Mal occlusion and orthodontics

 

Malocclusion

Poor positioning of the teeth.

Types of Malocclusion:




Class I
A Malocclusion where the bite is OK (the top teeth line up with the bottom teeth) but the teeth are crooked, crowded or turned.

Class II
A Malocclusion where the upper teeth stick out past the lower teeth. 

Class III
A Malocclusion where the lower teeth stick out past the upper teeth. This is also called an "underbite".

 

Occlusion

The alignment and spacing of your upper and lower teeth when you bite down.

Types of Occlusion:



Openbite - Anterior opening between upper and lower teeth.

Overbite - Vertical overlapping of the upper teeth over the lower.



    Overjet - Horizontal projection of the upper teeth beyond the lower.

   Crossbite - 
When top teeth bite inside the lower teeth. It can occur with the front  teeth or back teeth.

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O rings

O rings, also called A-lastics, are little rings used to attach the arch wire to the brackets. These rings come in standard gray or clear, but also come in a wide variety of colors to make braces more fun. A-lastics are changed at every appointment to maintain good attachment of the arch wire to the bracket, enabling our patients to enjoy many different color schemes throughout treatment.
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Palatal Widening Appliance

An appliance which is placed in the roof of the mouth to widen the upper dental arch. The maxilla, or upper dental arch, is joined in the center by a joint, which allows it to be painlessly separated and spread. Temporarily you may see a space develop between the upper two front teeth. This will slowly go away in a few days. Once this has occurred, the two halves knit back together and new bone fills in the space.

Care of appliance: Brush as usual. Brush the appliance and roof of the mouth thoroughly. Rinse often to clean any food lodged between the arch and appliance.
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Retainers


At the completion of the active phase of orthodontic treatment, braces are removed and removable appliances called retainers are placed. To retain means to hold. Teeth must be retained or held in their new positions while the tissues, meaning the bone, elastic membranes around the roots, the gums, tongue and lips have adapted themselves to the new tooth positions. Teeth can move if they are not retained. It is extremely important to wear your retainers as directed!
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Separator

A plastic or rubber donut piece which the dentist uses to create space between your teeth for bands.
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Orthodontic Care

Braces Care  /  Appliance Care  /  Elastics Care  /  Proper Diet

Braces Care

You will be shown the proper care of your braces when your orthodontic treatment begins. Proper cleansing of your mouth is necessary every time you eat. Teeth with braces are harder to clean, and trap food very easily. If food is left lodged on the brackets and wires, it can cause unsightly etching of the enamel on your teeth. Your most important job is to keep your mouth clean. If food is allowed to collect, the symptoms of gum disease will show in your mouth. The gums will swell and bleed and the pressure from the disease will slow down tooth movement.

BRUSHING: You should brush your teeth several times per day.

  1. Brush back and forth across……between the wires and gums on the upper and lower to loosen any food particles.

  2. Next, brush correctly as if you had no brackets or appliances on.

  3. Start on the outside of the uppers with the bristles at a 45 degree angle toward the gum and scrub with a circular motion two or three teeth at a time, then move on.

  4. Next, do the same on the inner surface of the upper teeth.

  5. Then, go to the lower teeth and repeat steps A & B.

Look in a mirror to see if you have missed any places. Your teeth, brackets and wires should be free of any food particles and plaque.

Note: If your gums bleed when brushing, they are not receiving enough stimulation.  Do not avoid brushing, but rather continue stimulating the area with the bristles. Be sure to angle your toothbrush so that the area under your gum line is cleaned. After 3 or 4 days of proper brushing, the bleeding should stop and your gums should be healthy.

FLOSSING: Use a special floss threader to floss with your braces on. Be sure to floss at least once per day.

FLUORIDE RINSE OR GEL: May be recommended for preventive measures.
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Appliance Care

Clean the retainer by brushing with toothpaste. If you are wearing a lower fixed retainer be extra careful to brush the wire and the inside of the lower teeth. Always bring your retainer to each appointment. Avoid flipping the retainer with your tongue, this can bother your mother. Place the retainer in the plastic case when it is re-moved from your mouth. Never wrap the retainer in a paper napkin or tissue, someone may throw it away. Don't put it in your pocket or you may break or lose it. Don't place in hot water to clean or sterilize.  Excessive heat will warp and ruin the retainer.
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Elastics Care

If elastics (rubber bands) are worn intermittently, they will continually "shock" the teeth and cause more soreness. Sore teeth between appointments usually indicate improper wear of headgear or elastics or inadequate hygiene. Wear your elastics correctly, attaching them as you were told. Wear elastics all the time, unless otherwise directed. Take your elastics off while brushing. Change elastics as directed, usually once or twice a day.
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Proper Diet

Avoid Sticky Foods such as:

 

Caramels

Skittles

Candy bars with caramel

Starbursts

Fruit Roll-Ups

Toffee

Gum

Gummy Bears

Candy or caramel apples

 

 

 

Avoid Hard or Tough Foods such as:

Pizza Crust

Ice cubes

Nuts

Bagels

Hard Candy

Popcorn Kernels

Corn Chips

 

 

 

Cut the following foods into small pieces and chew with the back teeth:

Apples

Pears

Carrots

Celery

Corn on the Cob

Chicken wings

Pizza

Spare Ribs

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Orthodontic Emergencies or Problems

Loose Bracket  /  Poking Wire  /  Wire out of Back Brace 
Poking Elastic (Rubber Band) Hook  /  Sore Teeth

Please feel free to contact the office if you are experiencing any discomfort or if you have any questions. Below are a few simple steps that might help if you are unable to contact us or if you need a “quick fix”.
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Loose Bracket

Occasionally, a glued bracket may come loose. You can remove the loose bracket and save it in an envelope to bring to the office or leave it where it is, if it is not causing any irritation. Call the office as soon as possible in order for us to allow time to re-glue the bracket.
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Poking Wire

If a wire is poking your gums or cheek there are several things you can try until you can get to the office for an appointment. First try a ball of wax on the wire that is causing the irritation. You may also try using a nail clipper or cuticle cutter to cut the extra piece of wire that is sticking out. Sometimes, a poking wire can be safely turned down so that it no longer causes discomfort. To do this you may use a pencil eraser, or some other smooth object, and tuck the offending wire back out of the way.
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Wire out of Back Brace

Please be careful to avoid hard or sticky foods that may bend the wire or cause it to come out of the back brace. If this does happen, you may use needle nose pliers or tweezers to put the wire back into the hole in the back brace. If you are unable to do this, you may clip the wire to ease the discomfort. Please call the office as soon as possible to schedule an appointment to replace the wire.
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Poking Elastic (Rubber Band) Hook

Some brackets have small hooks on them for elastic wear. These hooks can occasionally become irritating to the lips or cheeks. If this happens, you may either use a pencil eraser to carefully push the hook in, or you  can place a ball of wax on the hook to make the area feel smooth.
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Sore Teeth

You may be experiencing some discomfort after beginning treatment or at the change of wires or adjusting of appliances. This is normal and should diminish within 24-72 hours. A few suggestions to help with the discomfort:

  1. Rinse with warm water, eat a soft diet, take acetaminophen (Tylenol) or ibuprofen (Advil) as directed on the bottle.

  2. Chewing on the sore teeth may be sorer in the short term but feel better faster.

  3. If pain persists more than a few days, call our office.