Maxillofacial Surgery
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.
When facial reconstruction, including procedures involving the oral cavity, is called for, a specialist is needed. Surgical procedures of the neck and head area are performed by a maxillofacial surgeon.
Common maxillofacial procedures include denture-related procedures and jaw surgery.
Jaw Correction
Protruding chins, crooked or buck teeth or misaligned teeth are good candidates for maxillofacial surgery.
In some people, jaws do not grow at the same rate; one may come in larger than the other, or simply not be aligned properly with other bony structures in the skull. This can cause problems other than appearance issues; an improperly aligned jaw can cause problems with the tongue and lips, and speech and chewing problems as well. Jaw surgery can move jaws into their proper place.
Other kinds of maxillofacial surgery can correct problems with upper facial features such as the nose and cheek.
In addition to correcting jaw problems surgically, orthodontic appliances such as braces may be needed to restore bite relationship and ensure continued proper alignment of the jaw. In some cases, tiny wires or small rubber bands may be needed to keep the jaws in place and promote faster healing. In other cases, small "fixation" screws or plates may need to be inserted in the jaws to facilitate easy movement of the jaws following surgery.
Denture Fatigue
People who have worn dentures for a long time can sometimes experience loss of gum tissue and even bone, mostly from the wear and tear of the appliance on the soft tissues of their mouth.
In extreme cases, maxillofacial surgery, including bone grafts, manipulation of soft tissues or even jaw realignment, may be performed to correct such problems.
Orthodontist - Keller
1730 Rufe Snow Drive
Keller, TX 76248
817-427-2237
