Frequently Asked Questions
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Choosing when to start treatment, what kind of treatment, or even choosing an orthodontist can become confusing. We want to help simplify the process as much as possible so we’ve put together a list of questions that we frequently receive and feel will be helpful.
An orthodontist is a dentist who has taken several years of extra training beyond the basic dental degree. Here is what the American Association of Orthodontists (AAO) says:
“It takes many years to become an orthodontist. As in medicine, the educational requirements are demanding.
First, an orthodontist must complete college.
Next is a three- to four-year graduate program at a dental school in a university or other institution accredited by the American Dental Association (ADA).
Finally, there are at least two or three years of advanced specialty education in an ADA-accredited orthodontic residency program. The program is difficult. It includes advanced knowledge in biomedical, behavioral and basic sciences. The orthodontic resident learns the complex skills required to both manage tooth movement (orthodontics) and guide facial development (dentofacial orthopedics).
Only dentists who have successfully completed this advanced specialty education may call themselves orthodontists.”
Some dentists incorporate orthodontics into their practices. They have probably completed some extra coursework in tooth movement management and facial development. Some dentists who practice orthodontics have completed more coursework than others. Don’t feel shy about asking a dentist about his orthodontic qualifications; what extra training he has completed, and how many orthodontic patients he has seen. Just because a dentist says he or she “can do braces for you” doesn’t mean that they have all the training necessary to successfully handle complicated treatments. Some dentists confer with their their orthodontic colleagues to ensure that they’re doing things optimally.
If you’re considering getting braces from a dentist, you should get at least one opinion from an orthodontist to ensure that you are getting the correct type of treatment.
Occlusion is another word for your bite — how the teeth in your top and bottom jaw meet with each other.
Mal comes from the Latin root meaning “bad.” So, a malocclusion means a bad bite — a bite with problems.
It means that your top teeth do not line up properly with your bottom teeth.
Malocclusion is most often caused by hereditary factors such as an abnormal relationship between the size of the teeth and the size of the jaws. Malocclusion may also result from missing teeth or habits such as thumb sucking or tongue thrusting.
Malocclusions are classified based on the relationship of the maxillary (upper jaw) and mandibular (lower jaw) first permanent molars.
There are three basic classes of malocclusion, Class I, Class II, and Class III:
- Class I malocclusion involves crowding, spacing, or overlapping of the teeth. In this classification the upper jaw is in a normal relationship to the lower jaw; that is, neither jaw protrudes.
- Class II malocclusion occurs when the bottom jaw is in a more posterior (backward) position than normal. The top teeth appear to protrude out over the lower teeth. One example of this type of malocclusion is often referred to as “buck” teeth.
- Class III malocclusion occurs when the lower jaw is in a more anterior (forward) position than normal. The lower teeth protrude out beyond the upper teeth. This is often the most difficult type of malocclusion to correct.
The most common types of bite problems are:
- Overbite: Patients with overbites appear “bucktoothed” and have a receding chin. The lower front teeth are positioned too far behind the upper front teeth. This condition can result from a horizontal overdevelopment of the upper jaw or an underdevelopment of the lower jaw or a combination of both.
- Underbite: Patients with underbites have a strong jaw with a chin that juts straight out. The lower front teeth are positioned in front of the upper front teeth. This condition is caused by the horizontal underdevelopment of the upper jaw, the horizontal overdevelopment of the lower jaw, or most frequently a combination of both.
- Crossbite: This occurs when the upper teeth are biting inside the lower teeth. This is frequently the result of a narrow upper jaw. Crossbites also occur because of a mismatch in jaw size and position between the upper and lower jaw. Some crossbites also lead to asymmetry of the lower jaw by causing the jaw to be abnormally deflected to one side when closing the teeth together. Proper diagnosis determines how and when a crossbite needs correction.
- Openbite: This occurs when the upper front teeth cannot meet or overlap the lower front teeth even though the back teeth have closed together. Sometimes this this makes eating difficult. Open bites are caused by the overdevelopment of the back portion of the upper jaw in a vertical direction. As the back portion of the upper jaw grows vertically downward, the lower jaw will open in a clockwise direction. This explains why open bite patients have a long facial appearance.
That depends on your case. Orthodontics isn’t just about making your teeth straight or making them look better. Most dentists and orthodontists take a lot of things into consideration when recommending treatment, such as:
- how the top and bottom teeth meet with each other (i.e., your bite)
- how well you can chew your food
- whether you have a tongue thrust problem
- whether extraction or surgery will be necessary to correct your problems
- whether you will need any appliances in your treatment, such as a palate expander or headgear
So you see, it isn’t just a matter of making your teeth look pretty. There are a lot of other factors to take into consideration. This is why you sometimes need a full set of braces, even if you think that you only need them on top or bottom. Of course, there are some people whose bite’s are good and perhaps they only need a bit of straightening. People in this position often get braces only on top or bottom.
It depends on your specific case. When we are young and our jaws are still growing, dentists/orthodontists can work with our growth to straighten the teeth without extraction.
But once we are adults, dentists are limited to what is already in place. If your orthodontist recommends extraction, it may be wise to get at least one more (if not two more) opinions before going through with the procedure — once the teeth are gone, they’re gone! Your teeth and jaw help to shape your face. Changing the underlying structure will result in some changes in your facial appearance. You should discuss this with your orthodontist. There are newer types of bracket systems that apply lighter forces and may be able to correct your problems without extractions, such as Damon Brackets. You may want to ask your orthodontist about it.
Sometimes however, depending on your unique case, extraction may be the only way to successfully straighten your teeth and correct your bite.
Many people in the U.S. have dental insurance through their employers or as individuals/families. This insurance usually covers orthodontic treatment for children up to age 18, but does not cover adult orthodontics — or only covers it up to a certain dollar amount.
Remember, most insurance plans and discount dental plans do not cover treatment that is already in progress. So, if you are going to sign up for a dental plan or insurance plan, do it before any treatment begins. Also, beware of any waiting periods your dental plan may enforce. And by the way, jaw surgery or extraction is sometimes covered under your medical plan, so be sure to look into this, too.
Most people begin see changes in their teeth in the first 2 to 6 weeks of treatment.
Still have questions?
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