Despite bites manifesting in different forms, malocclusions occur due to one or more of the following environmental or genetic situations:
Myofunctional Habits – This includes habits such as bottle feeding, mouth breathing, thumb sucking, tongues thrusting, etc.
Genetics, Facial Development and Injury.
Common Bite Problems
Overbite:
An overbite is a when the upper front teeth overlap or cover part of the lower front teeth. This type of bite can wear down the front teeth, predominately the incisors (the two front teeth). Additionally, an overbite can cause damage to the gum tissue and often results in what is known as a “gummy” smile. Depending on the severity of the overbite (overbites that cause front teeth to mostly cover the lower teeth are called deep bites), most types of braces, including invisible aligners, will fix this issue.
Underbite:
Sometimes referred to as an anterior crossbite, an underbite can cause a “bulldog” appearance, where the lower jaw sits out in front of the upper jaw. This type of malocclusion causes stress on the jaw joints and if left untreated can cause tension headaches, jaw problems, and even TMJ disorders. This type of bite problem is typically more difficult to treat and may require a person to wear braces for a longer amount of time compared to someone with a mild overbite. In addition to braces, a severe underbite may require that a person undergo jaw surgery to reshape either the lower or upper jaw to create a proper bite. If you have an underbite, consult with your Arco orthodontist office to determine what the best course of action will be for you.
Crossbite:
A crossbite can affect one tooth or multiple teeth and is when the upper teeth fit inside of the lower teeth. This can be caused by misaligned teeth, bone or both. This type of bite can cause issues for people in terms of biting and chewing and tend to worsen over time. For this reason, it is crucial that you take your children to seen an orthodontist by the time they are seven. Even if there are no signs of malocclusion, your Arco orthodontist will be able to see if it may become an issue in the future. The quicker this problem can be dealt with, the better.
Openbite:
Similar to crossbites, early intervention is the best practice as open bites can cause potential swallowing and speech problems. There are two different types of open bites, anterior and posterior. An anterior open bite refers to when the upper and lower teeth do not overlap (or touch in some cases) when the back teeth are together. A posterior open bite is when the upper and lower teeth meet, but not the back teeth.
Custom braces may need to be created by your Arco orthodontist in order to treat this specific malocclusion.
Crowding:
When there isn’t enough space in your mouth for teeth to come in properly, it causes crowding. Crowding is one of the most common problems that orthodontists take care of and can be corrected by most braces. Crowding can cause people to lose confidence in their smile, but the issues of crowding go beyond appearance. Crowding makes it harder to clean teeth and get in between teeth while cleaning, resulting in increased cavities and gum disease, such as gingivitis.
Spacing:
Spacing, the opposite of crowding is another common malocclusion many people experience. Despite being the reverse of crowding, spacing, when not treated, can also lead to an influx of cavities and gum disease. This is because rather than not being able to clean between teeth like crowding, spacing allows for food particles and plaque to build up in these “wider” spaces, if not properly cared for. Similarly, the reason for spacing is due to a inconsistency of tooth size and jaw space. Damon braces (self-litigating braces) are a faster option for spacing than traditional braces. Call Randall Orthodontics to see if Damon braces are the right option for you.
Dental Midlines:
When the dental midlines of a person’s mouth don’t meet up this malocclusion can cause dental health to deteriorate as well as ongoing problems with the jaw. A dental midline issue is apparent when the top teeth don’t meet up with the bottom row of teeth. In many midline orthodontic cases, a person may need to have braces in addition to tooth extraction to correct the midline. Invisible aligners cannot be used for most midline issue.
The paintings you see below are ceiling tiles in our McNerney & Wenzon Dental offices. These tiles have been painted by our patients over the last 25 years. The original painting was painted by a patient referred to our office by “Turning Point,” a domestic violence agency. As she was in a tough spot, she offered to provide paintings in exchange for dental care for her two boys. So she would bring a wooden frame which I would cut to fit the ceiling. She would then stretch canvas and paint a scene, over time creating three pieces. During that time, she got cochlear implants and learned to hear. She also earned a Masters and then a Doctorate in order to be a counselor for other women going through what she had. Her little boys have grown to be wonderful men.
