Malocclusions

April 10, 2020

MalocclusionsYou’ve probably heard of overbites, crooked teeth, or underbites whether you know someone who has one of these conditions or if you’ve experienced one yourself. These conditions are considered different types of malocclusions, which is the official term for mismatched teeth or jaw issues caused by misalignments with your bite. Roughly 2/3 adults have some degree of malocclusion as very few people have perfectly aligned teeth. While some cases do not require significant treatment or treatment at all, we want to educate you on this common orthodontic occurrence and give a brief guide to malocclusions.

What is malocclusion?

Occlusion refers to the meeting of your teeth, or the actual contact of your teeth in your upper and lower jaws. Your teeth should fit easily and comfortably within your mouth without crowding, gaps, or any teeth that may be rotated or twisted. There should be a slight overlap of your upper jaw on your lower jaw so that your molars can fit into the grooves of their opposite molars.

Malocclusion refers to any deviation from the ideal occlusion. Most people have a malocclusion to some degree, but often it is so minor that treatment is not necessary unless for aesthetic reasons. There are three main categories of malocclusions:

Class 1 – This is the most common type of malocclusion where the bite is normal, but there may be a slight overlap.

Class 2 – Commonly referred to as an overbite where a severe overlap is present, meaning the upper teeth and jaw significantly protrude over the lower jaw and teeth.

Class 3 – More commonly known as an underbite, this class refers to cases where the lower jaw juts out causing the lower teeth to overlap the upper jaw and teeth.

The types of malocclusion can vary, but any type can cause issues for a patient. Common types of malocclusions include:

Crossbite – When the upper teeth bite down inside the lower teeth. It can occur on one side or both and may involve either the front or back teeth.

Open bite – When the front teeth do not overlap with the lower teeth or jaw when the mouth is closed there is a space between the top and bottom teeth.

Overbite – A severe overlap of the lower front teeth. In severe cases, the front teeth may hit the gums when a person bites their teeth together.

Overcrowding – Often caused by a lack of space resulting in teeth that overlap or become crooked, rotated, or twisted.

Overjet – Similar to an overbite, but occurs when the top teeth extend beyond the bottom teeth horizontally.

Spacing – Spaces that occur between two or more teeth

Underbite– An underbite is an anterior crossbite that occurs with the front teeth. When the mouth is closed the lower teeth protrude forward of the top teeth.

Symptoms

Symptoms of malocclusions vary depending on the classification, type, severity, and patient but common symptoms include:

  • Misaligned teeth
  • Abnormal signs of wear on teeth
  • Difficulty chewing or biting
  • Alteration in facial features
  • Frequent biting inside of the cheek or tongue
  • Headaches
  • Tooth grinding
  • Neck, shoulder, and upper back pain
  • Speech complications
  • Mouth, teeth, or jaw pain
  • Breathing through the mouth rather than the nose

Cause

There is no single direct cause for all malocclusions. The majority of the time it is heredity due to a size difference in the upper or lower jaw or jaw shape. Sometimes certain birth defects such as cleft lips or cleft palates can lead to the development of malocclusions.

It can also be acquired from childhood habits such as thumb sucking, pacifier usage, or bottle feeding beyond the age of three. Children who have little space between their baby teeth are likely to experience overcrowding with their permanent teeth which can result in malocclusions.

Other causes for malocclusion include abnormally shaped teeth or bite patterns, presence of extra teeth, loss of teeth due to injury or accident, or impacted teeth. Malocclusions may also occur due to poor dental care such as poorly-fitted crowns or other dental/orthodontic appliances. Medical conditions such as allergies or enlarged adenoids or tonsils may also lead to airway obstructions and could create a degree of malocclusion.

Diagnosis

Malocclusions are often diagnosed during routine dental exams. If suspected, x-rays, photographs, and molds are taken and often given to an orthodontist to study and confirm.

Treatment

If a malocclusion is confirmed, an orthodontist will handle treatment in most cases. Treatment varies depending on the type of malocclusion and is determined on an individual basis. Several factors are considered including age, medical history, overall health, and the severity of the malocclusion.

Common types of malocclusion treatments may include but are not limited to:

  • Orthodontic appliances such as braces, aligners, or retainers to correct the position of teeth
  • Extraction of teeth to alleviate overcrowding
  • Capping, bonding, or reshaping of teeth
  • A palatal expander can be used in younger patients to widen the jaw
  • Plates and wires may be used to help stabilize the jaw

In severe cases, surgery may be needed and you may need to be referred to a maxillofacial surgeon or oral surgeon.

If not treated, the malocclusion may worsen over time and become more pronounced. Depending on the type of malocclusion, it may become difficult for you to clean your teeth and gums which can put you at risk for tooth decay, gum disease, and even tooth loss.

