Phase I treatment is oftentimes necessary for younger patients to establish the proper foundation for future dental and facial development as they become adolescents and the permanent dentition erupts. Narrow upper and lower jaws or situations where the back teeth are in a crossbite situation are typical situations where early-intervention or Phase I treatment may be necessary. By creating the necessary space and properly aligning the existing teeth we can guide permanent teeth into their proper position. The second phase of treatment takes place after the permanent teeth have erupted. In many cases, Phase I treatment can reduce the length of time required for the second phase.
Class II problems represent an abnormal bite relationship in which the upper jaw and teeth are located in front of the lower jaw and teeth. Class II patients usually exhibit a convex facial profile with a recessed chin. In most cases this relationship is due to inherent characteristics.
A skeletal Class II problem occurs when the upper back molars are forward of the lower back molars, giving the patient the appearance of either a recessed lower jaw or an upper jaw that is protrusive.
Class III problems are also primarily genetic in origin. In this instance the lower jaw and teeth are positioned in front of the upper jaw and teeth. Facially, the appearance may give the impression that the lower jaw is excessively large, but in many cases the lack of upper jaw development is at fault. There are several treatment options to correct a Class III problem.
Psuedo Class III
Pseudo Class III, particularly in younger patients, is a function of habit and not necessarily hereditary and thus not a true skeletal Class III. A misaligned bite may cause the lower teeth to bite forward of the upper teeth giving the appearance of a Class III.
Interceptive treatment is imperative to prevent abnormal growth of both the upper and lower jaws.
Deep Incisor Overbite
Also known as an overbite, a deep bite is excessive vertical overlapping of the front teeth and is generally found in association with a discrepancy between the length of the upper and lower jaws. It usually results in excessive eruption of the upper or lower incisors or both.
An openbite can occur with the front teeth, known as an anterior openbite or with the back teeth, referred to as a posterior openbite. An anterior openbite is the lack of vertical overlap of the front teeth and can usually be traced to jaw disharmony or habits such as thumb sucking or the thrusting of the tongue against the front teeth. A posterior openbite is a problem in which the back teeth do not meet vertically prohibiting the jaw to function properly.
Excessive Gingival Display
Also known as a gummy smile, this orthodontic problem gives the appearance of excessive exposed gums on the upper arch. There are several treatment options for this problem. In severe cases surgery may be necessary to actually remove a section of the upper jaw shifting the jaw upward vertically reducing the amount of exposure of the upper gum tissue.
Crowding of the teeth is probably the most common orthodontic problem. Although many factors contribute to dental crowding, this problem typically stems from a discrepancy between space in each jaw and the size of the tooth.
Oftentimes crowding can be just one of several orthodontics problems. Crowding can be the cause of, or the result of other problems such as impacted teeth, retained teeth, or teeth that do no naturally fall out. Cross bite of the front or rear teeth can also cause the teeth to become crowded.
Spaces between teeth are another common problem associated with the need for orthodontic care. Like crowding, spacing may be related to a tooth-to-jaw size disharmony. Spacing may occur between the front and the back teeth. Tooth size discrepancies, such as smaller teeth or abnormally shaped teeth can also create abnormal spaces between the teeth.
A posterior crossbite will usually result from a narrow upper jaw or abnormally wide lower jaw. A narrow upper jaw will often force a patient to move their lower jaw forward or to the side when closing into a stable bite. When closed into this accommodating position, the lower teeth are located outside the upper teeth.
A posterior crossbite can involve one side of the jaw, known as a unilateral crossbite, or both sides of the jaw, known as a bilateral crossbite.