When patients saw her paintings they asked if they could paint ceiling tiles. Instead of canvas, they simply used the actual ceiling tiles. Our office now has tiles being painted by children of parents, who had painted a tile when they were younger. And it is so much nicer to have paintings to look at while you are having a dental visit.
McNerney & Wenzon Dental prides ourselves in delivering a high level of dental care to every person, always considering their individual desires and situations.
Our services range from simple dental maintenance to advanced reconstruction, delivered in a relaxed, comfortable atmosphere. We are committed to continuing professional education and use of state of the art techniques and materials. This makes possible innovations such as conscious sedation, dental implants, and extreme makeovers.
Whatever your aspirations may be, we look forward to creating a long-standing relationship to provide and maintain your family’s dental well-being.
Dr. Benedict Bachstein was born and raised in Germany where he completed his dental school studies with honors at the University of Munich. He then moved to Philadelphia and received his D.M.D. from the University of Pennsylvania in 2007.
Dr. Bachstein participated in dental research, co-authored several research articles and received many awards including:The Award for Outstanding Clinical Performance in Fixed Prosthodontics, an award for outstanding performance by the Academy of Operative Dentistry and recognition for clinical excellence by the University of Pennsylvania Department of Endodontics.
Dr. Bachstein attended the Albert Einstein Medical Center in Philadelphia where he completed his specialty training in Endodontics, served as Chief Resident’ and received recognition by the American Association of Endodontists for his work.
Dr. Bachstein teaches dental residents and serves as treasurer for the Grossman Study Club. He is the past president of the Southern Dental Society of New Jersey. His professional affiliations include the American Association of Endodontists, the American Dental Association, the Academy of Osseointegration, the New Jersey Dental Association, the Southern Dental Society of New Jersey and Alpha Omega. Dr. Bachstein is fluent in English and German.
Today’s orthodontic treatments are a lot more diverse than you remember from your youth. While metal braces are still very common, there are a lot more options than there used to be. One of those other options is lingual braces, which are braces that are adhered to the back of your teeth (the lingual or tongue side) instead of the front of the teeth making them less visible, practically invisible.
With lingual braces, the brackets, wires and even the elastics are all mounted to the back of your teeth, which is a desirous option if you don’t want people to know you are wearing braces. Whether you are a teenager who worries about peer pressure or an adult who has a career where appearance is an important factor, lingual braces are a way to get the treatment you need to correct your smile without other people having to know about it.
However, despite these positive points and the fact that is very similar in technique to traditional metal braces, lingual braces are not for everybody. You need to ask, am I a good candidate for lingual braces?
Here are a few things you should consider:
Comes Down to Bite
While most bite problems can be fixed just as well with lingual braces as with those that adhere to the outside of the teeth, there may be concerns with using lingual braces with a deep overbite. This is because the overbite might bear too much pressure on the brackets and cause them to fall off easily. After an evaluation, your orthodontist will be better equipped to tell if this is a problem that concerns you.
Drawbacks Vary Person to Person
Like with anything there are always some drawbacks to consider, but they tend to vary and are not always a deal breaker. Here are some issues you may or may not have:
Difficulties with speech. Because the braces are on the inside of your teeth, it will feel a little strange at first and you may experience some speech difficulty like a lisp or a whistling sound until you get used to them. This is because your tongue usually makes contact with the backs of your teeth as you create sounds. Your tongue however will eventually train itself to find a different place in the mouth.
Your best bet is to practice reading out loud and talking out loud until you feel like your speech is back to normal. There is a small percentage of people who will continue to have speech difficulty throughout the treatment period. Talk to your orthodontist about any risk factors you should be aware of.
Sore tongue. Because your tongue will be hitting up against your new braces a lot in the beginning, your tongue may hurt or start to develop sores. Your tongue will eventually toughen up, but in the meantime there are certain things you can do to soothe the pain. You can rinse your mouth in warm saltwater to help it heal or use an over-the counter medicine that has an anesthetic that can temporarily numb your tongue. Other things that can help include putting orthodontic wax over the sharp edges of the brackets or putting silicone pads over the braces.
Limited to what you can eat. Like with metal braces, there are certain foods that your orthodontist will recommend that you avoid while you are wearing lingual braces. Stay away from foods that are hard and very crunchy or those that are very sticky. Food stuck behind your teeth can be extra challenging to reach. Also, to avoid damaging your braces, it is best to always cut up your food into smaller pieces and avoid hard or sticky candy or gum.
