 Crossbite
Crossbite, which refers to a reversed bite relationship between the upper and lower teeth, can occur in the front and/or the sides of the mouth. One or more upper teeth bite on the inside of the lower teeth (instead of the other way around). This can occur with a single tooth or multiple teeth. Early correction of crossbite is recommended.
An uncorrected crossbite can result in the following:
premature wear of the teeth
gum disease, including bone loss
asymmetrical development of the jaws
dysfunctional chewing patterns, and thus, possibly, jaw joint problems
make your smile less attractive
How can a crossbite be orthodontically corrected?
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If there is a single tooth crossbite, it can be corrected with limited bracework or, possibly, with a removable appliance. With more than one tooth in crossbite, correction generally requires the use of an expander in conjunction with limited bracework.
Open bite
"Open bite" is a condition wherein there is insufficient vertical (up and down) overlap of the front teeth. It is generally a result of uneven growth of the jaws, but it can also be caused by extended mouth breathing (as, for instance, in patients with a nasal obstruction), extended oral habits such as tongue thrust or prolonged finger/thumb sucking (beyond the age of 5 years old). There is a strong genetic tendency with open bites, i.e., it can be a commonly "inherited" trait. Timing of treatment is critical to the overall success of the therapy.
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How can an open bite be corrected?
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First, it is very important to remove any harmful habits (such as finger or thumb sucking). We also like to make sure that there is no difficulty breathing through the nose. We have found, as an example, that there have been remarkable improvements in open bites when a deviated nasal septum has been corrected. Correction of other problems, such as enlarged adenoids, or enlarged turbinate bones in the nose, have also resulted in spontaneous improvements of open bites.
Open bites can be corrected through growth modification of the jaws using various orthodontic appliances, and braces themselves. We will also work with your dentist, on a technique known as "equilibration", to attempt to close less severe open bites. In more severe cases, especially in non-growing patients, orthodontics is sometimes combined with a surgical procedure that is performed by an oral surgeon.
Excessive Vertical Overbite ("deep bite")
Deep bite can be as little as the upper front teeth extending over the lower front teeth by 50% or so, or it can be as severe that the upper front teeth completely cover the lower front teeth. Often you cannot see the lower incisors. Deep bite is usually due to a disproportionate amount of eruption of front teeth, or-over development of the bone that supports the teeth. It commonly occurs in association with excessive horizontal overlap of the front teeth (see discussion, below).
Deep bite should be corrected because, left untreated, it can:
cause improper functioning of your front teeth
result in the lower front teeth biting into the gum tissue of the palate (roof of the mouth), thus leading to tissue problems.
unusual wear of the lower front teeth
contribute to jaw or jaw joint problems
make your smile less attractive
How can a deep bite be corrected?
Deep bite can be corrected through a differential movement of the front and the back teeth so that the teeth are aligned and the deep bite is corrected. This is generally accomplished with bracework, though a removable appliance, such as a Bionator, or a bite plane (a special type of retainer) is also used.
Excessive Horizontal Overbite (also know as "overjet")
Overjet is sometimes referred to as a "Class 2" malocclusion. Many people with overjet have been referred to as having "buck 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 or 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 of the teeth
make your smile less attractive
How can overjet be corrected?
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Overjet can be corrected through growth modification using braces, a combination of braces and elastics, or braces and headgear, or even a functional appliance (see discussion on functional appliances). We like to treat malocclusions involving overjet as early as possible, so as to eliminate, or reduce, the chance that extractions, or even jaw surgery, are necessary. In some cases, especially in non-growing patients, tooth extraction is required, or the patient desires to have a longer lower jaw, or larger chin. In these latter cases, jaw elongation surgery is employed in order to achieve the patient’s desired treatment result.
Underbite
An underbite is defined as when the lower front teeth protrude beyond the upper 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 lower incisors, missing upper teeth, or a combination of all the above. Early correction of underbite is recommended.
Asymmetry
Asymmetry refers to a malocclusion wherein the left side is not the same as the right side. Though the "rule" is that patients have a good similarity between the right and left sides, it is not uncommon to see noticeable differences. Many times, asymmetries are caused by an unequal growth of the jaws. Occasionally, however, a midline shift, or tipping of the "occlusal plane" can occur with missing teeth, or a crossbite.
How are asymmetries corrected?
Some asymmetries are amenable to treatment with braces only. Some require compensatory extractions. In cases with a skeletal component, bracework is commonly combined with a surgical procedure to correct the asymmetry. This is another reason that we want to see children by age 7. Many times, a simple interceptive procedure is sufficient to preclude a more severe asymmetry later in life.
Severely Impacted Canine
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