orthodontiCS TREATMENT types
Orthodontic Treatment Types
The technical term for an orthodontic problem is malocclusion. Malocclusions are categorized into two types:
Skeletal malocclusion occurs when the upper and lower jaws don't line up with one another or when the jaws are too big or too small for the teeth.
Dental malocclusion occurs when the teeth are out of line, crowded, turned or spaced too far apart.
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Generally people have a combination of both skeletal and dental malocclusions that must be addressed.
Orthodontists further classify orthodontic problems as follows:
Teeth may be aligned poorly because the dental arch is small and/or the teeth are large. The bone and gums over the roots of extremely crowded teeth may become thin and recede as a result of severe crowding. Impacted teeth, poor biting relationships and undesirable appearance may all result from crowding.
Our office philosophy is avoidance of extraction of the permanent teeth when possible. To attain that goal, it is sometimes necessary to remove a few baby teeth to avoid distortion of the jaw, damage to the teeth, improve the cleaning ability, and gain alignment of the erupting permanent teeth. The following discussion will help you understand the interceptive steps necessary to help your child attain a normal development:
Quite often we see young children (age 6-9 ) with moderate to severe crowding of the lower or upper front teeth. As the permanent teeth begin to erupt in the front part of the mouth, there will sometimes be two rows of teeth present at the same time. Usually it is the permanent teeth erupting to the tongue side of the baby teeth which gives the "double row" appearance.
The space available for alignment of the teeth is at a maximum in the front part of the mouth at age 8-9. The mouth gets bigger to allow the molars to erupt through growth in the back part of the jaw. At age nine, the jaw width across the front is as wide as it will be in the adult and any crowding present at that time will not self-correct due to growth. Sometimes, parents think if they wait, the mouth will grow to accommodate the permanent teeth. Not true! What you see at age eight is what you get later unless the space is managed by orthodontics.
If there is moderate to severe crowding in the front, then sometimes we will recommend removing two to four baby teeth to make room for the permanent teeth to erupt. Unless one of the erupting teeth is way out of line, the tongue pressure will usually align the four permanent incisors within a period of 3-6 months. Since we usually recommend removing the baby cuspids, there is no harm in doing this procedure to eliminate crowding.
Having to remove these baby teeth tells you something though! There may not be enough room for all the permanent teeth in the future. Early removal will allow most of the permanent teeth to align, so the bone will not be damaged by severely crowded permanent teeth. When the permanent bicuspids begin to erupt around age eleven, it may be necessary to begin treatment with braces or other orthodontic appliances to make more room, and try to avoid having to remove permanent teeth. We don't need to make those decisions until we see how much room is needed later, but it is best if we see your child on a regular basis to evaluate the growth and development.
Interceptive Orthodontic Treatment: Correction of Crowding in Young Patients
A deep overbite or deep bite occurs when the lower incisor (front) teeth bite too close or into the gum tissue behind the upper teeth. When the lower front teeth bite into the palate or gum tissue behind the upper front teeth, significant bone damage and discomfort can occur. A deep bite can also contribute to excessive wear of the incisor teeth.
Overjet or or upper protruding teeth is where the upper front teeth protrudes beyond normal contact with the lower front teeth. An overjet are prone to injury, often indicate a poor bite of the back teeth, and may indicate an unevenness in jaw growth. Commonly, protruded upper teeth are associated with a lower jaw that is short in proportion to the upper jaw.
An open bite results when the upper and lower incisor teeth do not touch when biting down. This open space between the upper and lower front teeth causes all the chewing pressure to be placed on the back teeth. This excessive biting pressure and rubbing together of the back teeth makes chewing less efficient and may contribute to significant tooth wear.
About 3 to 5 percent of the population has a lower jaw that is to some degree longer than the upper jaw known as an underbite or lower jaw protrusion. This can cause the lower front teeth to protrude ahead of the upper front teeth creating a crossbite. Careful monitoring of jaw growth and tooth development is indicated for these patients.
The most common type of a crossbite is when the upper teeth bite inside the lower teeth (toward the tongue). Crossbites of both back teeth and front teeth are commonly corrected early due to biting and chewing difficulties.