Cleaning your teeth properly takes extra effort. Because the braces are on the back of your teeth, it can be harder to get rid of all the food and plaque stuck between your teeth and between your braces. An electric toothbrush can help and so can specialty dental flosses. Ask your orthodontist for a demonstration of the best way to clean your teeth and gums while wearing lingual braces.
Lingual braces can also be more expensive than other techniques depending on your dental insurance coverage. If money is an issue, then you may want to stick to the traditional metal braces which are often less expensive. It doesn’t hurt though to ask about payment options if you really would prefer the lingual braces.
Not everyone is going to have all these issues though. The good news is that the technology used in creating lingual braces is improving every day. The brackets have gotten a lot smaller and also more rounded and smoother to the touch so they will cause less tongue irritation. Also everyone’s experience is very individualized and what may bother one person may not be an issue for you. If you know someone who currently wears lingual braces or wore them in the past, ask them about their experiences with it and would they recommend this type of braces to others.
If keeping your braces invisible is of utmost importance than lingual braces is definitely worth consideration. There are also other less noticeable orthodontic options are available as well. There is Invisalign which are removable, clear plastic aligners as well as ceramic braces that are tooth-colored and so blend in better to your teeth.
Make sure you thoroughly research all options before making any final decisions. Talk to your orthodontist about the pros and cons of each and ask which technique will get the best results for your particular situation.
Also remember that not all orthodontists specialize in lingual braces. Lingual braces require special training so make sure you choose someone who is skilled in the more complex wire bending that is required with this type of braces.
Finally, no matter which type of braces you choose, following good oral hygiene is essential to keep your teeth and gums healthy throughout the treatment process. Floss and brush your teeth, gums and braces twice a day daily.
The link between periodontal (gum) disease and other inflammatory conditions such as heart disease and diabetes has long been established, but the mechanism behind that association has, until now, remained a mystery.
This month, a team of scientists and clinicians led by the University of Toronto's Faculty of Dentistry say they've found the reason why—and it's related to the body's own hyperactive immune response. The findings were published in October in the Journal of Dental Research.
Science has already established that state of your oral health is an important indicator of overall health. "There are statistically significant correlations between periodontitis (oral inflammatory disease) and systemic diseases ranging from diabetes to cardiovascular diseases," says Howard Tenenbaum, professor at the University of Toronto's Faculty of Dentistry, and chief dentist at Sinai Health Systems in Toronto, who is one of the authors of the study.
To find what links those conditions, the researchers focused on the behaviors of cells primarily activated by gum disease—neutrophils, which are cells of the innate immune system. Through in vivo models, the researchers found that the immune system releases an abundance of these neutrophils to tackle the bacterial infections responsible for periodontitis, more commonly known as gum disease.
Activated to fight an oral infection, a systemic effect was noted: Once periodontal inflammation was present, an overabundance of neutrophils circulated, 'primed' for attack. The hyper-vigilant immune system then responds with an excess of force to any secondary infection.
"It's almost as if these white blood cells are in second gear when should be in first," says Michael Glogauer, professor at the University of Toronto's Faculty of Dentistry and the study's senior author.
That's when the body becomes susceptible to damage from secondary inflammatory conditions. With the immune system already primed by the neutrophils for attack, a secondary event causes those immune cells to destroy affected tissues and organs.
"The [neutrophils] are much more likely to release cytokines much more quickly, leading to negative outcomes," adds Glogauer, who is also dentist-in-chief at the University Health Network and head of dental oncology at Toronto's Princess Margaret Cancer Centre.
Produced initially in in vivo models, the findings were confirmed through a controlled clinical experiment.
The study's findings underscore the importance of oral health as a vital indicator of potential complications for other inflammatory conditions, as well as disease model outcomes.
"We believe this is the mechanism by which oral hygiene can impact vulnerability to unrelated secondary health challenges," says lead author Noah Fine, a postdoctoral fellow at the University of Toronto's Faculty of Dentistry.
When Kate Faith was laid off in March at the start of the coronavirus pandemic, her stress levels skyrocketed. She worried about making ends meet as a single parent to her 1-year-old daughter and about her family and friends catching the virus. The 37-year-old's sleep worsened, and the additional stress caused Faith's longtime habit of grinding her teeth and clenching her jaw to intensify.
