Orthodontics

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Who Needs Orthodontic Treatment?

Adults and children both seek orthodontic treatment for:

Malocclusion (incorrect bite) Tooth alignment (crooked teeth) Improvement of overall appearance, including gaps between teeth

Classification of Occlusion
Class I Class II Class III

Upper and Lower molars align properly, but teeth are crooked. 72% of ortho cases.

Upper molars are positioned too far forward (anterior) compared to the lower molars. 22% of ortho cases.

The upper first molar is positioned behind the lower first molar. 6% of ortho cases.

Examples of Malocclusion

Overbite The upper front teeth cover too much (more than 30%) of the lower front teeth. Also called a deep bite. This may be seen in a Class I or II malocclusion.

Examples of Malocclusion

Overjet causes buckteeth. The upper front teeth are positioned too far forward (normal distance between upper and lower front teeth is 1-3 mm). This is typical in Class II maloclussion.

Examples of Malocclusion

Underbite causes a bulldog appearance. The lower front teeth are positioned in front of the upper front teeth. This is seen in Cass III malocclusions.

Examples of Malocclusion

Crossbite The upper teeth should overlap the lower teeth slightly when the jaws are closed. When this does not occur, it is called a crossbite. May occur in any class of malocclusion.

Examples of Malocclusion

Open bite open space exists between upper and lower teeth when jaws are closed. Often caused by thumbsucking, seen in all classes of malocclusion.

Examples of Malocclusion

Midline shift the center of the upper front teeth is not aligned with the center of the lower front teeth. Can be seen in all classes of malocclusion.

What causes malocclusion?

Genetics - You may inherit a small mouth from mom and large teeth from dad. Tooth loss - If a tooth is lost from an injury, cavities, or gum disease, the remaining teeth may shift. Bad habits such as thumbsucking can shift teeth or cause them to erupt improperly. Malnutrition Nutritional deficits can restrict the growth of jaws and teeth.

When is the best time for ortho?

The jaws of pre-teens and teens are still growing. Therefore, it is easier to shift teeth at this stage. Sometime, two separate phases of braces are necessary for treatment.

It is becoming more common for adults to seek

Phase I when patients are 6 to 7 years old, to make room for the permanent teeth to erupt properly Phase II at age 12 (or when permanent teeth have erupted) a second round of braces are applied to straighten teeth and correct bite.

orthodontic treatment. Their treatment may take longer to complete.

Space Maintainers

When a primary, or deciduous, tooth (commonly called baby tooth) is lost too early, the space needs to be held open until the permanent tooth is ready to erupt.

Space Maintainers

A space maintainer is an appliance made of metal or plastic and may be removable or cemented onto neighboring teeth.

Removable space maintainer

Band and loop maintainer

Lower lingual holding arch

Why does malocclusion need corrected?

An incorrect bite can have long-term effects including:

Interference with normal growth and development of jaws Difficulty swallowing Impaired chewing Speech defects Susceptibility to cavities and gum disease Poor aesthetics

How do braces work?

Teeth can be GRADUALLY moved into proper position by applying pressure in certain directions using bands, wires, and elastics. A series of clear trays, such as Invisalign, may also be used.

standard braces

lingual braces

Clear braces

virtually invisible Invisalign trays

How do braces work?

Removeable appliances may also be used such as: Palatal expander to widen the arch Jaw repositioning appliance, or splint, to retrain the jaw to close properly Headgear- involves a strap that wraps around the head and attaches to a wire or face bow in the front. used to slow the growth of the upper jaw and move front teeth towards the back.

palatal expander

Jaw repositioning appliance

Headgear

How do braces work?

Treatment typically lasts 1 to 2 years. After braces are removed, retainers are used to hold the teeth in their new position. Typically, retainers are worn 24 hours a day for the first six months and then worn only at night thereafter. Permanent retainers, bonded to the back side of front teeth, may also be used.

Home care for ortho patients

Braces collect food and plaque very easily. Often, ortho patients are children or teenagers who do not have optimum brushing and flossing habits. If braces are not kept clean, tooth decay and gum inflammation easily occur. Orthodontists may decide to remove braces prematurely if the patients hygiene is poor.

Home care for ortho patients

Brushing

Special orthodontic toothbrushes or battery toothbrushes may be useful. Patients need to brush both above and below the brackets, paying special attention to the space between the gumline and the brackets.

Home care for ortho patients

Flossing

Flossing around braces is time consuming. Superfloss (strands of floss with stiff ends) or floss threaders are used to floss beneath the wires. Interdental brushes can be used between the wire and the tooth, between brackets.

Home care for ortho patients

A fluoride mouthwash, either over-the-counter or prescription, is usually recommended to help prevent tooth decay around the brackets and to reduce decalcification. A oral irrigator such as a Waterpik, may be used to flush debris from the brackets.

Home care for ortho patients.

Dental Check-ups

An orthodontic patient needs to visit his or her general dentist at least every 6 months for a cleaning and check-up to monitor the health of the teeth and gums, ensuring great results when treatment is complete!