped or fractured, or if they are loose or tender to the touch, make sure to see a dentist within 12 hours. Try to locate any pieces of the tooth that have come off, as it may be possible to reattach them to the crown with tooth-colored bonding material.

Knocked-Out Teeth

Knocked out tooth.If a permanent tooth has been knocked out of its socket (avulsed), immediate attention is required. First, recover the tooth — and if it's dirty, gently clean it off with water. Try not to touch the root portion of the tooth. Next, if possible, place the tooth back into its socket (making sure it is in the proper orientation), and apply gentle, sustained pressure to the area for five minutes. You can use a wad of wet tissue or gauze to help grasp and hold the tooth in place. Get emergency dental treatment as soon as possible afterward, and be sure to check whether a tetanus shot or booster is needed.

If it isn't possible to replant the tooth, have the patient hold it between his teeth and cheek, or place it into a plastic bag with the patient's saliva, or into a cup of cold milk. Control bleeding from the tooth socket by applying pressure to the area (use gauze if possible), and get the patient and the tooth to an emergency treatment center as soon as possible. Primary (baby) teeth, however, don't usually need to be replanted.

Partially Displaced Teeth

If teeth are driven into or pushed partially out of the jaw, or if they are out of alignment, the patient should see a dentist or oral surgeon within six hours of the accident. A careful examination of the mouth (plus x-rays if needed) should reveal the extent of the damage, and indicate what restorative treatments are likely to be required.

Soft-Tissue Injuries

In addition to the teeth, dental injuries often involve damage to the gums, the tongue, and the inside of the mouth. When these soft-tissue injuries occur, it's best to take the following immediate actions, and then see a dentist as soon as possible: Wash and rinse the area with soap and water if possible, or remove debris and foreign material by hand. Bleeding can usually be controlled by applying direct, gentle pressure to gauze pads placed on the wound. If it can't be controlled after about 10 minutes, go to an emergency room.

Don't hesitate to call the dental office for more specific information about handling a traumatic dental injury.

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