Common Treatments
Open Bite
An open bite is one dental disorder that is more often than not caused by the patient himself. The basic issue is that the front teeth, both upper and lower are forced outwards to an extent that the teeth of the upper and the lower jaw do not touch each other, even when the mouth is closed. This has several effects. First, and most prominently, the patient's smile is adversely affected. Often this results in loss of self esteem. The patient could also develop a lisp which, though cute when he is a child, is not so attractive in later years
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Essentially, the problem is caused by any action by the patient which puts a strain on the alignment of the teeth, especially when the patient is young. Prominent culprits in this regard are thumb sucking, tongue thrusting and chewing on a pencil or some similar object. Prolonged and incorrect use of feeding bottles and pacifiers could also contribute to the development of the condition.
Yet another reason for this condition could be a temporomandibular joint disorder (TMJ) where the patient suffers from chronic pain in the jaw and uses his tongue to push the teeth apart so that his jaw can be in a more comfortable position. Quite often, if you consult a doctor for frequent headaches and sensitive teeth, she will check you out for an open bite and temporomandibular joint disorder as well.
While correcting this condition is relatively straightforward, the correction does not tend to be permanent. This is because straightening the teeth using braces enlarges the socket in the jaw. As soon as the restraint offered by the brace is removed, the tongue gets back to work and pushes the teeth to their original position. It is quite clear, then, that the problem is best corrected early. The best cure is to prevent the open bite from occurring in the first place. You can gently eliminate thumb sucking and reduce the dependence on the pacifier. If the treatment is delayed, the patient may end up with poor speech and an unattractive smile.
Overbite
This adult patient, age 25, required braces and jaw surgery to correct his severe overbite, with treatment taking two years. His problem could have been corrected without surgery if he had been treated before he was a teenager.
A condition where the front teeth overlap the lower teeth excessively is called an overbite. It is a common orthodontic condition. The problem often has its roots in the size of the jaws and poor care of children's teeth. Prolonged use of feeding bottles or pacifiers may also result in the upper teeth being pushed out.
Overbites typically result in improper functioning, and an unnatural appearance of the front teeth. They may also result in excessive wearing of the lower front teeth. Since the lower teeth "undercut" the upper ones, it may also cause damage to the upper gums and palate. This may lead to periodontal problems, i.e. problems with the supporting structures of the teeth. Of course, a deep overbite will also make the face look less attractive than it otherwise would look.
In the past, people often choose to live with an overbite unless it was especially deep, in which case corrective braces or even surgery would be required. However, with increasing use of clear braces and the Invisalign orthodontic process, this condition is now relatively easy to correct, and more people are electing to get their condition corrected than ever before.
Correction can be done at any age, though treatment is usually undertaken for children in the 10 – 14 age group. During this period, treatment is easier because the jaw is easier to manipulate than in adults. Based on the degree of the overbite, the orthodontist may recommend straightening, braces or surgery. If braces are to be used, the treatment may last for up to two and a half years. In most other cases, it will be less. It may also be worth checking to see if the treatment is included in your dental insurance. Often, if the need for surgery is for cosmetic reasons, it may not be covered.
Under Bite
Patient's underbite was causing her jaw joint discomfort and excessive wear patterns on her teeth. After about 30 months of treatment starting at age 32, she now finds smiling and chewing much easier.
In an under bite, the lower teeth grow or extend past the upper front teeth. While this is less frequent in comparison to the overbite, it is not a rare condition by any means. Medically the situation is described as a class III malocclusion. It is also called prognathism.
During infancy, the jaws and tooth structure are very susceptible to pressures and habits like thumb sucking, tongue thrusting and prolonged use of pacifiers and feeding bottles. This can lead to an under bite. Sometimes, an accident or a tumor may also cause severe damage to the jaw, which could cause this malocclusion. Or, the undergrowth of an upper jaw or overgrowth of the lower jaw can be the cause. It can also occur due to flared upper incisors, missing lower incisors or both occurring in some combination to a varying degree. Dentists usually recommend early correction of under bite conditions.
Dentists recommend that underbites be corrected early because they can cause poor functioning of the teeth, and can lead to digestive problems. The molars of a person suffering from this condition will not fit together correctly, often resulting in chewing difficulty. Incorrect seating of teeth will also result in uneven wear and will result in damage to teeth. In many cases, the upper teeth will interfere with the lower gums and could even damage them. A patient may also find that he has a greater tendency to bite his tongue. If the condition is severe, it may also aggravate jaw joint (TMJ) problems.
