Crowded Teeth:

The most common orthodontic problem is teeth crowding. Severely crowded teeth can be resolved in one of three ways: 1. inter-proximal reduction (teeth slenderizing), 2. remove teeth, or 3. increase the size of the dental arches.

Each of these three methods for resolving crowded teeth have their advantages and disadvantages but the advantages of increasing the size of the dental arches far outweigh the advantages of the other two methods. The advantages for increasing the size of the dental arches include: retaining teeth, improving facial aesthetics, improving airway health, and improving TMJ health.

I encourage anyone who is contemplating orthodontic treatment to specifically ask the treating doctor three questions: 1. What effects will your proposed treatment have on my facial aesthetics; including my profile? 2. How will your proposed treatment affect my TMJ? And #3. How will your proposed treatment affect my airway? If the doctor cannot address these three critical questions in an intelligent, confident and easy-to-understand manner then you will be better served by consulting with a different doctor.

In our office, we will never move a tooth before we evaluate the effects that tooth movement will have on facial aesthetics, TMJ health and airway health. Tooth movement should enhance, not compromise, health and beauty.

We utilize advanced technology to properly diagnose and treat each individual case. There is never a cookie cutter approach to orthodontics in our office. By utilizing CBCT imaging technology, every orthodontic patient receives the necessary imaging to properly diagnose their individual case. We are able to evaluate the health of each patient’s TMJ and airway before any tooth movement occurs. We are then able to evaluate the improvement in TMJ and airway health as treatment progresses.

Class II Bite:

When the upper jaw is narrow the lower jaw is often unable to grow forward and is trapped in a retruded position. This is called a class II bite. The potentially adverse consequences of a class II bite are numerous, including:

• compromised facial aesthetics (nose looks long, weak chin, narrow underdeveloped face)
• excessive overjet (upper front teeth stick out in front of the lower front teeth–”buck teeth”)
• deep bite (upper front teeth cover too much of the lower front teeth).
• TMJD (Temporomandibular Joint Dysfunction)
• compromised airway leading to sleep breathing disorders

There are two ways to fix this problem: remove two upper bicuspids and retract the upper front teeth to eliminate the overjet, or bring the lower jaw forward. If bicuspids are extracted and upper front teeth are retracted then the only adverse consequence of a class II bite that is resolved is the excessive overjet. The likelihood of TMJD and sleep breathing disorders remain and the compromised facial aesthetics actually get worse. By retracting the upper front teeth the nose appears even larger, the upper lip becomes unsupported and therefore excessively small, and the smile becomes more narrow.

A far better approach to treating a class II bite is to bring the lower jaw forward. This can be done surgically or it can also be done using a comfortable, easy-to-wear removable appliance. In our office, we choose to treat class II bites with simple appliances. Two of the appliances that we commonly use are the Twin Block and the Herbst. Take a look at the before/after photos at the bottom of this page for an example of Dr. Brad treating a class II bite with an oral appliance and braces.

If you feel you may suffer from Crooked or Crowded Teeth, or a Class ll Bite, we invite you to give us a call (714-838-0760) for a consultation or second opinion to determine if you would be an eligible candidate for treatment.