Orthodontics in Brevard, NC, North Carolina

Orthodontics is the specialty of dentistry focused on the diagnosis and treatment of dental and associated facial irregularities. The results of orthodontic treatment can be dramatic – beautiful smiles, improved dental health and an enhanced quality of life for many people of all ages. Orthodontic problems, which can result from genetic and environmental factors, must be diagnosed before treatment begins. Proper diagnosis involves taking photographs, x-rays, and dental impressions, which enable our practice to make informative decisions about the form of treatment necessary.

Treatment typically lasts from 6 to 30 months, depending on age and the severity of the orthodontic problem. Outstanding results are also dependent on maximizing the coordination of care between you and our practice. We are committed to delivering the best possible service in order for you to achieve your orthodontic objectives.

Treatment Timing

Water Oak Dental Group provides orthodontic treatment for adults, adolescents and children. We follow the guidelines established by the American Association of Orthodontists by recommending that an orthodontic evaluation take place at or before 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.

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.

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.

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.

Openbite can be corrected through growth modification of the jaws using braces, extrusion of the front and 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.

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:

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.

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

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

Impacted teeth

Impactions can be caused by improper positioning of the developing tooth bud. This can cause the tooth to fail to erupt into the mouth. Impactions can also be caused by early loss of primary teeth or crowding of teeth. Wisdom teeth are the most commonly impacted teeth. Canines and premolars can also be impacted.

Usually the impacted tooth is exposed over the course of a few months and brought into the correct position of the mouth. Correction of impacted teeth may involve a minor surgical procedure performed by an oral surgeon working closely with our practice. This will allow us to then guide eruption of the impacted tooth into proper position.

Missing teeth

Missing teeth is the absence of a tooth or teeth that should normally be present. This can be caused by trauma or lack of development.

cause improper functioning of teeth
cause premature wear of teeth
cause asymmetric alignment of the teeth
make your smile less attractive

Depending upon the situation, the space can be closed with braces or opened for tooth replacement. A bridge or dental implant are restorative options if a space is created.

Crowding of the Teeth

Crowding is the lack of space for all the teeth to fit normally within the jaws. The teeth may be twisted or displaced. Crowding occurs when there is disharmony in the tooth to jaw size relationship or when the teeth are larger than the available space. Crowding can be caused by improper eruption of teeth and early or late loss of primary teeth.

Extra space can be created by expansion of the arches or extraction of teeth. Once space is created, braces will eliminate crowding and align the teeth. Correction of crowding can help prevent dental decay and periodontal disease by improving the ability to remove plaque from the teeth.

Spacing of the Teeth

Spacing (the opposite of crowding), is an excess of space for your teeth which results in gaps between your teeth. This generally occurs when the teeth are smaller than the available space. Spacing can also be caused by protrusive teeth, missing teeth, impacted teeth or abnormal tissue attachments to the gums.

The spaces can be closed by moving the teeth together and properly aligning them within the arch.

Classification of Face and Teeth

Classification of Teeth

The classification of bites are broken up into three main categories: Class I, II, and III.

Class 1: 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.

To provide you with a better understanding of bite classifications, we have provided the following multimedia presentation. Many common questions pertaining to bite classification are discussed.

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Classificaiton 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: Maxillary-Mandibular Dental Protrusion – teeth: This is an example of a dental malocclusion that may require the removal of teeth for correction.
Maxillary-Mandibular Dental Retrusion – teeth: This is an example of a dental malocclusion that may be treated with expansion rather than removing teeth.

Class 2: Maxillary Dental Protrusion – teeth: This malocclusion may require the removal of teeth.
Mandibular Retrognathism – jaws: The lower jawbone has not grown as much as the upper jaw. This example of a Class II malocclusion demonstrates the need for early growth guidance.

Maxillary Dental Protrusion – teeth
Mandibular Retrognathism – jaws
These Class malocclusions are more difficult to treat due to the skeletal disharmony and may require orthognathic surgery in conjunction with orthodontic treatment.

Class 3: Mandibular Dental Protrusion – teeth: The lower teeth are too far in front of the upper teeth. This malocclusion is treated with orthodontic procedures which may require the extraction of teeth due to the dental protrusion.

Mandibular Prognathism – jaws: The lower jaw bone has outgrown the upper jaw. This malocclusion is more difficult to treat due to the skeletal disharmony and may require orthognathic surgery in conj–unction with orthodontic treatment.

Braces

How do braces straighten crooked teeth?

Braces use constant, gentle pressure, which over time, move teeth into their proper positions. Your braces are at work every moment of your orthodontic treatment. The two main components of your braces are: the brackets that are placed on your teeth and the main archwire that connects them. The bracket is a piece of shaped metal or ceramic that we affix to each tooth. The archwire is bent to reflect your “ideal” bite. In other words, it reflects the way we want you to look after treatment.

