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

 

What do orthodontists do?

Orthodontists are dental specialists who diagnose and treat problems with the position, alignment or spacing of the teeth, and related irregularities in the face and the jaw. A number of special treatments, including braces and other oral appliances, are used to correct these problems.

Why should I (or my loved ones) get orthodontic treatment?

The magic of orthodontics video

There are two good reasons: aesthetics and function. Having an attractive smile not only changes the way people see you — it enhances your own self-image as well. Orthodontic treatment also allows your teeth to function better and makes it easier to keep them clean, which can improve your overall health.

When should orthodontic treatment be started?

You're never too old to begin orthodontic treatment — but if you start at an earlier age, your problems may be easier to treat. The American Association of Orthodontists recommends that a child who may need orthodontic treatment should come in for a first visit around age 7.

How can I recognize a potential bite problem?

Teeth that are protruding, crowded together or erupting out of position are clear indications that treatment is needed (View Examples). Less obvious signs are mouth breathing, frequent biting of the cheek or palate, speech difficulties, and thumb sucking that goes past 3-4 years of age. If teeth don't meet properly when the mouth closes, or if jaws make sounds or shift as they move, this may also indicate an orthodontic problem.

Does getting braces hurt? What about wearing them?

Having braces put on is generally painless. Some people experience minor aches and pains in the first couple of days or so, as they adjust to wearing their appliances; periodic adjustments may sometimes cause soreness as well, though it typically lasts only a short time. Over-the-counter pain relievers can be used to alleviate any discomfort, but are usually unnecessary.

How long will treatment take?

It's different for each person, but generally the active stage of treatment (that is, wearing braces or other appliances) may take from 6-30 months. After that, a retainer is worn for at least several months more.

How often will I come in for an appointment?

It depends on what's being done, and how often you need to be monitored. During active treatment, you'll typically visit the office once every 4 to 10 weeks.

Will I need to have any teeth extracted?

If your teeth are severely crowded (because your mouth is too small to properly accommodate all of them) — or if you have impacted teeth (teeth that are trapped beneath the gum line by other teeth) — then extraction may be necessary. In the case of younger patients, early treatment may make extraction unnecessary.

Will I have to watch what I eat?

Yes — you should pass up the types of foods that could damage or become trapped in your braces. Some of these include raw vegetables, hard candy, caramel, taffy and ice cubes (fortunately, ice cream is OK). You will receive a list of foods to avoid.

Will I be able to play sports/ play my instrument?

In a word: Yes. Of course, whether you wear braces or not, we recommend you wear a mouthguard when playing most sports. Musicians are generally able to play their instruments just as they did before, but they may need a short adjustment period after getting braces.

Do I still need to see my regular dentist while I'm getting orthodontic treatment?

You do — in fact, it's more important than ever! Keeping teeth free of plaque (and potentially, decay) can be challenging when you're wearing braces. Your dentist can help you avoid these problems with frequent cleanings and exams.

Will I wear a retainer when my braces come off?

Almost always, the answer is yes: If you don't wear a retainer, your teeth can rapidly shift out of position — and then all the effort put into your treatment is lost! Your retainer helps you maintain that good-looking smile for a lifetime.

Is orthodontic care very expensive?

Orthodontic care is a long-term investment in your health and well-being. Yet its cost hasn't increased as fast as many other consumer prices, and many financing options are available that make orthodontic care affordable. Weighed against the true cost of living with problem teeth, however, orthodontic treatment can be a wise investment indeed.

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