Gummy Smile
Description & Causes
One of the things we see a lot here at Joseph Orthodontics is what we like to call a “gummy smile.” This is a condition where too much pink tissue can be seen when a person speaks or smiles. The condition is quite common—approximately 7% of men and 14% of women feel that they have a gummy smile. The condition typically occurs when someone has an enlarged upper jaw, a short upper lip, short upper front teeth, or a forward position of the front teeth. Sometimes it can also be be by disproportionate lip length or tooth height.
Treatment options
Orthodontic treatment, periodontal surgery, jaw surgery, or some combination of the aforementioned professional work can correct a gummy smile. In general, active treatment time with orthodontic appliances ranges from 1 to 3 years. The actual time depends on the growth of the patient’s mouth and face, the cooperation of the patient, and the severity of the problem. Custom-made appliances are designed by the orthodontist according to the problem being treated. They may be removable or fixed (cemented and/or bonded to the teeth), and made of metal, ceramic or plastic. By placing a constant, gentle force in a carefully controlled direction, braces can slowly move teeth through their supporting bone to a new desirable position.
The cost of treatment depends on several factors, including the severity of the patient’s problem and the treatment approach selected. You will be able to thoroughly discuss fees and payment options prior to beginning treatment. A convenient payment plan might be an option. Generally, treatment fees may be paid over the course of active treatment. Arrangements commonly offered in orthodontic offices may include an initial down payment with monthly installments, credit card payment, finance company agreements, and other innovative ways to make treatment affordable.
Crowding
Descriptions & Causes
If your teeth are crooked, turned, or overlapped, you are not alone—virtually 90% of the population has an orthodontic condition known as crowding. Generally caused by genetics (a relatively small jaw or relatively large teeth) or by habits such as nail biting and thumb sucking, crowding is easily fixed with orthodontia.
Treatment options
Typical treatment for crowded teeth involves the placement of highly detailed orthodontic “braces” on all the upper and lower teeth. In adolescents or adults, braces may be worn between 2 and 3 years, depending on how crowded or misaligned the teeth are. Once the teeth are stable in their alignment, the braces are removed and a fixed retainer is placed on the back of the lower teeth to hold them in place; the upper teeth are held with a removable retainer. Retainers are worn for two or more years depending on the severity of the original condition. The lower retainer should be worn as long as possible, as the highest chance of relapse occurs with the lower front teeth.
When crowding is detected early in children (when baby teeth are still present), a functional appliance or braces can be placed so that when the baby teeth fall out, the appliance/braces hold back the rest of the molars, acting as a “spacer.” The patient is instructed to turn the appliance’s screw each night, which slowly widens the upper jaw in order to make room for the impending adult teeth. Although the expansion process is achieved in approximately 4 months, the appliance should be worn for the next 6 to 9 months to ensure maximum long-term results.
Whether braces, an oral appliance, or extraction is used to reduce tooth crowding, Dr. Joseph knows the quickest and most efficient way to resolve your situation. Be sure to alert him to your expectations and time constraints. Undoubtedly, a healthy smile will follow.
Spacing
Description & Causes
In orthodontics, spacing means exactly what it sounds like: there is too much space between your teeth. This condition is the exact opposite of crowding and is known clinically as “diastema.” Spacing occurs in approximately 5% to 10% of the population. Like crowding, spacing may be caused by genetic factors. For example, if you inherit a large jaw from your mother, but small-sized teeth from your father, you probably will have too much space in your mouth! Spacing may affect all of your teeth or just a portion of them. In addition, chronic thumb sucking as a child can also create or widen spaces between the teeth.
Treatment options
Although not medically necessary, many people choose to recreate their smile through orthodontics. Many are concerned about how they look; a healthy and aligned smile helps to bolster self-confidence and self-esteem. In rare cases, however, spacing may significantly affect your ability to bite or chew; in these circumstances, orthodontic “braces” are required. Some cosmetic dentists use computer-imaging technology to provide the opportunity to view how the teeth will look after treatment. In addition, this technology can help you decide whether bonding or braces is right for you.
The most popular (and least-invasive) type of treatment for spacing is braces. Typically, patients with excess space between their teeth wear braces for 6 to 9 months, followed by the use of a retainer (to maintain the teeth’s new position). Depending on the severity of the case, braces may be placed on the upper or lower teeth. Whatever condition you are seeking treatment for, Dr. Joseph will tailor treatment to fit your lifestyle, age, and desired duration of treatment.