The wire threads through the brackets and, as the wire tries to return to its original shape, it applies pressure to move your teeth. Picture your tooth resting in your jaw bone. With pressure on one side from the archwire, the bone on the other side gives way. The tooth moves. New bone grows in behind.

Attached to your braces, elastics (rubber bands) exert the proper force that creates the right amount of pressure to move teeth. In order for this force to remain constant, elastics must be worn all the time and changed every day.

Retainers

Once the active period is completed, your braces are removed. The next step is called retention. Retainers are utilized to hold your teeth in their new positions until your bone, gums, and muscles adapt to the new teeth positions. You must wear your retainer as instructed, otherwise your teeth may move toward their original positions and the benefit of wearing your braces will be lost.

The doctor will determine how long you need to wear your retainer. Time varies with each patient. Some people may need retainers for an extended period of time in order to eliminate shifting of the teeth. In some cases, permanent retention may be necessary.
The retention period is an important part of your overall treatment and should not be neglected!

Remember, wear them in your mouth, not in your pocket. Retainers work when you follow our instructions.

Clean your retainers! After meals, clean all parts of the retainer with a brush.

Handle your retainers with care. Retainers are easy to lose. If you take your retainers out, always place them in your retainer case for safety. Click here for more information on caring for your retainers.

Frequently Asked Questions

Questions from the patient

It is usually difficult for you to determine if treatment is necessary because there are many problems that can occur even though the front teeth look straight. Also, there are some problems that look intimidating and complex which will resolve on their own. Asking your dentist is good reference. Our initial exam is complimentary and we would be more than happy to see your child and make any recommendations necessary.

Although determining if treatment is necessary is difficult for you to assess, the following symptoms may help in prompting you to seek our orthodontic advice.

Ask your child to open their mouth, and let you look at their teeth. If you see any signs of crooked teeth, gaps between your child's teeth or overlapping teeth, your child may need orthodontic treatment.

Ask your child to bite all the way down, but keeping their lips open so you can see their teeth. Do the front top teeth line up with the bottom? Do the top teeth protrude out away from the bottom teeth? Do the top front teeth cover more than 50% of the bottom teeth? Are the top teeth behind the bottom teeth? All these are indicators for potential orthodontic treatment.

Look at the alignment of your child's jaw. Does the jaw shift off center when your child bites down? If you see any misalignment or shifting of the jaw, your child may have a skeletal problem, which requires early orthodontic intervention.

The American Association of Orthodontists recommends that your child be evaluated by age 7. Early detection of some orthodontic problems is important in order to take early corrective action and avoid more difficult treatment later.

No, age is not a factor, only the health of your gums and bone which support your teeth. About 25% of our orthodontic patients are adults and that number is still growing!

Orthodontic treatment has improved dramatically. As a rule, braces make your teeth sore for a few days, but it is not painful. This annoyance can be relieved with an over-the-counter pain reliever. Today's braces are smaller, more comfortable and use technology that reduces the discomfort. We use the latest in miniature braces and the highest quality of orthodontic materials in order to reduce discomfort and treatment time.

Yes. When teeth are missing, adjacent teeth will drift into the empty space. This will cause a functional, esthetic or periodontal problem. Orthodontic treatment will correct and prevent these problems and will also provide proper alignment for your dentist to replace the missing teeth.

Questions about the treatment

Phase I or Interceptive Treatment usually starts while the child has most of their baby teeth and a few of their permanent front incisors. This stage in development is usually about the age of 7. The goal of Phase I treatment is to intercept a moderate or severe orthodontic problem early in order to reduce or eliminate it. These problems include skeletal dysplasia, crossbites and crowding. Phase I treatment takes advantage of the early growth spurt and turns a difficult orthodontic problem into a more manageable one. This helps reduce the need for extractions or surgery and delivers better long term results and treatment options. Most Phase I patients require a Phase II treatment in order to achieve an ideal bite.

Phase II treatment usually occurs a number of years later. Usually we are waiting for 12-16 more permanent teeth to erupt before Phase II begins. This most commonly occurs at the age of 12 or 13. The goal of Phase II treatment is to achieve an ideal occlusion with all of the permanent teeth.

This is another name for orthodontic treatment in the permanent dentition at any age. It is more commonly used when a Phase I treatment was not performed.

Absolutely not! Only certain bites require early intervention. All others can wait until most if not all their permanent teeth erupt.

Can I wait on Phase I/Interceptive Orthodontic Treatment until my child is older?

This is not recommended. If your child needs Phase I treatment this usually means that he has a difficult problem that requires attention now. If no orthodontic action is taken, treatment options become limited, more difficult, and the long-term stability may be compromised. In addition, it may lead to extractions, oral surgery and increased costs.

Braces may be on between 6 months to 30 months, or longer depending on the age of the patient, the severity of the problem, the patient's cooperation, and the degree of movement possible.

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Introduction