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Perhaps you are already planning for the years when your teenager will need orthodontic work. But hearing that your seven-year-old would benefit from orthodontic treatment? That might come as a complete surprise! It’s a recommendation with real benefits, though—early intervention can save children from tooth and bite problems now, and even simplify their future orthodontic care.

Treating young children for orthodontic problems is called “interceptive orthodontics.” When the permanent teeth start arriving, there might be problems with spacing, bite or protruding teeth. Often, treatment while the bones are still growing is the best way to prevent more serious problems later.

We recommend that your child have an orthodontic consultation with Dr. Joseph Brogan around the age of seven. This exam is especially important for children who may have been thumb suckers or used a pacifier after the age of three, or if you notice obvious teeth, speech or bite issues.

• Crowding and Spacing Issues

Teeth are arranged in two crescent shapes called arches. When the arch of your child’s mouth is small, the permanent teeth can become very crowded as they erupt. Formerly, teeth were removed to make more room. Now, early use of a palatal expander can enlarge the upper dental arch in order to help the permanent teeth come in without crowding. The need for future tooth extraction is reduced, and there is a better chance for correct spacing and alignment with early treatment.

On the other hand, when a child loses a tooth too soon, too much space left between baby teeth can also be a problem. The remaining teeth can shift, leaving the wrong place open for the adult tooth to come in. We might recommend a space maintainer so that there is no shifting of the teeth and there is room for the proper adult tooth to erupt in its proper spot.

• Malocclusions (Bite Problems)

Some malocclusions, like a crossbite, can be caused by problems with jaw and facial structure. Again, we might recommend a palatal expander to help the upper arch of the teeth to fit properly with the lower jaw. Problems with overbite, open bite and other bite issues can also be addressed at this age if necessary. Early care can discourage TMJ (temporomandibular joint) disorders, reduce speech problems, and improve facial symmetry. 

• Protruding Front Teeth

Teeth that protrude are much more likely to be damaged when playing or after a fall. Methods such as braces or appliances can reposition them and protect them from breaking or fracturing.

Many children will not need early intervention, and many can wait until they are older for orthodontic work. But if your young child has orthodontic problems that should be addressed, early intervention can do more than set the stage for successful orthodontics in the teen years. Talk to our Philadelphia, PA team about what we can do for your child. Interceptive orthodontics can protect teeth, guide jaw and speech development, modify harmful oral habits and help to adjust bite problems before they become serious—when it comes to your child’s dental health, the best solutions are early ones!

The words “overbite” and “overjet” certainly sound similar. Both conditions concern your front teeth. Both conditions fall under the same category of bite problems—Class II malocclusions, if you want to be technical. So it’s not surprising that they’re often used interchangeably. But while there are similarities, overbite and overjet are also distinctly different.

• Overbite/Overjet Geometry

In a healthy bite, the front top teeth project slightly beyond, and slightly overlap, the bottom teeth. The key word here is “slightly.” With a Class II malocclusion, the upper front teeth project further beyond the lower teeth than they should.

Of course, teeth and bites are as individual as we are, so there are variations in just how and just how much the overlap occurs. In diagnosing an overbite vs. an overjet, the difference comes down to a matter of vertical vs. horizontal.

An overbite, or deep bite, occurs when the top teeth vertically overlap the bottom teeth more than they should for a healthy bite. Generally, when a person’s top teeth cover more than a quarter of the bottom teeth when biting down, or more than two to three millimeters, that person is said to have an overbite.

An overjet, commonly known as protruding or buck teeth, is the result of a horizontal overlap that is broader than normal. This causes the top teeth to project outward toward the lips more than they do in a typical bite. An overjet is usually diagnosed when the horizontal distance between the top and bottom teeth exceeds two to three millimeters.

• Overbite/Overjet Causes

The causes for both an overbite and an overjet might be dental (caused by tooth alignment), or skeletal (caused by bone development), or a combination of both. These bite problems can run in families. They are also affected by the size and position of the jaws and the shape and position of the teeth.

Early oral habits, such as prolonged and vigorous thumb-sucking or pacifier use, can also contribute to the development of a Class II malocclusion, particularly an overjet. Consistent pressure from thump or pacifier pushes the teeth outward as they erupt, which encourages them to protrude. These oral habits can affect the shape of the palate and jaw, too.

• Overbite/Overjet Treatments

There are many types of treatment available to correct teeth and bite misalignments. Dr. Joseph Brogan will tailor your treatment to your specific malocclusion for the best orthodontic outcome.

If you have a mild malocclusion, and minor dental issues are the main cause of that malocclusion, either braces or clear aligners can be effective for an overjet or an overbite. Elastics (rubber bands) are often used as part of this treatment.

If the malocclusion is due to bite problems caused by uneven upper and lower jaw development, devices called functional appliances can be used with braces to help guide the growth of the jawbones while young patients’ bones are still forming. These include appliances that work inside the mouth to help the upper and lower jaws grow proportionally, and external appliances such as headgear.