Treatment of an under bite is often more involved than overbites or other, simpler malocclusions. Often the orthodontist will need to modify the jaw growth or extract some teeth. In extreme case, there may be need for surgical intervention.
Overjet/Buck Teeth: Protruding front teeth
At age ten, patient had a big overjet with the top teeth protruding beyond the bottom. She had two phases of treatment. The first helped her jaws to grow more harmoniously and the second aligned her teeth and bite. At age 13, she was proudly displaying her new smile.
At some time or the other, we have all seen children with buck teeth being referred to as "mice" or "rabbits" by their friends. Many children suffer from a severe complex due to this problem. However, it need not be so. The problem is easily correctable, more so if it corrected early, since the jaw structure is malleable and the facial bones have not fused yet.
Essentially, what happens is that children force their front teeth out due to prolonged use of pacifiers or thumb sucking. Over time, the teeth protrude out giving the typical look of buck teeth. This condition is also called an open bite condition, especially if the deformation is large and separation occurs between individual teeth. At times, the condition is hereditary, but poor dental habits often make things worse.
Very often, if the open bite is prominent enough, the front teeth do not touch each other, even when the jaw is closed. This puts strain on the other teeth when biting or chewing. There may also be considerable chewing difficulty and digestion may well suffer. If the deformation is large, there may be strain on the jaws and during breathing. Patients having prominent buck teeth often need to resort to mouth breathing and may suffer considerably on this account.
The treatment is fairly straightforward and can be started at any time. Essentially it consists of using orthodontic braces to correct the alignment of the teeth. While a number of systems of braces exist, they all involve a combination of wires, brackets and bands which slowly force the teeth to move to their correct location.
While there is definitely some discomfort associated with the use of braces and the treatment takes time, the results are often a complete metamorphosis of the face. Modern orthodontics has made great advances in tooth and jaw restoration and can totally transform a person's looks as well as their function. It is a pity that many of us do not take advantage of the skills of orthodontists and, through the magic of braces, live more fulfilling lives.
Bruxism: Teeth Grinding
In the dental literature, bruxism has been defined as "the gritting, clenching and grinding of teeth, especially during sleep." The practical fact of the matter is that nearly every one bruxes at some time or the other during their life. What matters is the degree of the bruxing. If the teeth grinding is severe then it can result in sleep disorders and a host of associated dental problems, such as loosening of the teeth, fracture, and excessive wear.
With heavy bruxing, the teeth tend to wear out faster. In fact, the edges where upper and lower teeth meet may become quite raw and tender. Teeth will also tend to have an evenly aligned appearance because they have been filed down to a straight line.
This wearing out can result in the nerve endings becoming exposed, which can then cause the teeth to develop sensitivity to hot or cold. A patient will also find small fractures on the teeth and small pieces chipping off.
Stress has also been found to be a major factor with bruxing. Stressed out people tend to brux more. In fact, it has been stated that bruxing provides one of the earliest signs of increasing stress. Since stress can affect a person in many ways, it is worth it to heed this early sign and taking corrective action.
The condition of your bite also has much to do with bruxism. In general, if your bite is comfortable and relaxed, the tendency for teeth grinding is significantly reduced. Another indicator is the headache many people have upon waking up. This is caused by the unnatural tension in the muscles of the jaw. Patients often undergo bite therapy to correct this disorder.
A simple TMJ appliance to reduce the effect of heavy bruxing is a mouthguard (also known as a nightguard). This is an acrylic device that fits snugly between the rows of your teeth to reduce the effect of teeth grinding on each other. While a mouthguard is not a true solution to bruxing, it certainly ensures that your teeth do not get worn down as fast due to the heavy pressure. Most people adapt easily to the use of a mouthguard and enjoy much better sleep as a result.
In summary, the way to treat bruxism is through a three-pronged attack. Reduce stress in your life, correct your bite and ensure that there is no residual strain on your jaw when it is in the natural position and finally, use a mouth guard to minimize the damage.
Sleep Apnea
Sleep apnea is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep. Breathing pauses can last from a few seconds to minutes, and can occur 5-30 times an hour. Typically, normal breathing then starts again, sometimes with a loud snort or choking sound.
Sleep apnea is a chronic condition that disrupts your sleep. It causes you to move out of deep sleep and into light sleep when your breathing pattern changes. This results in poor sleep quality that makes you tired during the day.
