There are a variety of reasons for seeking orthodontic treatment, sometimes more than one is present in the same individual. Many of these are best evaluated while the patient is still growing. That is why the American Association of Orthodontists recommends receiving your first orthodontic evaluation by the age of 7.
Crowding of the teeth (Crooked teeth)
Crowding of the teeth is one of the most common issues addressed with orthodontic treatment. Mild to moderate crowding can be successfully addressed by utilizing braces and/or aligners to move the teeth into their ideal positions. Severe crowding is usually caused by jaws that are too small to accommodate the size of the teeth present. Removal of teeth may be required to correct the imbalance and prevent the development of gum recession and bone loss in the future.
Deep overbite (Overlapping of the front teeth)
Deep overbite is another common occurrence. If left untreated, the edges of the upper and lower front teeth can undergo extensive wear and tear, leaving them permanently damaged. In a case like this, bite blocks are placed behind the upper front teeth, in addition to braces, to allow the front teeth to close into their ideal final position. The braces are then used to move the rest of the teeth into proper position. The blocks are removed at the end of treatment.
Overjet (Protruding upper front teeth)
Protrusion of the upper front teeth is a result of the poor alignment of the upper and lower molars relative to each other, with the uppers being more forward than is ideal. In cases of mild to moderate protrusion, elastics that stretch from the top to the bottom teeth are often used in conjunction with braces. In severe cases of protrusion, tooth removal may be indicated to ideally realign the position of the front teeth relative to each other.
Spacing of teeth
Closure of spaces is generally readily achieved by the placement of braces and/or aligners. Spaces have a tendency to reopen following the completion of treatment. For this reason, fixed (permanent) retainers are typically utilized in these cases to prevent relapse (spaces reopening).
Phase I (Early Treatment)
Phase I treatment can be indicated for a number of reasons. The most common reason for early intervention is a bite issue that if left uncorrected, will make comprehensive treatment more complex, possible requiring tooth removal or surgery that may have been avoided. One example of such an issue is a crossbite in which the upper and lower jaws do not fit together properly due to a width discrepancy. Crossbite is addressed with a palatal expansion appliance. If left untreated, growth of the face can become asymmetric.
Openbite (Front teeth don’t touch)
Openbite is one of the most complex situations that an orthodontist can face. It can be related to an oral habit, like thumb sucking, a tongue thrust, a tooth positional issue, a jaw positional issue, or a combination of the above. As a result, correction may involve multiple treatment approaches including, palatal expansion, braces, tooth removal, or even jaw surgery to achieve the most ideal result. Lifetime fixed (permanent) retention is a must.
Underbite (Protruding lower front teeth)
Approximately 5% of the population is missing one or more teeth, of these, the lateral incisor (the teeth on either side of the front teeth) are the most common. This can be managed with braces in a number of ways. First, space can be maintained in order to allow a permanent replacement, but nothing permanent should be done until all growth has completed. In the interim, a resin bonded bridge can be used to replace the missing tooth/teeth and maintain the space until the individual is ready for the placement of permanent implants. In some cases, the spaces are closed, rather than maintained, and the cuspids (eye teeth) can be modified to take the place of the laterals.