Common Orthodontic Corrections in Adults and Children

Orthodontics is the specialty of dentistry focused on the diagnosis and treatment of dental and associated facial irregularities.  The results of orthodontic treatment can be dramatic – beautiful smiles, improved dental health and an enhanced quality of life for many people of all ages.  Orthodontic problems, which can result from genetic and environmental factors, must be diagnosed before treatment begins.  Proper diagnosis involves taking photographs, x-rays, and dental impressions, which enable our practice to make informative decisions about the form of treatment necessary.

            Treatment typically lasts from 6 to 30 months, depending on age, and the severity of the orthodontic problem.  Outstanding results are also dependent on maximizing the coordination of care between you and our practice.   We are committed to delivering the best possible service in order for you to achieve your orthodontic objectives.

The Benefits of Orthodontic Treatment

Crooked and crowded teeth are hard to clean and maintain.  This may contribute to conditions that cause not only tooth decay but also eventual gum disease and tooth loss.  Other orthodontic problems can contribute to abnormal wear of tooth surfaces, inefficient chewing function, excessive stress on gum tissue and the bone that supports the teeth, or misalignment of the jaw joints, which can result in chronic headaches or pain in the face of neck.

      When left untreated, many orthodontic problems become worse.  Treatment by a dentist to correct the original problem is often less costly than the additional dental care required to treat more serious problems that can develop in later years.

      The value of an attractive smile should not be underestimated.  A pleasing appearance is a vital asset to one’s self-confidence.  Self-esteem often improves as treatment brings teeth, lips and face into proportion.  In this way, orthodontic treatment can benefit social and career success, as well as improve one’s general attitude toward life.

Treatment Timing

            Dr. Farian provides orthodontic treatment for children, adolescents and adults.  It is recommended that an orthodontic evaluation take place at age seven for all children.  This early evaluation can help to determine the best time to begin any necessary treatment.

            Many progressive treatments are now available for patients seven to eleven years of age that provide significant benefits, especially when jaw irregularities are present. These treatments may also prevent certain conditions from worsening. Treating children with these types of problems during their growth stages allows our practice to achieve results that may not be possible when face and jaw bones have fully developed. This early treatment can simplify or eliminate additional treatment for the child.

Orthodontics for Children

            Dr. Farian recommends that the initial orthodontic evaluation should occur at the first sign of orthodontic problems or no later than age 7.  Usually by the seventh birthday, the child’s permanent teeth have started to erupt and the presence of spaces, crowding, rotations, cross-bites, and other orthodontic problems has begun to become evident.  At this early age, orthodontic treatment may not be necessary but early detection of some orthodontic problems is important in order to take early corrective action and avoid more difficult treatment later.

Orthodontics for Adults

            Dr. Farian also provides outstanding orthodontic treatment for adults.  A significant percentage of our orthodontic patient’s are adults.  Orthodontic treatment at later stages in life can dramatically improve your personal appearance and self-esteem.  Improving the health of your teeth and gums is equally important.  Crooked teeth and a bad bite can contribute to gum and bone loss, tooth decay, abnormal wear of the tooth enamel and surfaces, even headaches and sometimes jaw joint (TMJ) pain. 

A beautiful smile and a good functional bite is an asset at any age.  Using modern orthodontic appliances and techniques, many orthodontic problems can be corrected in children and adults.  The main difference seen between children and adults is the lack of, or minimal potential for jaw growth.  Understanding these differences, a customized treatment plan for all of our patients (children or adults) can bring about significant changes.

Different Types of Braces

            Metal braces are the most popular with kids and teenagers.  They love using different colors of ligature ties.  These braces are much smaller than ever before.

            Translucent clear ceramic braces are the most popular with adults.  You have to be very close to someone to be able to see them.  Yet, because they are a ceramic material, they are more fragile.

Can you be too old for braces?

            No, age is not a factor, only the health of your gums and bone which support teeth. 

Will it hurt?