"I've been dealing with clenching my jaw and grinding my teeth on and off since college, but because I have a night guard, I usually just work through it," said Faith, who lives in South Philadelphia. "But in March, things just got so much worse. I never thought I would do so much damage to my teeth."
Dentists around the country say they've seen a surge in excessive teeth grinding or clenching, known as bruxism, since the pandemic began. Chronic teeth grinding wears down enamel, the outermost protective layer of the tooth, resulting in teeth fractures, or even loss of teeth in serious cases. It can also cause muscles around the jaw to ache.
Many dentists attribute the recent surge in bruxism to increased stress, which has been linked to bruxism in a number of studies, though not as a direct cause.
The increase did not come as a surprise to Thomas Sollecito, chair of oral medicine at the University of Pennsylvania School of Dental Medicine.
"I would be surprised if there wasn't an increase," he said. "The stress and distress of the world's events will affect things like sleep and someone's clenching and grinding. If we're constantly under that duress, the frequency and intensity of clenching and grinding is just going to continue."
The most common thing people might notice if they're grinding or clenching their teeth excessively is a tension headache, which can feel like dull pain or pressure across the forehead or in the back of the head, Sollecito said. Specifically, the overuse of muscles that close the jaw can cause temporal headaches, which are felt in the temples on the side of the head.
"People may also notice more discomfort with normal activity," Sollecito said. "They might feel pain even if with routine chewing because their muscles have undergone more 'exercise' by clenching and grinding."
Although Jennie Spotila had been struggling with the effects of bruxism over the last few years due to increased stress from personal issues, she said the pandemic made the issue significantly worse. Right before COVID-19 closed dental offices, Spotila, a 52-year-old disability activist living in Montgomery County, got a temporary crown because she broke a tooth from grinding.
"I was afraid to go to the dentist again, so I didn't go back until June to get the impression taken for the permanent crown," Spotila said. "And in the meantime, I had cracked another tooth, within the first few months of the pandemic. My dentist jokingly asked, 'Have you been under a lot of stress?' and I thought, 'Um, yes.'"
She got a night guard, based on her dentist's recommendation, and started wearing it while she slept to reduce the grinding. But Spotila said that she now catches herself grinding or clenching or teeth during the day as well.
"I just try to stop and consciously relax the jaw," she said. "I know that this issue is stress-related. I never ground my teeth before, ever, until the last couple of years."
Hai Qing, a dentist who practices in Bucks County, said he's seen a handful of patients come in recently with joint issues, a sign of excessive teeth grinding or clenching. Qing recalled one patient who, after being asked to take on more responsibilities at work during COVID-19, broke her night guard from excessive grinding.
Qing said it's important to patient's saliva for acidity as it can exacerbate bruxism.
"Bruxism causes more severe damage when the saliva is acidic in a short amount of time," he said. "We try to control that by looking at their dietary habits and making adjustments. We also want to make sure the patients don't have any fragile or weak teeth, so we can protect those as well."
When Faith saw her dentist in April, she mentioned that her grinding had gotten worse. Her teeth were starting to develop sharp edges on the side because she had ground down the centers. She was given a prescription for an anti-inflammatory, which was supposed to alleviate the pain. But things didn't improve.
"When I saw my jaw and migraine doctor in June, I told him I couldn't take it any longer," Faith said. "I would wake up in the morning and my jaw would be throbbing from grinding all night long, even though I wear my night guard to protect my teeth."
She eventually scheduled a temporomandibular joint (TMJ) arthroscopy, a surgery that relieves pain and restores the jaw's full range of motion, at Thomas Jefferson University Hospital at the end of September. Faith said that she's also hoping to get acupuncture for her jaw, a treatment that has relieved her pain in the past, once she finds a new job.
"I feel better but my stressors haven't really subsided yet," Faith said. "I'm still in the circumstances I was in March. I need to find a way to manage the stress, but I don't know how to keep thisfrom happening over and over at night until things are better."
(10/26/2020) by Bethany Ao, The Philadelphia Inquirer
Dr. Richard Jacobson is a recognized expert, clinician, and researcher in orthodontics for children and adults. He has been in practice for over 30 years and has analyzed, documented, and completed treatment on over 12,000 patients.
