About Orthodontics

Who is an Orthodontist?

An orthodontist is a specialist in the diagnosis, prevention and treatment of dental and facial irregularities. Orthodontists must first attend college, and then complete a four-year dental graduate program at a university dental school or other institution accredited by the Commission on Dental Accreditation of the American Dental Association (ADA). They must then successfully complete an additional two- to three-year residency program of advanced education in orthodontics. This residency program must also be accredited by the ADA. Through this training, the orthodontist learns the skills required to manage tooth movement (orthodontics) and guide facial development (dentofacial orthopedics).

Only dentists who have successfully completed this advanced specialty education may call themselves orthodontists.  The American Dental Association has recognized that “specialists are necessary to protect the public, nurture the art and science of dentistry, and improve the quality of care.”

What causes Orthodontic problems or malocclusions (“bad bite”)?

While most malocclusions are inherited there are some that are acquired:

Inherited problems include crowding of teeth, too much space between teeth, extra or missing teeth, and a wide variety of other irregularities of the jaws, teeth and face.

Acquired malocclusions can be caused by trauma (accidents), thumb, finger or pacifier sucking, airway obstruction by enlarged tonsils and adenoids, dental disease or premature loss of primary (baby) or permanent teeth.

Whether inherited or acquired, many of these problems affect not only alignment of the teeth but also facial development and appearance as well.

Proper diagnosis involves taking a thorough history and evaluation of Diagnostic Records, which enable Dr. Patel to make informative decisions about the form of treatment that may be necessary or recommended.  Orthodontic treatment typically lasts from 6 to 36 months, with the average being about 24 months, depending on age, and the severity of the orthodontic problem. Treatment time may be longer in some individuals. Outstanding results are also dependent on maximizing the coordination of care between you and our practice. We are committed to providing the very best in Orthodontic Care in a safe and most efficient manner and help you achieve your orthodontic treatment objectives.

Orthodontic Treatment Timing

Dr. Patel provides orthodontic treatment for adults, adolescents and children. We follow the guidelines established by the American Association of Orthodontists (AAO) by recommending that an orthodontic evaluation take place at age 7 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 7 to 11 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.

Early Treatment: (Age 7-11 years)

Dr. Patel follows the guidelines established by the American Association of Orthodontists by recommending that an orthodontic screening take place no later than 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. Waiting until all the permanent teeth have come in, or until facial growth is nearly complete, may make correction of some jaw discrepancy problems more difficult. These treatments may also prevent certain conditions from worsening. Treating children with these types of problems during their growth stages allows Dr. Patel, to achieve results that may not be possible when face and jaw bones have fully developed. This early treatment may simplify or minimize the need for additional or extended treatment for the child at a later age.

Some orthodontic problems are easier to correct if detected early rather than waiting until jaw growth has slowed. Early treatment may sometimes help a patient avoid jaw surgery or other serious corrections later in life.

The bite of the back teeth is established when the first molars erupt. At that time, (around age 7) we can evaluate the position of the upper and lower teeth as they bite together to ensure they are not in an unhealthy position.

For some, a timely screening will lead to significant treatment benefits; for most, the principal immediate benefit is a parent’s peace of mind. For those patients who have clear indications for treatment at an early age, this treatment presents the opportunity to:

• Influence jaw growth in a positive manner.
• Harmonize width of the dental arches.
• Improve tooth eruption patterns.
• Lower risk of trauma to protruded upper incisors.
• Correct harmful oral habits.
• Improve esthetics and self-esteem.
• Simplify and/or shorten treatment time for later orthodontics.
• Reduce likelihood of impacted permanent teeth.

Teens & Adolescents Treatment (Ages 11-18)

Between the ages of 11 and 15 is the most common time for orthodontic treatment – and for good reason. By 12, most if not all of the permanent teeth have erupted and are in place, and crooked teeth, gaps and bad bites can easily be treated. These problems will hardly ever correct themselves, so this is when most parents decide to seek orthodontic treatment.  Selecting a treatment plan that addresses many of issues affecting the orthodontic issues – both dental and skeletal, make a difference in the final treatment outcomes.

For most teens, braces are a right of passage; something they share with other kids their age. Many can hardly wait until they can get their braces on – and that’s good for a number of reasons. While it’s never too late for orthodontic treatment, having braces or Clear aligner treatment as a teen lets us take advantage of the natural growth happening during these important developmental years. Oftentimes, positive and corrective results can be achieved by initiating treatment during the pre-pubertal and pubertal growth.

