Pacific Dental Spa

Family Dentistry

Do you want the perfect smile?

Did you know that teeth crowding is in most cases a bone issue?

     Most patients that seek and/or need braces think that they have a dental problem. But to their surprise; it is usually a bone deficiency. Try to think about it as if you inherited your fathers big teeth and your mother small bones...

     At the age of six, we all start to develop in our mouth our first permanent teeth. Teeth never change in size unless they are affected by decay or unusual wear and tear. This means that we will start to have "adult" size teeth when we are still kids and developing. In other words, big teeth with small bone structures. In most cases we will have most of our permanent teeth when we have not yet finished growing. This will actually aggravate the appearance of crowding.

     We always grow according to the genetics in our families passed on from our father and mother to us. This will decide, speed, length, width, and all the other characteristics that our teeth and bone structures in general will have and grow accordingly.

How can we make space in the bone before the permanent teeth come out?

     The best approach for remodeling the bone structure to the most convenient size and shape would be with orthopedic appliances (active retainer like appliances) . This will not only make the space for the permanent teeth to erupt in the mouth, but also accelerate the change from baby teeth to permanent teeth (exfoliation) as well as correct a bone deficiency. Orthopedic appliances could be fixed and/or removable. We highly recommend for them to be removable, allowing a better hygiene. Once we have managed a proper size and shape on both arches (maxilla & mandible), the permanent teeth will find their space and we would have reduced considerably the orthodontic treatment (braces) to come.

     Orthopedics would be a very important part of any pre-orthodontic treatment. It reduces considerably the time of treatment with fixed appliances (usually braces) at the same time we reduce the risk of having secondary effects of the braces or prolonged fixed appliance treatments (orthodontics), such as decay, inflammation of the gums, plaque accumulation, bad breath, etc; all caused by a poor hygiene. Braces will help trap more food and plaque and require a lot more time to maintain in clean conditions.

     The best timing to wear orthopedic appliances in general would be in mixed dentition; this is when both baby teeth and permanent teeth are present at the same time in the patients mouth.

Example: Please notice sever decalsification on the enamel of the teeth caused poor hygiene in a prolonged orthodontic treatment....

When is the best age to put braces?

     Braces should be placed at the perfect timing were all the permanent teeth have erupted in the mouth completely! All orthodontic treatments take, in general, several months and even years to finish. So the smartest thing to do is to reduce as much as possible the use of braces so that the hygiene is not compromised. The best way to reduce considerably an orthodontic treatment is with the proper use of orthopedic appliances before the use of braces.

     Braces (orthodontic treatment) will correct dental deficiency s. All bone deficiency s should be addressed prior to braces.

Do you have to extract teeth to put braces on?

     This would be an old technique used to correct a bone deficiency dentally! Extractions of HEALTHY teeth should be avoided! Baby teeth sometimes need a little help, but in general they should fall out naturally. Pulling out teeth to make space at in early age is not the best approach. This should be done skeletally with orthopedic appliances before braces are placed. If this is done on permanent teeth, it could compromise in the future, the patients TMJĀ“s health, as well as prolonging an orthodontic treatment and compromising the patients oral hygiene for a longer period of time.

What moves our teeth?

     By the time most orthodontic treatments are finished, the patient has not yet finished growing and bone structures may change in size and/or form; compromising the dental treatment done with bone movement. Naturally, there are two factors that may change and affect an orthodontic treatment: The first would be, growth. Teens will stop growing orally on average between the ages of 14 and 16. There may be cases where they might keep on growing a bit more after sixteen. The growth should be checked with x rays by your doctor and monitored all through the treatment. The other factor that may compromise an orthodontic treatment with post treatment dental movement would be the eruption of the wisdom teeth (third molars). These two factors should be considered at the beginning of the treatment in order to guaranty an effective orthopedic and/or orthodontic approach.

     There may be other factors that can move teeth after treatment. But are considered not ordinary. Such as illness, trauma, bad habits (nail biting), etc.

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