What Is Orthodontics?
Orthodontics is a form of dentistry that specializes in the diagnosis, prevention and treatment of dental and facial irregularities. Technically speaking, these problems are classified as "malocclusion," meaning "bad bite." Dr. Wiesse is skilled in the design, application and control of corrective appliances, such as braces, to bring teeth, lips and jaws into proper alignment and to achieve facial balance.
Most people associate orthodontia with the application of braces to correct crooked teeth in children. Dr. Wiesse, however, treats a wide variety of conditions in people of all ages - from overbites to underbites.
Malocclusions are usually inherited or acquired.
Acquired malocclusions can be caused by accidents (called "trauma"), sucking of the thumb, finger or pacifiers, tonsils and adenoids that obstruct the airway, and disease or premature loss of primary or permanent teeth.
Inherited malocclusions that determined how well your teeth fit together are largely determined by such attributes as tooth and jaw size. For example, people can inherit large teeth and small dental arches, or the reverse. A "poor bite" is often caused by teeth that have too much or too little room in the jaw. Other common causes of crooked teeth are factors that move the teeth out of place, including oral habits and early tooth loss, which leads to tooth shifting.
Regardless of whether malocclusions are inherited or acquired, many of these problems affect not only alignment of the teeth but also facial development and appearance as well.
Most cases of malocclusions are mild, or cosmetic, in nature; for example, a poor bite does not cause severe impediments to talking or eating. In some people, however, the condition is so severe that they cannot eat or speak properly.
A poor bite does not ordinarily cause tooth decay, periodontal disease, or temporomandibular (TM) disorder. It may, however, make it difficult to properly care for one's teeth.
Although a majority of the population have some type of malocclusion, not all people require or seek orthodontic treatment. For example, with or without a history of orthodontic treatment, 65% of adults develop crowded, crooked lower front teeth. This is a natural result of change over time and does not necessarily require orthodontic treatment.
Symptoms that trigger orthodontics
If you or your child have any of the following symptoms, have your general or pediatric dentist evaluate whether a poor bite may be responsible:
- Difficulty chewing due to tooth pain or difficulty aligning teeth
- Facial muscle or jaw pain
- Permanent teeth coming in (erupting) out of their normal position
- Problems with biting the cheek or roof of the mouth
- Speech difficulties
Early Warning Signs
Early interceptive orthodontic treatment usually starts before the eruption of the permanent teeth or when the child has very few permanent teeth present. Our goal at Dr. Wiesse's office is to guide the growth of the upper and/or lower jaw to make adequate space for the eruption of all the permanent teeth. We feel that children should be evaluated by the age of four to see if there is a bone problem (orthopedic) or a tooth problem (orthodontic).
Deep Bite - Do the upper teeth completely hide the lower teeth when you bite down, or does your child bite on the roof of their mouth?Early Treatment (Phase I)
Open Bite - Do the upper and lower teeth not meet in the front when your child bites together?
Overjet - Do the upper front teeth seem to be more noticeable and stick out quite a bit, compared to the lower front teeth?
Facial Asymmetry- When looking at your child from the front does it appear that their face, or chin are shifted to one side. Are they growing crooked?
Crossbite - When you look into your child's mouth are the upper teeth on the inside of the lower teeth? If you think of the upper jaw as the garage and the lower jaw as the caræthe garage should be bigger than the car!
Habits - Does your child suck their finger or their thumb? Do they breathe through their mouth instead of their nose? Do they stick their tongue between their teeth when they swallow?
Crowding - Are the permanent teeth starting to come in crowded?
Headaches - Does your child complain frequently of headaches? If your child grinds their teeth, or has a deep bite, the muscles may be over worked and can contribute to headaches in children.
Earaches - Sometimes a bad bite or a deep bite can cause undue pressure on the small membranes of the ear, contributing to earaches.
These are all sign that your child may need early intervention!
Functional Appliances work with your child's growth and development to guide the jaws to their proper size.
Contact us for an assessment of your child, if you have noticed any of the above symptoms.
If the patient has a problem such as the upper jaw being too narrow, or an underdeveloped lower jaw, this will require a special appliance called a functional jaw orthopedic appliance to correct the problem. Minor tooth crowding can also be corrected early if it appears as though it may compromise the eruption of other permanent teeth.
Underdeveloped Lower Jaw
Normal Jaw 7 Months Later
It is always less expensive to correct a problem when the patient is younger rather than wait for the problem to become more serious in the future.
Other benefits of early treatment:
- Improve profiles, smiles and self-esteem
- Correct harmful habits, such as thumb sucking and tongue thrusting. Functional appliances develop the arches and make more room for the tongue.
- Improved speech
- Reduction of the time in fixed braces and frequently eliminates the need for the extraction of permanent teeth
- Increases nasal breathing which improves health
- Eliminates airway constriction
- Creates beautiful broad smiles by developing the arches
- Eliminates grinding of the teeth at night
- Prevents headaches and earaches
Cross Bite Pre-Treatment
Cross Bite Corrected 3 Years Later
Functional habits include thum sucking, mouth breathing or a tongue thrust habit which can contribute to the unfavorable growth of the jaws. Oral habits can commonly cause the upper front teeth to stick out and can contribute to speech problems. The best way to intercept a habit is to first make certain that the child has a proper size airway and can breath through the nose. In cases where there are serious allergies, swollen adenoids or tonsils, a referral to an Ear, Nose & Throat Specialist must be done.
Effects of Finger Habit
After airway considerations are addressed an upper fixed habit- breaking appliance could be made to stop the oral habit. Most parents prefer the fixed appliances, which cannot be removed by the child. A tiny patient friendly crib at the front of the appliance helps to remind the patient not to place their tongue, finger of thumb in this area of the mouth. Active treatment usually takes 4 to 5 months. Then if an arch development appliance was used, the crib could be removed, and the child wears the appliance as a retainer for another 6 months to prevent a relapse.
Orthodontics (Phase II)
Orthodontics is usually our Second Phase of treatment, following the use of functional appliances. The braces would now be placed to move the teeth into alignment to support the development of the bone achieved in the first phase of treatment. The second phase of treatment is initiated when most of the permanent teeth have erupted.
Braces are the small, square metal attachments (called brackets) that are bonded with special orthodontic adhesive to the teeth. There is a small slot in the in the middle of the bracket into which the orthodontic wire fits. In order to hold the wire in place, small tiny elastics are wrapped around the outside of the braces. It is the combination of the braces, the wire and the elastic that help the tooth move into is proper position.
To help make the wearing of braces more fun, patients have a choice of at least 40 different colored elastics.
The model below has red and green elastics in keeping with the Christmas spirit.
This phase of treatment usually last between 12-24 months depending of the amount of tooth movement necessary to align the teeth and to establish a proper bite. It is important to remember that treatment time is estimated. Dr.Wiesse has specific treatment goals in mind and will usually continue treatment until these goals have been achieved. Patient cooperation is the best way to keep on time with your treatment. Be sure to take care of your braces and to wear your rubber bands as instructed and we will both be able to achieve our desired result.
After phase II is completed it is necessary to wear retainers to hold the final result. The great part about our retainers is that they are virtually invisible which helps guarantee patient acceptance and ensures they will be worn at the appropriate times.