Types of Improper Bites
An improper bite doesn't look good. That is the usual reason that people seek treatment from an orthodontist. In addition, an improper bite causes difficulty in chewing. In people with crowded teeth, it can lead to more cavities or gum disease. Treatment of an irregular bite can improve your overall oral health and stabilize your bite.
Incorrect bites are grouped into categories. Common bite problems include:
Crossbite — Here, the upper teeth rest significantly inside or outside the lower teeth. A crossbite often can make it difficult to bite or chew. It also may cause the jaw to shift to one side as it grows.
Crowding — Permanent teeth may not have room to move into the right position:
- If there is not enough room for the teeth
- If the teeth are unusually large compared with the size of the dental arch
- If the jaw is narrower than it should be
Deep overbite — This occurs when the upper front teeth (incisors) overlap too far over the lower teeth. In some cases, the biting edges of the upper teeth touch the lower front gum tissue and the lower front teeth may bite into the roof of the mouth.
Underbite — A crossbite of the front teeth is commonly referred to as an underbite if the lower teeth are ahead of the upper teeth. This may also be a sign that the jaws are not in the correct position. Sometimes surgery is needed.
Open bite — If your upper and lower front teeth don't meet when you bite down, this is called an open bite. This may make it impossible to bite off food with the front teeth. It also can affect speech. Because the front teeth don't share equally in the biting force, the back teeth may receive too much pressure. This makes chewing less efficient. It can lead to premature wear of the back teeth.
Spacing problems — Some people have missing teeth or unusually small teeth in a normal sized jaw. This can result in large spaces between the teeth. People who have lost one or multiple teeth may have uneven spacing because adjacent teeth may drift into the unoccupied areas. Braces can be used to shift the position of these teeth so the missing tooth or teeth can be replaced.
Treatment: Braces and Retainers
Everyone has a slightly different bite, so treatment techniques vary. Braces are the most common approach. They help to move the teeth slowly by applying precise amounts of light pressure over a long period of time.
Most orthodontic treatments occur in two phases:
- The active phase — Braces or other appliances are used to move the teeth into proper alignment and correct the bite.
- The retention phase — A retainer is used to hold the teeth in their new positions for the long term.
- In addition to braces, orthodontists sometimes use special appliances (called functional appliances) to direct the growth of the jaw in young children. These appliances are rarely used in adults. That's because they are not effective after growth is complete.
Getting Braces
You can choose braces (brackets) made of metal, ceramic or plastic. However, orthodontic treatment is most often done using stainless steel brackets.
Ceramic or plastic brackets often are chosen for the sake of appearance. But plastic brackets may stain and discolor by the end of treatment. Bands made of plastic or ceramic also have more friction between the wire and brackets. This can increase treatment time. Your orthodontist will discuss the available options.
The cost of braces varies, but expect to pay between $2,000 and $6,000. The cost may depend on how severe the problem is. Some insurance plans may cover part of the cost. Others will not cover it at all.
Braces work by applying continuous pressure to move teeth in a specific direction. Braces are usually worn for about one to three years, depending on how severe your problem is. As treatment progresses, teeth change position. Your orthodontist will adjust the braces as needed.
A few decades ago, braces consisted of thick bands of steel wrapped around all of the teeth. These days, stronger bonding agents are available. Smaller braces can be used, and orthodontic bands rarely have to be used on front teeth.
When applying braces, the orthodontist will attach small brackets to your teeth with special dental bonding agents. He or she will then place wires called arch wires through the brackets. The arch wires usually are made of a variety of metal alloys. They act as tracks to create the "path of movement" that guides the teeth to their correct positions.
Wires made of clear or tooth-colored materials are less visible than stainless-steel wires. However, they are more expensive and may not work as well. Tiny elastic bands called ligatures also can be used to hold the arch wires to the brackets. Patients can choose from a multitude of colors at each visit.
Expect some minor discomfort for the first few days after getting braces. Your teeth may be sore. The wires, brackets and bands also may irritate your tongue, cheeks or lips. Your doctor will give you some special soft wax to cover any sharp areas on your braces that may be irritating you. Most of the discomfort disappears within a week or two. You also may have moderate discomfort when wires are changed or adjusted. Taking ibuprofen (Motrin, Advil) or other over-the-counter painkillers can help to ease any discomfort.
Wearing a Retainer
A retainer's purpose is to maintain tooth positions after treatment is completed and braces are removed. Once your bite has been corrected, bone and gums need more time to stabilize around the teeth.
The recommended length of time for wearing a retainer varies. Most children and teenagers wear retainers until their early to mid-20s or until their wisdom teeth come in or are removed. You should strictly follow your orthodontist's advice because he or she knows your treatment best.