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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.
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.
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.
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.
standard braces
lingual braces
Clear braces
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
Headgear
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.
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.
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.
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.
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.
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!