Tongue Thrust
Description & Causes
Swallowing occurs 24 hours per day and about 2000 times each day. Each time you swallow, 1 to 6 pounds of pressure is applied to the inside structures of the mouth. Normally when a person swallows, the middle section of the tongue is placed on the roof of the mouth. When the tongue is placed between and behind the teeth, this pressure pushes the teeth apart and out, causing distortions of the face and teeth. This abnormal swallowing motion is known as “tongue thrust.” This condition is most common in children with prior severe thumb sucking habits.
Treatment options
Myofunctional therapy (with a speech therapist) is a popular method of treating tongue thrust. In severe cases, a special appliance may be prescribed with or without braces. The appliance is clear and has two heavy wires curving back onto the roof of the mouth behind the upper front teeth. These wires do not interfere with the tongue as long as the tongue is in the proper swallowing position. If the mouth is opened during the swallow (tongue thrust position), the motion brings down the wires into the path of the tongue and the thrusting motion is prevented. The appliance may also be used in combination with vertical elastic bands to again reinforce the habit.
As with any orthodontic therapy, the earlier a problem is detected, the less time is required for treatment. If you suspect your child (or yourself!) is a tongue thruster, be sure to let Dr. Joseph know as soon as possible. Unfortunately, many parents fail to recognize the importance of correcting tongue thrust while the child is still young, and the problem goes unnoticed for years. When this occurs, the length required for treatment increases and the child’s self-esteem can be lowered. The problem can usually be repaired in a small child in under two years. It is important, however, that both the parent and patient strictly comply with the treatment prescribed by the doctor.
Crossbite
Description & Causes
An individual with a crossbite will have teeth that are out of place when the mouth is closed. In most instances, this means that one set of your teeth will either fall inside or outside of the opposing set. For example, your upper teeth may sit inside of the lower teeth when the jaw is closed. Many of the causes of crossbite are apparent in childhood or early adulthood. Two of the biggest causes of crossbite are heredity and delayed loss of baby teeth. Both of these situations could cause the teeth to be out of the proper position. Misaligned teeth can cause premature wear and muscular problems in the jaw.
Treatment options
Treatment for crossbite depends upon the severity of the problem and the age of the patient. Children are often easier to treat because their teeth are still in the process of developing. In addition, children are more accepting of the idea of wearing braces. Orthodontics, however, are used to properly align the teeth of both children and adults. In extreme cases, surgery may be required to align the jaws. Temporomandibular joint disorder (TMJ) is another problem that can develop from jaw problems. Over time, orthodontic treatment is the best solution for individuals with crossbite.
Eliminating crossbite can take over a year and requires periodic visits to the orthodontist. Dr. Joseph can formulate a treatment plan based on your individual concerns and desires. You may discover that making multiple payments may be the most effective way to finance the procedure. We are always more than willing to help answer any financial questions you may have. Using a credit card or financing the treatment through a third party are ways that you can resolve financing concerns and begin redesigning your smile.
Open Bite
Description & Causes
Open bite is an oral condition that occurs when certain teeth, usually your front teeth, do not make contact with each other. Open bite gives the illusion that a person’s mouth is never really closed, because there is always space between the teeth. Since open bite is not a common problem, those who seek treatment do so primarily for aesthetic reasons. For patients who have moderate to extreme open bite, treatment is important since the condition can affect the joints of the jaw and cause recurring pain throughout the region.
There are a number of circumstances that could be responsible for open bite. Thumb sucking and tongue thrusting are habits that can have an affect on the development of open bite. Speech problems such as lisping can also cause open bite. Genetics can create a situation where the upper and lower jaw are unaligned. Your dentist should be able to spot these causes and refer you to an orthodontist for proper treatment.
Treatment options
While open bite can often be treated with braces, in moderate to extreme cases a more complex solution is required. These cases are more difficult to handle because both the teeth and the jaw are involved. Many individuals with moderate to extreme open bite require surgery to correct their jaw. In addition, they need braces before and after the surgery to achieve proper alignment. The entire treatment procedure requires a significant financial investment, and in severe cases, may take more than 3 years to complete. The price of treatment and the time needed to complete it vary between adults and children since their mouths are in different stages of development. Even so, many individuals pay for the procedure in installments, whether they work out a payment plan with their surgeon or through a third party.