            Orthodontic treatment has improved dramatically.  As a rule, braces make your teeth sore for a few days, but it is not painful.  This annoyance can be relieved with over–the-counter pain reliever.  Today’s braces are smaller, more comfortable and use technology that reduces the discomfort.  We use the latest in miniature braces and the highest quality of orthodontic materials in order to reduce discomfort and treatment time.

How do braces straighten crooked teeth?

            Braces use constant, gentle pressure, which over time, move teeth into their proper positions.  Your braces are at work every moment of your orthodontic treatment.  The two main components of your braces are: the brackets that are placed on your teeth and the main archwire that connects them.  The bracket is a piece of shaped metal or ceramic that we affix to each tooth.  The archwire is bent to reflect your “ideal” bite.  In other words, if reflects the way we want you to look after treatment.

            The wire threads through the brackets and, as the wire tries to return to its original shape, it applies pressure to move your teeth.  Picture your tooth resting in your jaw bone.  With pressure on one side from the archwire, the bone on the other side gives way.  The tooth moves.  New bone grows in behind.

            Attached to your braces, elastics (rubber bands) exert the proper force that creates the right amount of pressure to move teeth.  In order for this force to remain constant, elastics must be worn all the time and changed every day.

Home Care

Brushing:

            You will notice that it is much harder to keep your teeth clean with braces.  Food compacts in the brackets and between your teeth, and can only be removed by brushing and flossing.  If plaque remains on the teeth for any length of time, it will leave a permanent white scar on the surface.  Brushing after meals should become part of your daily schedule.  Use a soft toothbrush with firm pressure and brush at a 45 degree angle to the tooth; brush in small circles above and below the brackets.

Your toothbrush will wear out faster because of your appliances, so be sure to replace it whenever the bristles start to fray.  A waterpik can be a useful addition but it cannot remove the sticky plaque that adheres to the teeth.  Flossing is important and should be done everyday.

Eating Habits:

Please do not eat hard foods: nuts, ice, crisp taco shells, whole apples and carrots (cut them into pieces first), hard French bread crust and rolls, spareribs, corn on the cob (cut the corn off the cob before eating), and popcorn! These foods risk breaking brackets and wires.  Also beware of nail biting and pen or pencil chewing habits, since these can damage your braces.  Do not eat sticky foods: taffy, caramels, bubble gum, sticky candy of any sort.  A small piece of sugarless gum occasionally is acceptable.  Use common sense about most foods.

Braces:

Check braces once a week for anything loose or bent.  If a bracket or band comes loose or you break a wire, please call our office so that we can arrange an appointment long enough to repair it.  Try to explain what has happened and be as specific as possible with the receptionist.  If you lose your rubber bands, drop by the office and pick some up.

Sore Teeth:

After braces are placed in the mouth it is normal for the teeth to be sore for about 2 or 3 days.  Tylenol or Advil will help relieve this discomfort.  Sore irritation to the cheeks and tongue is normal, but if you feel anything sharp is poking you or any sores are developing, please call our office at (440) 526-9100. 

Elastics:

Attached to your braces, elastics (rubber bands) exert the proper force that creates the right amount of pressure to move teeth.  In order for this force to remain constant, elastics must be worn all the time and changed every day.  Any time missed in wearing your elastics will only make your treatment take longer, so remember these things:

1. You are responsible for placing the elastics on your braces between appointments.  Make sure to wear them as instructed.  Remove them only when brushing your teeth, gums and braces after meals.  Then put them back on immediately.
2. Always carry a few elastics with you, so if one breaks you can replace it right away.  If your supply is low, drop by the office and pick some up.

3. If you forget to insert your elastics one day, don’t double up the next day, just follow your regular instructions.

4. Elastics become worn out.  When they lose their elasticity, they don’t provide the proper pressure on your teeth and jaws.  It is very important to change them as directed, even when they are not broken.

Retainers & Appliances:

1. The removable appliance is carefully designed to move or to hold your teeth.  It is important that it be worn according to instructions and be brought to each appointment.