Dr. Jacobson has advanced training and extensive experience in orthodontics for jaw surgery, jaw and bite disorders, temporomandibular joint disorders and obstructive sleep apnea.
The core of his treatment philosophy is directed toward progressively enhancing the overall health, optimal function, and natural aesthetics of his patients. His treatment is preventative, interceptive, corrective, and bio-mimetic. Dr. Jacobson received his postdoctoral certification at the UCLA School of Dentistry’s Department of Orthodontics in 1981.
He then pursued advanced training in jaw and bite disorders at the UCLA Temporomandibular Joint Department earning a master’s degree in oral biology in 1983. Over the next five years, he received additional training at the American Institute of Bio-progressive Education where he was invited to teach with one of his mentors Dr. Robert M Ricketts, world renown for his contributions to the profession of orthodontics and his expertise in temporomandibular joint disorders and orthodontics for jaw surgery.
Dr. Jacobson later befriended Tom Graber DDS MS PHD and incorporates his teachings into his lectures, presentations and clinical practice in Pacific Palisades, CA.
The Cure for the Common Doctor.
If you talk to his peers, they will tell you that Dr. Richard Jacobson is widely considered to be one of the finest orthodontists alive. A Master of his craft, with over 12,000 cases served. Dozens of awards and citations. Both a teacher and innovator, constantly giving back to the profession.
But his patients don’t tell you that.
They tell you about his energy. His infectious laugh. His curiosity.. His passion for the work…the science…the art of creating a perfect smile. They tell you they wish all their doctors were like him.
And then, they tell you to go and see him.
Which is why Dr. J’s practice has become the premiere destination for people from ALL walks of life, and their families, from ‘far and wide’ including Hollywood professionals* both above and below the line: Word of mouth. But don’t take our word for it.
As soon as the milk teeth start to erupt, they need to be looked after and brushed daily; the first tooth often emerges at 6 months, but some babies are born with a tooth or two.
Some parents are of the attitude that baby teeth aren’t important because another set will grow later in childhood. This is far from the case, baby teeth are extremely important. If they are not properly looked after your child may have difficulty chewing and also speaking clearly. They also provide a framework for the adult teeth to grow. Over 40% of children have cavities in their baby teeth. At this essential time in young children’s lives, in terms of learning, milk teeth need to be looked after. Brushing teeth is an a grown up’s responsibilty, until they are 6 or 7, when they start brushing their own teeth.
Copying teeth brushing:
Children learn by watching and copying. If you want to demonstrate the correct way to brush your children’s teeth, brush your own teeth at the same time. Show them how to brush each surface, including the backs of teeth and molars. It is also a good idea to get your children to brush your own teeth; they will find this really amusing, although expect to have toothpaste around your mouth afterwards. You should supervise them brushing their teeth until they can rinse out their mouths and spit independently. This is normally between 6 and 7 years of age.
Reward charts for effective brushing:
Usually, young children respond well to dental reward charts and bribery. Set up a monthly chart and reward a sticker for every day that your children’s teeth are brushed. At the end of the month offer them a small prize, perhaps a certificate showing that they are outstanding at brushing their teeth. It is good to positively reward a child for brushing their teeth and they will feel proud in doing so. Teeth should be brushed twice a day and it needs to be part of their regular morning and evening routine. If you give them a mirror to look in, they will be able to see where to brush and how to move the toothbrush in the right motion.
Watch appropriate videos and read stories about tooth brushing:
Many cartoon characters have videos online about brushing your teeth and having good dental hygiene. There are also some wonderful songs that can encourage your child to brush their teeth. Children love music and singing songs whilst brushing helps make it interesting. It is important to make this everyday task fun, so that it doesn’t feel like a chore. You can also purchase toothbrushes that flash for two minutes, helping children to brush their teeth for a good amount of time.
Encouraging your children to brush their teeth is so important. Daily positive reinforcement will help them to develop good habits as they grow to adulthood. Don’t forget that once their first couple of teeth have started to emerge, it is a good idea to book them in for their first dental check up.
Teething is the process where an infant’s teeth erupt through the gums. This can lead to various symptoms, such as mild fussiness and discomfort.
Fever may coincide with teething, but it likely indicates a separate health issue, such as an infection.