Adult Treatment:

More and more adults today are seeking orthodontic treatment to improve their smile. In fact, over 35 percent of our patients are adults!

We offer a full range of treatments specifically designed for adults – leaving you with a dramatically different smile and healthier bite. Orthodontic treatment is not only designed to improve the appearance of your smile, but improve the health of your teeth and gums as well. By seeking orthodontic treatment as an adult you can possibly avoid severe tooth decay, gum and bone loss, irregular wear of the tooth enamel, and TMD pain.

Because adults are highly motivated to complete their orthodontic treatment they are usually more compliant with the instructions for wear and care of Orthodontic appliances.  This can result in treatment time that’s less than that for a teenager, with the same great results.

We offer a wide selection of braces to aligners to hybrid solutions to meet the individual needs and desires of each of our adult patients. From clear and aesthetic braces to clear aligners that can be worn to improve mild cases of misaligned teeth, we are confident we can help you achieve and maintain the beautiful, healthy smile you’ve always dreamed about.

Classification of Face and Teeth:

Class I:

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 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 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. Like Class II problems, they can be genetically inherited.

Classification of Face:

It is not sufficient to categorize orthodontic malocclusions on the basis of a classification of the teeth alone. The relationship with other craniofacial structures must also be taken into consideration.

Class 1:

Class 2:

Class 3:

Common Orthodontic Disorders:

1. 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. This can occur with a single tooth or multiple teeth. Early correction of crossbite is recommended.

Crossbite should be corrected because it can:

• cause premature wear of the teeth
• cause gum disease including bone loss
• cause asymmetrical development of the jaws
• cause dysfunctional chewing patterns
• make your smile less attractive

before

after

How can a crossbite be orthodontically corrected?

If there is a single tooth crossbite, the tooth can be moved with braces into the correct position. In some cases, a retainer can be utilized. With multiple teeth in crossbite, the arch needs to be expanded with braces or other intra-oral appliances.

 

2. Openbite:

Openbite is an insufficient vertical overlap of the teeth. It is caused by oral habits such as tongue thrust, digit sucking or when the jaws don’t grow evenly. Timing of treatment is critical to the overall success of the therapy.

How can an openbite be orthodontically corrected?

Openbite can be corrected through growth modification of the jaws using braces, extrusion of the anterior teeth and in some cases surgical correction of the jaws. Also breaking oral habits, such as digit sucking, will facilitate the correction of an openbite.

before

after

 

3. Overbite:

Class II Overbite

Overbite occurs when the upper front teeth protrude over the lower front teeth. Generally there is no contact between the upper and lower front teeth. Often you cannot see the lower incisors. Overbite is due to a disproportionate amount of eruption of front teeth or over development of the bone that supports the teeth and a front to back discrepancy in the growth of the upper or lower jaw (Class II Relationship). Overbite is also known as a deep bite.

Overbite should be corrected because it can:

• cause improper functioning of your front teeth
• result in the lower front teeth biting into the gum tissue of the upper palate leading to tissue problems
• unusual wear of the lower front teeth
• cause jaw or joint problems
• make your smile less attractive

before

after

How can an overbite be orthodontically corrected?

Overbite can be corrected through moving the front teeth up and/or bringing the back teeth together, which will “open” the bite so the teeth are properly aligned and the deep bite is eliminated.

 

4. Overjet:

Class II Overjet

Overjet is also known as protrusion. In this case, the lower teeth are too far behind the upper front teeth. This can be caused by an improper alignment of the molars (Class II Relationship), 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 sucking, finger sucking or tongue thrusting can exacerbate the condition.

Overjet should be corrected because it can:

• prevent proper functioning of the front teeth
• lead to premature wear
• make your smile less attractive

before

after

How can overjet be orthodontically corrected?

Overjet can be corrected through growth modification using a functional appliance and/or elastics to reduce the skeletal imbalance or extraction of teeth.

 

5. 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 (Class III Relationship). Underbite can also be caused by flared upper incisors, missing lower teeth or a combination of all the above. Early correction of underbite is recommended.

Underbite should be corrected because it can:

• prevent proper functioning of the front teeth or molars which can lead to premature wear of the teeth
• cause chewing or eating problems
• cause jaw or joint problems
• make your smile less attractive

before

after

How can an underbite be orthodontically corrected?

Underbite can be corrected through growth modification of the jaws, extraction of teeth and in some cases, surgical correction of the jaws.