The most common type of sleep apnea is obstructive sleep apnea. This most often means that the airway has collapsed or is blocked during sleep. When you try to breath, any air that squeezes past the blockage can cause loud snoring.
Common Symptoms
- Loud snoring followed by cessation of breathing
- Gasping and choking during sleep
- Excessive daytime sleepiness
- Drowsy driving
- Awakened not rested in the morning
- A sour taste in the mouth in the morning
- Morning headaches
Treatment Options
A convenient and inexpensive approach is an oral appliance provided by an orthodontist. Oral appliances are worn during sleep to prevent the collapse of the tongue and soft tissues in the back of the throat so that the airway stays open during sleep. They are worn much like an orthodontic appliance/retainer or sports mouth guard. The appliance will allow for adequate air intake, which allows for normal sleep for people who snore and have sleep apnea.
Oral appliances are custom fit for maximum comfort and ease, and have been shown to be highly effective in treating symptoms of sleep apnea, especially snoring and interrupted breathing.
There are many different types of sleep apnea dental devices, including the Herbst appliance, OSAP, Silent Nite, and Somnoguard AP Pro. The different devices account for variation in jaw size and shape, type and severity of apnea, and tolerance levels.
Depending on which appliance is used, they can last for years. Most appliances are constructed to withstand normal wear and tear, and we can repair or reinforce your appliance periodically to increase its functionality. Tooth grinding and other excess wear and tear can shorten the lifespan of your appliance.
Thumb Sucking
Thumb sucking is a common habit with small children. What starts as a cute habit has the potential to grow into a cause for major deformation of the jaw bones and of tooth structure. Not only does the child run the risk of developing buck teeth, he also faces a possibility of lisping and other speech disorders.
In this article, we take a look at the problems that prolonged thumb sucking can lead to and how to avoid or correct them.
How Does It Start
Sucking a thumb may start off as a replacement for the pacifier or the feeding bottle and slowly develop into a dependence, where the child uses its fingers, a thumb or other objects to calm themselves.
Over time, this tends to displace the teeth from their natural position and causes a number of disorders of the teeth.
A prominent problem associated with sucking thumbs is the development of buck teeth. In extreme cases this could even lead to an anterior open bite. In this condition, the misalignment of the teeth becomes so large that the front teeth of the lower and upper jaw do not touch even if the jaw is closed.
Under these conditions, the patient could experience problems in speaking for which he may need to undergo corrective surgery of the teeth and extensive speech therapy.
Yet another problem which is not genetic in nature but is caused by the patient himself is tongue thrusting. Often, out of habit, or due to a condition called tempromandibular joint disorder (TMJ), the patient uses his tongue to separate the teeth.
This eases the immediate problem but has an additional side effect wherein the alignment of the teeth is disturbed. The resultant effects are very similar to those associated with thumb sucking often occur.
Discouraging Thumb Sucking
What should parents do to stop thumb sucking? They can try to gently discourage the child and distract him from doing this by providing other activities that attract him. Often the problem is psychological and the child sucks his thumb for security or when he is confused.
If this is the case, we can often help matters by providing the security the child needs.
Tongue Thrust
Tongue thrust is a pattern in which the tongue protrudes through the front teeth during swallowing, speech, and while the tongue is at rest. Nearly all young children exhibit a swallowing pattern involving tongue protrusion, but by the age of six, most have switched to a normal swallowing pattern. People who tongue thrust do it naturally and are usually unaware of the behavior.
How Does It Happen?
There are many possible causes for tongue thrust, some of which are interrelated. One of the most likely causes is mouth breathing. People with large tonsils/adenoids, nasal obstructions, or allergies often have difficulty breathing easily and consistently through the nose. When the lips are parted to breathe, there is a gravitational pull downward on the tongue. As a result, the tongue shifts from the correct position on the upper hard palate to a lowered, more forward position.
There are various types of tongue thrust, depending on the location and direction of the tongue pressure exerted on the teeth. A diagnosis by a qualified professional will ultimately determine the plan for treatment.
Effects of Tongue Thrust
Persistent tongue thrust leads to dental malocclusions, such as shifting of teeth and a bad bite. Normal tooth alignment can be altered due to the constant pressure of the tongue against the teeth. Speech can also be affected. A person with abnormal swallowing patterns may suffer a lisp or have difficulty articulating some sounds.
Another potential consequence involves the muscles of the face. Because the muscles of the face, lips, and throat are not being used correctly, a dull or sluggish appearance and full, weak lips can develop.