2. Wear your appliance at all times, even while you are asleep.  It may be removed while eating, swimming, or playing vigorous sports activities.  Avoid flipping your appliance with your tongue.  This can cause damage to your teeth or breakage of your appliance.

3. Your new appliance may make your teeth sore for a day or two, especially after an adjustment.  If you have a sore spot on your gums, call our office so we can adjust the appliance. You may notice a change in your speech with the appliance in place, but in two or three days your speech will return to normal.

4. Clean your appliance by brushing it daily with toothpaste.  Flossing of your teeth should also be done every day.

5. Never wrap your appliance in a paper napkin or tissue and set it down on a table.  You or someone else may throw it away.  Don’t put it in your pocket when playing or you may break or lose it.  Whenever it is not in your mouth, it should be in its plastic appliance case.

6. Keep your appliance away from dogs or cats as they love to chew on them.  Avoid storing them near any source of heat.  Do not boil your retainer to sterilize it!  If needed, bring to the office and we will be happy to disinfect it for you.

7. An additional charge will be incurred for lost or broken appliances.

If your elastics break frequently, a wire or band loosens, or a hook breaks off – please call our office immediately.  Don’t wait until your next appointment.  These problems need to be corrected as soon as possible.

Orthodontic Disorders

Crossbite:

Crossbite can occur in the front and/or the sides of the mouth.  One or more upper teeth bite on the inside of the lower teeth.  Crossbites of both back teeth and front teeth are commonly corrected early due to biting and chewing difficulties.
 
Openbite:

Openbite is when the upper and lower incisor teeth do not touch when biting down and impacts proper chewing.  It is caused by oral habits such as tongue thrust, thumb sucking, or when the jaws don’t grow proportionately. 

Overbite:
(Class II Overbite)

Overbite occurs when the upper front teeth overlap the lower front teeth.  Generally there is no contact between the upper and lower front teeth.  Overbite is due to a disproportionate amount of eruption of front teeth, or over development of the bone that supports the teeth, and a discrepancy in the growth of the upper or lower jaws.  Overbite is also known as a deep bite.

Overjet:
(Class II Overjet)

Overjet is also known as protrusion.  It is where the lower teeth are too far behind the upper front teeth.  This can be caused by an improper alignment of teeth; a skeletal imbalance of the upper and lower jaw, flared upper incisors; missing lower teeth; or a combination of all the above.  In addition, oral habits such as thumb or finger sucking or tongue thrusting can worsen the condition.

Underbite:
(Class III Underbite)

The lower teeth protrude past the front teeth.  An underbite is usually caused by undergrowth of the upper jaw, overgrowth of the lower jaw, or a combination of the two.  It can also be caused by flared lower incisors, retruded upper incisors, missing lower teeth or a combination of all the above.

Problems and Treatment

Crowding:

Crowding is the lack of space for all the teeth to fit normally within the jaws.  The teeth may be twisted or displaced.  Crowding occurs when there is disharmony in the tooth to jaw size relationship, or when the teeth are larger than the available space.  Crowding can be caused by improper eruption of teeth and early or late loss of primary teeth.

Spacing:

Spacing, the opposite of crowding, is an excess of space for your teeth, resulting in gaps between your teeth.  This generally occurs when the teeth are smaller than the available space.  Spacing can be caused by protrusion of teeth, missing or impacted teeth, or abnormal tissue attachments to the gums.
 
Impacted Teeth:

Impactions can be caused by improper positioning of the developing tooth.  This can cause the tooth to fail to erupt into the mouth.  Impactions can be caused by early loss of primary teeth or crowding of the permanent teeth.

Missing Teeth:

Missing teeth is the absence of a tooth or teeth that should normally be present.  This can be caused by trauma or lack of development.

Classification of Teeth:

The classification of bites are broken up into three main categories:  Class 1, II, and III.

Class 1:

Class I is a normal relationship between the upper teeth, lower teeth and jaws or balanced bite.

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 overgrowth 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 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.  Class III problems can be genetically inherited.