For more information on malocclusion and treatment options or to schedule a consultation, please contact Bracify 3D Orthodontics today.

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Braces, Mouthguards, and Sports

Braces, Mouthguards, and SportsWe understand that orthodontic treatment can result in many changes to your everyday life such as your diet and oral hygiene habits. However, one thing that shouldn’t change is your participation in sports. Braces don’t always mean a spot on the bench for the season! You can continue to play sports while straightening your smile if you take some safety precautions. One way to protect your smile as you play is by using a mouthguard–especially if you have braces!

What is a mouthguard?

A mouthguard is a cushioning oral appliance made of flexible material that fits snugly over your teeth to help protect against injuries to the teeth and mouth. Mouthguards also prevent your jaws from coming together fully, reducing the risk of jaw joint injuries and concussion.

Why should you wear a mouthguard while playing sports?

Any sport can run the risk of mouth, teeth, and jaw injuries however some sports are a greater risk than others such as hockey, rugby, and football. These sports have a long record of causing tooth loss, chipped teeth, and broken jaws, and not all incidents occur at a professional level. Incidents can occur at any age, so we strongly encourage and advise our patients to wear mouthguards when they play or train.

Mouthguards are designed to absorb the impact and shock to prevent severe injury to your teeth, cheeks, tongue, and gums. Though you may think your braces are enough to prevent tooth loss, wearing a mouthguard in addition to braces will also protect your lips, cheeks, and tongues from lacerations if an injury does occur.

While traditional braces are a common and effective method to straightening teeth, there are other orthodontic options such as clear aligners and removable plates. If your child has a removable appliance, it may need to be removed for their safety during contact sports. However, you still need to wear a mouthguard while being active. Ask your orthodontist what treatment option is best for your oral health.

How to Choose a Mouthguard

There are two main types of mouthguards to choose from when making your decision: boil-and-bite mouthguards or custom-fitted mouthguards. As always, consult with your oral health team on which option is best for your needs. Make sure your mouthguard is designed to fit patients with braces for maximum protection and comfort. One factor to consider when deciding what mouthguard is right for you is how many mouthguards you may need throughout the season and whether a double mouthguard will be required for your sport. Some sports such as wrestling require mouthguards to cover both the top and bottom teeth.

Boil-and-Bite
Boil-and-bite mouthguards are made of medical-grade silicone and can be remolded several times if necessary. To use this type of mouthguard, the guard is heated to a boil and then after a brief cooling period, can be placed into your mouth to make an impression.

Some important notes to keep in mind when using this method with braces:

  • Do not form the mouthguard over the braces in a way that will pull on the brackets causing damage or potentially removing the braces off.
  • Before molding, be sure to cover your teeth and braces completely with a strip of orthodontic wax or foil. Without this barrier over the brackets, the mouthguard may seal around the brackets making it hard to get off and possibly damage your treatment or teeth. Once the mold is set, you can remove the barrier and wear the guard right over your braces.
  • Though this can be a great option for most, it is important to note that as your teeth move due to your orthodontic treatment, your mouthguard will become loose and need to be remolded.

If you select a boil-and-bite mouthguard, be sure that you select one that is designed for braces and has enough room to accommodate your teeth, braces, and gums.

Custom-Fitted
Your orthodontist or dentist can make you a customized mouthguard from an impression of your teeth. Though this option can be more expensive, it ensures a proper and comfortable fit. One of the major disadvantages of a customized mouthguard is that you will have to replace it regularly as your teeth shift with treatment.

Caring For Your Mouthguard

It is important to take care of your mouthguard as well. Bacteria will begin to accumulate in a used mouthguard, so be sure to clean them after each use. You can brush them with toothpaste or rinse them with an antimicrobial solution. With proper care, your mouthguard can last up to a year. Avoid chewing on them as this can damage the material and loosen the fit. We recommend patients with moldable mouthguards replace them every year to ensure optimal protection.

Dental injuries are very common in recreational and professional sports. That is why the best way to protect your smile while you play is to use a mouthguard. Mouthguards can absorb the energy of an impact to reduce the severity of injury to your mouth and jaw. For more information on mouthguards during orthodontic treatment or to schedule a consultation, contact Bracify 3D Orthodontics today.

Visiting The Orthodontist During COVID-19

Visiting The Orthodontist During COVID-19We want you to know that even now, we are still here for you and your orthodontic needs. We are committed to the health and safety of our patients, staff, families, and community during the COVID-19 pandemic.

Though your experience may look different now as we take necessary steps to best protect our patients, staff, and doctors, we remain dedicated to providing you with high-quality care while still following the CDC guidelines. Our staff has undergone training and education on the importance of hygiene, facemasks, protective gear, and etiquette. We routinely clean and sterilize all surfaces, supplies, equipment, and tools within our office because when you walk into any healthcare facility, you should feel confident that you are in a safe and clean environment.