There are two main reasons why teething and infections occur at similar times:
Increased exposure to new pathogens: At 6–12 months of age, the infant is sucking and chewing various objects as they explore their world by putting things in their mouth. This exposes them to new pathogens.
Loss of antibodies:
When infants are 6–12 months old, they begin to lose antibodies that their mother transfers to them during birth. This means their immune system has to respond to more infections, such as colds.
To summarize, fever may occur around the same time as teething. However, fever is a sign of infection, rather than a normal symptom of teething.
Fever definition:
In infants, the definition of fever depends partly on their age and the method used to take their temperature. Medical professionals define fever as below:
Infants younger than 3 months of age: Fever is a temperature of 100.4oF (38oC) and higher.
Older infants and children: Fever is a temperature of 101.2oF (38.4oC) and higher.
How to treat a fever:
A fever is a sign that the body is fighting an infection or disease. As such, it is not the fever itself that requires treatment, but the underlying issue.
However, Texas Children’s Hospital advises parents and caregivers to treat a fever that makes their child uncomfortable. They recommend the following remedies:
-Offering an age- and weight-appropriate dose of acetaminophen, which people can determine by first consulting a doctor.
-Dressing an infant lightly, to avoid trapping excess body heat
-Ensuring the infant drinks plenty of fluids.
When to see a doctor:
Call a doctor immediately if an infant is less than 3 months of age and has a fever of 100.4°F (30°C) or higher.
People should also call a doctor immediately if a child is older than 3 months of age and shows any of the following symptoms:
-Inconsolable crying.
-Difficulty awakening.
-Unexplained rash.
-Severe vomiting or diarrhea.
-Weakness or lethargy.
-Seizures.
-A fever that repeatedly rises to 104°F (40°C) or higher.
Teething is not dangerous. It resolves on its own in around 8 days. Typically, infants with teething symptoms may experience some pain for the 5 days before their teeth erupt, and for another 3 days after they surface.
However, babies teethe many times during their first few years of life. As such, it can be helpful for parents and caregivers to develop a way to manage teething symptoms.
Are you practicing good oral hygiene? Poor oral hygiene can lead to a lot of problems with your oral health as well as your general wellness. However, there are still a lot of people that do not practice good oral hygiene. If you want to avoid major dental issues in the future, these tips will help improve your oral health.
Tips for proper oral hygiene
Brush and floss regularly
Brushing your teeth at least twice a day is very important to your oral health because it helps to reduce the bacteria in your mouth and as a result, your chances of having cavities and dealing with tooth decay. Ideally, you should brush your teeth after every meal, but since most people do not go around with a toothbrush in their pockets, you should rinse your mouth out with water or mouthwash after eating a meal if you are not at home.
Flossing is also very important because it helps to remove the food particles that are still stuck between your teeth after you brush. When you are done flossing, rinse your mouth with mouthwash to remove any lingering food particles in your mouth.
Visit your dentist regularly
Regular trips to the dentist significantly improve your oral hygiene because you will get your teeth cleaned with a strong solution of fluoride, which helps to prevent cavities. Your dentist will also provide you with tips on how to clean your mouth properly and can spot signs of other health problems like oral cancer, allowing you to get treatment early and improving your chance of survival.
Avoid tobacco products
Cigarettes and other tobacco products are bad for your health, and they also put you at risk of gum disease and oral cancer. If you are a smoker, you have to give up the habit to decrease your chances of getting oral cancer or gum disease.
If you are unable to quit on your own, there are plenty of products available over the counter or by prescription to help you stop smoking.
Change your diet
Eating sugary and starchy foods is bad for your oral health because the bacteria in your mouth feed off the sugars, leading to the formation of plaque on your teeth. If the plaque is not removed, it will harden and become tartar, which leads to gingivitis and more serious gum disease.
If you must have sugary foods, eat them in moderation and make sure you brush your teeth shortly after eating to remove the bacteria in your mouth and prevent plaque and tartar buildup.
If you drink sodas and sugary drinks, use a straw to drink the beverage so your teeth do not get exposed to the sugar in the drink.
The bottom line
Practicing good oral hygiene improves your oral health and helps you avoid major dental problems in the future. If you want to learn more ways to practice good oral health, ask your dentist for tips on how to properly take care of your mouth.
