Common Orthodontic Issues

Crowding of the teeth

Before

After

Patient started treatment at age 11 and wore braces for 26 months. He loves his new smile.

Open bite - Front teeth don't touch

Before

After

Patient sucked her thumb as a young child. She started treatment at age 13. She had braces and a special appliance — called a crib — to retrain the tongue, for 28 months. Now she can bite the lettuce out of a sandwich.

Deep overbite - Lower front teeth bite into palate

Before

After

This adult patient, age 25, required braces and jaw surgery to correct his severe overbite, with treatment taking two years. His problem could have been corrected without surgery if he had been treated before he was a teenager.

Missing lateral incisors

Before

After

This patient's lateral incisors were congenitally missing. She had braces for 20 months to move the teeth into their correct positions, then the missing teeth were replaced with bonded "Maryland" bridges.

Underbite - Lower front teeth in front of upper teeth

Before

After

Patient's underbite was causing her jaw joint discomfort and excessive wear patterns on her teeth. After about 30 months of treatment starting at age 32, she now finds smiling and chewing much easier.

Spacing of teeth

Before

After

Patient was bothered by the spaces between his teeth. Braces closed the spaces and gave him an ideal bite in 24 months. Special glued-in retainers help keep the spaces closed.

Overjet - Protruding front teeth

Before

After

At age ten, patient had a big overjet with the top teeth protruding beyond the bottom. She had two phases of treatment. The first helped her jaws to grow more harmoniously and the second aligned her teeth and bite. At age 13, she was proudly displaying her new smile.

Non-braces treatment

Before

After

Sometimes braces are not needed to get noticeable improvements in tooth alignment. This patient was first seen at age seven for crowding of the lower permanent teeth. A procedure was performed to reduce the width of the adjacent baby teeth and the permanent incisors aligned on their own in nine months.

Phase-One

Before

After

Patient's parents were concerned about both aesthetics and the health of the erupting permanent teeth when they brought him to the orthodontist at age eight. The lower front teeth were crowded and touching the palate, and the upper front teeth were extremely displaced from their normal positions. After 12 months of Phase-One treatment with an expander and partial braces, patient's appearance and dental function were vastly improved.

Impacted Teeth

An impacted tooth is a relatively common finding. An impacted tooth is one that is encased in bone and hasn’t erupted or come into the mouth. Less commonly, the impaction may involve soft tissue only. An impacted tooth may be caused by a lack of space, an abnormal eruption path, ankylosis (fusion of the tooth to the bone) primary failure of eruption (reason for impaction is unknown) or improper development. The most commonly impacted teeth are third molars (wisdom teeth), canines and second molars.

An impacted tooth may be a difficult situation to manage. The difficulty of bringing in the tooth depends on factors such as the age of the patient, the extent of the tooth’s development (the more developed the tooth root, the more difficult it usually is), where it is impacted, and the angle of the tooth. All these factors are taken into account when formulating a plan and predicting what the prognosis or outcome may be.

For mild impactions, creating enough space can help the tooth come into the mouth on its own. This may be done with braces, expanders, and sometimes extractions. In more severe impactions, it is necessary to open space and then undergo a surgical procedure in which the impacted tooth is exposed, and a small chain is bonded to the tooth. The orthodontist uses this chain to pull the tooth into place.

If an impaction is not too severe and is treated at the right time, the outcome is usually successful. However, there are risks to any impacted tooth, including any surgical procedure to retrieve it. Those risks include, but are not limited to:

• Damage to the roots of the impacted tooth or other teeth (root shortening)

• Discoloration of the impacted tooth or adjacent teeth, and possible need for root canal therapy

• Fusion of the tooth to the bone, resulting in lack of movement

• Unfavorable movement of the teeth adjacent to the impacted tooth

• Loss of attachment of the chain that is placed during the surgery

• Development of gingival recession or other periodontal problems

Failure of the impacted tooth to come in, requiring extraction (a future replacement tooth/restoration would be needed.)

Our goal is to help you make the best decision for you and your family regarding your treatment. We encourage you to ask any questions you may have regarding treatment options. Thank you for allowing us to help you with your orthodontic needs.