Our additional safety measures help limit contact with others so that your visit can be a safe and healthy one.

Practices in Place

Before You Arrive
Prior to your appointment, you will be asked to fill out a pre-screening questionnaire. This enables us to conduct a rough check of your health status and includes questions about recent coughs, fever, or potential contact with people who have been infected with COVID-19. You may be asked to complete this before scheduling an appointment and upon your arrival, in case your answers may have changed.

We would also like to inform our patients that we are limiting the number of people allowed in our office at a time to reduce the number of interactions between staff and patients.

Upon Arrival
Once you arrive at our office, a nurse will likely take your temperature. Depending on our current restrictions, you may be asked to wait in your car or outside after check-in until your room is ready.

If allowed in our waiting room, please continue to wear your mask until you are seated in the dental office and told to remove your mask. You may notice that magazines and commonly touched surfaces have been removed and signs placed on chairs and tables for social distancing purposes. Sanitizer is also available for your use.

During Your Appointment
Once you’re in the dental chair, you may notice some changes. We are currently asking patients to do a pre-procedural rinse­, a mixture of diluted hydrogen peroxide or iodine, to reduce the level of oral microorganisms present in your mouth and upper throat. It is important to note that these oral rinses are specially formulated for dental use and should only be used in a medical setting.

Our staff members may also wear different face shields, gowns, and goggles than previous appointments to help protect against and prevent the spread of germs and contamination.

After You Leave
After each appointment, surfaces are disinfected with hospital-grade cleaners, and tools are sterilized after each use. Air filters are also placed throughout the office to increase ventilation and help to keep the air clean and safe for your visit.

The COVID-19 pandemic has changed many aspects of our daily lives and this includes your visits to our office. Even with the pandemic, it is important to attend your scheduled appointments as delaying treatment or pushing back appointments can affect your orthodontic treatment plan or allow underlying conditions to progress and worsen. We take pride in our safety measures to ensure your health and safety. For more information on our safety precautions or to schedule an appointment, contact Bracify 3D Orthodontics today.

The Oral Health Connection

The Oral Health ConnectionFrom a young age, we are taught the importance of taking care of our teeth with brushing and flossing to prevent cavities and other painful oral conditions, but poor oral hygiene can lead to more than a toothache. Did you know that your oral health and general health are connected?

Research shows that poor oral health can be associated with several major health conditions such as heart disease, diabetes, and high blood pressure. This information is especially important for patients who are undergoing or considering orthodontic treatment, as appliances sometimes increase bacterial growth in your mouth which may lead to complications. Fortunately, our team is here to ensure your oral health is well managed so that your smile can remain happy and healthy.

How can my oral health affect my general health?

Your mouth can be a window into your body’s overall health and wellness as many signs of infection, nutritional deficiencies, and warning signs of serious health conditions often present themselves in your oral health. Your mouth is filled with countless bacteria, some good and some bad. The overgrowth of bad bacteria can cause tooth decay and periodontal disease, also known as gum disease.

Gum disease is a condition where bacterial growth within the mouth results in an infection of the surrounding and supporting soft tissue of teeth. One of the most common causes of gum disease is the build-up of plaque that hardens into tartar which can only be removed by professionals. This buildup irritates the gums causing them to become swollen, red, and recede. As they recede higher, the infection continues to spread and can lead to eventual tooth and bone loss.

Braces and other orthodontic appliances provide extra surface areas in the mouth for harmful bacteria to grow. We understand brushing and flossing can become difficult with braces in the way, however, it is a vital part of maintaining your oral health and hygiene. Failing to brush and floss daily with braces can impact your treatment, oral health, and increase your risk for other conditions.

Conditions Associated with Gum Disease

Harmful bacteria and infection can easily spread from the mouth to the rest of the body through the bloodstream. For patients with gum disease, the added bacteria in your mouth can increase your risk for infections and certain health conditions including the following:

  • Diabetes
  • Heart disease
  • High blood sugar and pressure
  • Obesity
  • Respiratory conditions

Although gum disease may contribute to these conditions, it is important to note that just because these conditions may occur at the same time, does not mean that one directly caused the other. Studies show that conditions that lower your body’s resistance to infection are likely to increase your risk for other health complications including oral health conditions.

Signs

Common signs of gum disease may include the following:

  • Bad breath
  • Frequent mouth infections
  • Gums that bleed when you floss or brush
  • Loose teeth
  • Pus between teeth and gums
  • Swollen, red, and tender gums
  • Unpleasant taste in the mouth

If you notice any of these symptoms, bring them to our attention as these signs may be signs of gum disease or other serious health conditions.

