Orthodontic Appliances
The American Association of Orthodontists recommends that all children see an orthodontist by at least age seven or sooner if something is obviously wrong before age seven. Fortunately, most young patients don’t need anything more than observation while the permanent teeth are growing into place.
Many young patients have problems, which will not, or should not wait. Most orthodontic problems are inherited and cannot be prevented; however something can usually be done before these problems become more difficult and more expensive to manage.
It is recommended you consult with an orthodontist prior to having your dentist remove any baby teeth or permanent teeth. To ensure the best overall dental and facial development, all patients should have an orthodontic consultation sometime between the ages of four and seven.
Dr. Montoya offers early examinations and observation consultations. Contact us to schedule a complimentary consultation.
Classifications of Teeth
The classification of bites is divided into three main categories: Class I, II, and III. This classification refers to the position of the first molars, and how they fit together.
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Class I Class I is a normal relationship between the upper teeth, lower teeth and jaws or balanced bite. |
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Class I normal |
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Class I crowding |
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Class I Spacing |
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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 over growth 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 correct position.
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Class II division 1 |
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Class II division 2 |
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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. Like Class II problems, they can be genetically inherited. Class III problems are sometimes treated via surgical correction of one or both jaws.
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Class III functional or dental |
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Class III skeletal |
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Orthodontic Problems
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Overjet Upper front teeth protrude |
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Deep bite |
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Underbite |
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Open bite |
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Crowding |
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Excess Spacing |
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Mid-Line Misalignment |
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Crossbite |
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Phases of Treatment
Phase1: Treatment usually takes 12 to 18 months and is done between the ages of 7-9. A variety of appliances may be used to correct specific problems.
Maintenance Phase: During the time between the first and second phase the patient will be seen every few months per year. This is to monitor the eruption of the permanent teeth and loss of primary teeth.
Phase2 (if required): During the first phase of treatment Dr. Montoya has no control over 16 unerupted permanent teeth. If they grow in and problems still exist, further treatment, known as Phase 2, will be required. A separate fee will be quoted at that time. Treatment usually takes 12-24 months.
Full Treatment: If you decide to wait, treatment will be started when all permanent teeth have erupted. Full treatment usually takes 18-30 months. The length of treatment depends on the severity of malocclusion and orthodontic problems.
Proper Braces Care and Brushing Techniques
Brushing and flossing your teeth can be challenging when wearing braces but it is extremely important that you do both consistently and thoroughly.
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Foods to Avoid During Treatment: Eating proper foods and minimizing sugar intake are essential during orthodontic treatment. Your braces can be damaged by eating hard, sticky, and chewy foods.
- Hard foods : Nuts, Candy, Hard Pretzels
- Crunchy food: Popcorn, Ice, Chips, etc.
- Sticky foods: Gum, Chewy Candy (Skittles, Taffy, Gummy Bears, Caramel, etc.)
- Chewy food: Bagels, Hard Rolls, etc.
- Foods you have to bite into : Corn on the Cob, Apples, Carrots (cut these foods up into smaller pieces and chew on back teeth)
- Chewing on Hard Objects (for example, pens, pencils or fingernails) can damage the braces. Damaged braces will add time to your treatment.
Advances in technology have vastly improved appearance issues with orthodontia.
Braces today are made from extremely lightweight and natural-colored materials. The materials that braces attach to – brackets – are bonded to the surfaces of teeth but can be later removed.People can expect to wear braces for about two years – less or more in some cases. Adults are usually required to wear braces for longer periods of time.
Comfort issues
Because orthodontic appliances need to be adjusted from time to time to ensure they continue to move the teeth into their correct position, they can create pressure on the teeth and jaws. This mild discomfort usually subsides following each orthodontia adjustment.
Hygiene issues
People who wear braces must be diligent in ensuring that food particles and other debris do not get trapped in the network of brackets and wires. In addition, brackets can leave stains on enamel if the area surrounding them is not cleaned on a daily basis.
Daily oral hygiene such as brushing, flossing and rinsing are a necessity. Some people with orthodontic appliances can benefit from using water picks, which emit small pressurized bursts of water that can effectively rinse away such debris.
Another caveat: Braces and sticky foods don’t mix. Naturally, crunchy snacks and chewy substances should be avoided at all costs because they can cause orthodontia to be loosened or damaged.
Retainers
When braces are removed, the patient is often fitted with a special device called a retainer, such as the name implies, retains the proper arch and location of the teeth (which can sometimes shift out of position without a retainer).
Space maintainers
Space maintainers are nifty devices that can help teeth grow in normally following premature tooth loss, injury or other problems.
The devices can help ensure that proper spaces are maintained to allow future permanent teeth to erupt.
If your child loses a baby tooth early through decay or injury, his or her other teeth could shift and begin to fill the vacant space. When your child's permanent teeth emerge, there's not enough room for them. The result is crooked or crowded teeth and difficulties with chewing or speaking.
Other appliances that correct jaw-growth problems
- Bionator – This is a device that helps both jaws grow in proportion to one another. A bionator usually keeps the lower jaw forward, and helps teeth to properly erupt, leading to a natural and correct bite relationship.
- Headgear – Such a device, worn for several hours a day, exerts a specified amount of pressure on the upper mouth, teeth and jaws) and is used to ensure proper eruption of upper teeth and guide upper jaw growth direction.
- Herbst – This kind of device is affixed semi-permanently to both sets of molars, and keeps the lower jaw from shifting backward, preventing protruding upper teeth.
- Palatal expansion device – A narrow upper jaw can sometimes cause a crossbite (when lower and upper teeth don’t fit properly). A palatal expansion device is applied to the upper teeth near the back of the mouth, helping the upper jaw width to expand.
- Upper jaw expansion appliance – Narrow upper jaws also can be corrected with a device that gradually widens them over time.
Orthodontist - Keller
1730 Rufe Snow Drive
Keller, TX 76248
817-427-2237
