Who is a Candidate for Treatment?

Orthodontic Treatment

Common Orthodontic Corrections in Adults and Children

Orthodontics is the speciality 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. In fact, over 25% of the patients we treat are adults! 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 course of treatment necessary.

Length of treatment typically depends on 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.

Orthodontic Treatment Timing

Dr. Bob Good and Dr. Ron Good provide 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 age 7 for all children. This early evaluation can help to determine the best time to begin any necessary treatment. If a child is not yet dentally ready to begin treatment, they will be placed in our Pre-orthodontic Guidance Program, during which time the doctors will monitor your child's growth and development. Periodic evaluations allow Drs. Good to determine when and how to best treat your child’s particular needs.

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.

Teeth & Face Classifications

Classification of Teeth

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

Class I:

Class I is a normal relationship between the upper teeth, lower teeth and jaws or balanced bite.

Normal

Crowding

Spacing

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.

Division 1

Division 2

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.

Skeleton

Dental

Classification 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 I:

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 II:

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 and 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 III:

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 conjunction with orthodontic treatment.

Impacted & Missing Teeth

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.

This problem should be corrected because it can:

Cause damage to the root structure of adjacent teeth
Interfere with the sinus cavity
Leave unwanted spaces
Lead to improper functioning of the teeth
Cause premature wear of the teeth
Cause asymmetric alignment of the teeth

How can impacted teeth be orthodontically corrected?

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.

This problem should be corrected because it can:

Cause improper functioning of teeth
Cause premature wear of teeth
Cause asymmetric alignment of the teeth
Make your smile less attractive

How can missing teeth be orthodontically corrected?

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 & Spacing

Crowding of Teeth

Crowding is the lack of space for all the teeth to fit normally within the jaws. The teeth may be rotated 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. To discuss crowding and the spacing of teeth, please feel free to contact us to schedule an appointment.

Crowding should be corrected because it can:

Prevent proper cleaning of all the surfaces of your teeth
Cause dental decay
Increase the chances of gum disease
Prevent proper functioning of teeth
Make your smile less attractive

How can crowding be orthodontically corrected?

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 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.

Spacing should be corrected because it can:

Result in gum problems due to the lack of protection by the teeth
Prevent proper functioning of the teeth
Make your smile less attractive

How can spacing of the teeth be orthodontically corrected?

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

Common Orthodontic Concerns

Crossbite

Crossbite can occur in the front and/or the sides of the mouth when 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.

Crossbite should be corrected because it can:

Cause premature wear of the teeth
Cause gum disease including bone loss
Cause asymmetrical development of the jaws
Cause dysfunctional chewing patterns
Make your smile less attractive

How can a crossbite be orthodontically corrected?

Openbite can be corrected through growth modification of the jaws using braces, extrusion of the anterior teeth and in some cases surgical correction of the jaws. Also breaking oral habits, such as finger or thumb sucking, will facilitate the correction of an openbite.

Class II 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:

Cause improper functioning of your front teeth
Result in the lower front teeth biting into the gum tissue of the upper palate leading to tissue problems
Unusual wear of the lower front teeth
Cause jaw or joint problems
Make your smile less attractive

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

Class II 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 should be corrected because it can:

Prevent proper functioning of the front teeth
Lead to premature wear
Make your smile less attractive

How can overjet be orthodontically corrected?

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

Underbite

Class III 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 should be corrected because it can:

Prevent proper functioning of the front teeth or molars which can lead to premature wear of the teeth
Cause chewing or eating problems
Cause jaw or joint problems
Make your smile less attractive

How can an underbite be orthodontically corrected?

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

Orthodontic Concerns

Surgical Orthodontics

What is Surgical Orthodontics?

Just as orthodontics repositions teeth, surgical orthodontics (also known as orthognathic surgery) corrects jaw irregularities to improve the patient’s ability to chew, speak and breathe and for improved facial appearance. In other words, surgical orthodontics straightens your jaw. Moving the jaws also moves the teeth, so orthodontic treatment is always performed in conjunction with jaw correction. This helps make sure teeth are in their proper position after surgery.

Who needs Orthognathic Surgery?

Dr. Bob Good and Dr. Ron Good will consider orthognathic surgery treatment for non-growing adult patients with improper bites and patients with facial aesthetic concerns. Jaw growth is usually completed by age 16 for girls and 18-20 for boys. All growth must be complete before jaw surgery can be performed. However, the pre-surgical tooth movement (braces) can begin one to two years prior to these ages.

How does Orthognathic Surgery work?

During your orthodontic treatment, which usually lasts 18-24 months, you wear braces and will visit Drs. Good for scheduled adjustments to your braces. As your teeth move with the braces, you may think that your bite is getting worse rather than better. However, when your jaws are placed in proper alignment during orthognathic surgery, the teeth will then fit into their proper position.

Surgery will be performed in the hospital with an oral surgeon and can take several hours, depending on the amount and type of surgery needed. In lower jaw surgery, the jawbone behind the teeth is separated and the tooth-bearing portion is move forward or backward, as needed. In upper jaw surgery, the jaw can be repositioned forward or backward, or the jaw can be raised or lowered. Certain movements may require the jaws to be separated, with bone added or removed to achieve the proper alignment and stability.

When you have completed surgery, you should be able to return to work or school within two weeks. After necessary healing time (about 4-8 weeks), Dr. Bob Good and Dr. Ron Good “fine-tune” your bite. In most cases, braces are removed 6-12 months following surgery. After braces are removed, you will wear retainers to maintain your beautiful “Good” smile.

Bioesthetic Orthodontics

Bioesthetic Orthodontics

Bioesthetic Orthodontics is based on a combination of biologic form and functional occlusion goals. By arranging the teeth to work in harmony with the alignment of the jaw joints, a more stable result is attainable.

Often times, patients have teeth that in addition to being misaligned are not of proper shape and form.

Although the teeth can be orthodontically straightened, proper function is unachievable due to inadequate tooth form. Proper form can be established with restorative dentistry following orthodontic treatment. Teeth with the proper form are not only more beautiful but function together better.

Beauty meets form….the secret to a healthy smile!

TMJ Dysfunction

TMJ Dysfunction

Many people suffer from dizziness, earaches, face, head, neck, shoulder and back pain, without knowing the cause of their pain. Previously, many patients seeking medical cures for these types of problems were told it was “all in their mind” and they would go from specialist to specialist seeking a cure. Today, however, it is known that the condition termed TMJ or TMD (temporomandibular joint) syndrome accounts for a large number of these previously uncured and painful ailments. Correcting the problem rather than the symptom is at the heart of TMJ treatment.

With new knowledge and technology, dentist and orthodontist are able to diagnose and treat TMJ problems which previously have been overlooked. Additionally, the medical profession is becoming more aware of dentistry’s involvement and physicians are referring patients to orthodontists knowledgeable in TMJ treatment. Dr. Bob and Dr. Ron are both board certified specialists in orthodontics and facial orthopedics.

Malocclusion and the TMJ

Your jaw joints, which hold your lower jaw in place, are suspended beneath your skull by an intricate system of muscles and tendons. The jaw joints, also known as the temporomandibular joints (TMJ), are some of the most complex in the body. The jaw joint, the surrounding muscles and the fit of your teeth are interrelated, each affecting the other as you make every day jaw movements such as speaking and chewing. The way your teeth fit together is called occlusion.

When your teeth are not in proper relationship to each other and your jaw joints, the jaw automatically shifts to a new position in an attempt to compensate for the misalignment of your teeth, a condition known as malocclusion.