Orthodontic Care and Good Oral Health Practices

If you have gum disease or a serious condition that can increase your risk of bacterial infections, orthodontic treatment may or not be possible. In moderate to severe cases, gum disease can cause your teeth to shift into undesirable positions during treatment. In other cases, the inflammation of gums may cause bleeding and sores due to friction against the appliances during treatment which can lead to infection. These complications may cause treatment to stop early to avoid increasing patient risk of infection. However, that doesn’t mean that if you are diabetic and have gum disease you are unable to receive orthodontic care. We will conduct a thorough evaluation of your teeth to determine the best course of treatment for your needs to ensure your oral health. Always tell your oral health care team about any changes in your health, especially if you have other health conditions such as lung disease, diabetes, or heart disease as well as any medications you are on as these may affect your treatment and oral health.

To best protect your mouth, it is important to practice good oral health practices regularly and attend routine professional cleanings throughout the year. You should brush at least twice a day for two minutes at a 45-degree angle with an ADA-approved toothbrush and toothpaste. Flossing helps to remove plaque and food particles that can’t be removed with brushing and we recommend patients floss at least once a day. You should replace your toothbrush every three months or once the bristles begin to break down.

Though brushing and floss can be your main defense against oral complications, routine exams and cleanings are also important as our staff is trained to identify and treat oral health conditions and look for signs that may cause concern. For more information about the importance of your oral health or to schedule an appointment, please contact Bracify 3D Orthodontics today.

Flossing with Braces

Flossing with BracesWhen you have orthodontic treatment, a significant portion of your teeth may be covered allowing food particles to easily get trapped between your teeth and behind brackets, wires, and rubber bands. During your treatment, we cannot emphasize enough how important it is to remember to floss your teeth daily when you have braces or other orthodontic appliances.

Why is Flossing Important?

Brushing only removes plaque from the surface of your teeth, while flossing works to remove plaque from areas of your teeth your toothbrush can’t reach such as between teeth and underneath the gumline to keep your oral health in check. This is important if you have traditional orthodontic treatment as your appliance may prevent your toothbrush from fully brushing the surface of your teeth.

If you do not remove plaque daily, it can harden into tartar and increase your risk for gum inflammation and gum disease, which are two common dental conditions often associated with not flossing enough. To keep your teeth and gums strong and healthy, you should make flossing a part of your daily routine. It doesn’t matter if you floss at night or in the morning, it is just important that you do so at least once a day.

When teeth touch, the narrow space between them can only be cleaned through flossing. As soon as children have teeth that touch one another, it is time to help them floss. By starting early, you protect their smile as they grow and help to instill good oral health habits.

Flossing with Braces

Braces and other orthodontic appliances provide extra surface areas in the mouth for plaque to grow. We understand flossing can become difficult with braces in the way, however, it is a vital part of maintaining your oral health and hygiene. Failing to floss daily with braces can impact your treatment and oral health negatively and may lead to the following dental health concerns:

  • Bad breath
  • Cavities
  • Discolored teeth
  • Gum disease
  • Tooth decay

Tools to Make Flossing Easier

There is no doubt that flossing with braces can become a daunting task when navigating between wires and brackets. However, there are several flossing options that can help make the process easier.

  • Dental Tape- If your gums are sensitive, dental tape can be an ideal flossing method. Dental tape is an ultrathin floss and that is smooth, waxed, and spongy. This tape is thinner and wider than traditional floss allowing it to glide between teeth more easily.
  • Floss Threaders- Floss threaders are tools that can speed up the traditional flossing process by helping pull floss between the brackets and wires.
  • Interdental Brushes- Proxy brushes, or interdental brushes, are round/cone-shaped brushes with small bristles made of silicone or nylon held together by a wire. This flexible brush is designed to fit in-between your teeth and comes in a variety of sizes so that you can select the one (or ones) that work best for your teeth.
  • Oral Irrigators- Oral irrigators, or water flossers, use a steady stream of water to clean between the teeth and along your gum line. Some brands of oral irrigators offer special tips for patients with orthodontic appliances that enable them to clean around brackets easier than the standard tips.
  • Traditional Floss- This method can be difficult for patients with braces as threading floss around the brackets and wires takes time. We recommend using wax-coated single-strand floss that can easily be maneuvered between your braces.

If you find flossing with braces difficult, our orthodontic team can demonstrate various flossing types and methods that work well with braces. We will work with you to find the one that works best for you. We recommend patients floss at least once a day and follow up with an interdental brush to clean under the wires and around the brackets.

It is normal to feel some discomfort and notice bleeding when you first start to floss. After flossing regularly for a few weeks, your gums will feel better and the bleeding will stop. If you continue to experience discomfort, you may need to consult your dentist. For more information on how to floss with braces or to schedule an appointment, contact Bracify 3D Orthodontics today.

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