In some cases, where the malocclusion is skeletal in nature as well as dental, surgical treatment might be necessary to reshape the jawbone itself. Orthodontic treatment is usually needed as well both before and after surgery.

• Overbite/Overjet Consequences

Over time, a deep overbite can cause damaged gum tissue, worn enamel, and fractured teeth. When teeth protrude because of an overjet, they can lead to self-consciousness and are more at risk for injury. Both malocclusions share dental and medical consequences, including concerns about facial and jaw appearance, problems speaking or chewing, headaches, and face and jaw pain.

Class II malocclusions aren’t all the same, and orthodontic patients aren’t all the same either. You may have a minor malocclusion or a significant one. You may have an overbite, or an overjet, or a combination of different bite and alignment concerns. Your malocclusion may not bother you at all, or it may cause pain, discomfort, or self-consciousness.

That’s why every overbite or overjet should be evaluated by an orthodontist. When you visit our Philadelphia, PA orthodontic office, Dr. Joseph Brogan will be able to diagnose the exact nature of your malocclusion, the reason for it, and your best individualized treatment plan. An overbite and an overjet are different malocclusions, but you and your orthodontist want the same outcome for each: a healthy, attractive, and confident smile!

Poor April. While other months celebrate romance, or giving thanks, or costumes and candy, April has—April Fool’s Day and a tax deadline. We might be forgiven for thinking these two dates seem more like warnings than celebrations.

So here’s a new topic for the April calendar: National Facial Protection Month! Take the opportunity this month to review your safety practices while you’re enjoying your favorite activities.

• Mouthguards

If you have a mouthguard for sports or athletic activities, wear it! In any activity or sport where humans come into contact with solid objects (including other humans) tooth injury is possible. A mouthguard will help protect you from dental injuries caused by falls, physical contact, or other accidents that might happen in your active life. And it’s not just your teeth—mouthguards protect your lips, tongue, and jaw as well.

You can buy mouthguards in stock sizes or shape-to-fit models, or you can have a guard made especially for you at our Philadelphia, PA office. Custom mouthguards fit perfectly and are designed to make breathing and speaking easy and comfortable. If you wear braces, a custom mouthguard can be designed to protect your smile and your appliance. Just talk to Dr. Joseph Brogan for suggestions!

After all the time and work you’ve put into your orthodontic care, don’t let a sports injury set you back. What else should you consider for your facial protection?

• Helmets

If there’s a helmet available for your sport, use it! Helmets are especially important for protecting athletes from brain injury and concussion, and they help protect the face and jaw as well.

• Face Guards

If you’ve experienced a puck speeding toward you, or a defensive tackle hurtling your way, or a fast ball coming in at 90 miles an hour, you know the importance of wearing a face guard. These guards can help protect your eyes, face, teeth, and jaws. Many sports now recommend using face guards—it’s worth checking to see if your sport is one of them.

• Eye Protection

And let’s not forget eye protection. Whether it’s safety glasses or a visor, protecting your eyes and the bones around them is extremely important. You can even get sports goggles or protective sports glasses with prescription lenses to keep you safe and seeing clearly.

So here are a few suggestions for your calendar this month:

• If you haven’t gotten a mouthguard yet, now’s the time. Tooth and mouth injuries occur in sports beyond hockey and football. If you play basketball, ski, skateboard, ride a bike—in fact, almost any sport where you can fall or make contact with a person or object—a mouthguard is a must.
• If you need to replace an ill-fitting or damaged helmet and face guard, do it before your next game. And do replace a bike helmet if you’ve been in a crash—most likely it won’t be as protective, even if damage isn’t visible.
• Talk to your eye doctor about protective eyewear if off-the-rack products don’t work for you.
• If you are a parent or caregiver, make sure your child athlete has the proper facial protection—and uses it.
• If you are a coach, make sure your athletes have the right protective gear—and wear it.
• It’s also a great time to commit to using your protective gear every single time you’re active.

But, wait—these reminders are helpful and important, but weren’t we promised something to celebrate this April? Good catch! The great news is, using facial protection for sports and athletic activities gives you rewards you can celebrate all year: fewer injuries, fewer visits to the emergency room, and a beautiful, healthy, intact smile. Suit up!

Time to brush! So, you make sure you gently brush the plaque off the outside surfaces of your teeth. You want to present a gleaming smile to the world, after all. And you make sure to brush the inside surfaces as well, because who wants to feel a fuzzy patch of plaque every time their tongue hits their teeth? And, naturally, you remember to clean the tops of your molars, because those crevices make them more cavity-prone than any other surface.

Done? Not quite!

You might be surprised to learn that no matter how well you’ve brushed all the visible surfaces of your teeth, you’ve left quite a bit of enamel untouched—the adjoining, or touching, surfaces of the teeth that sit next to each other.

You’ve probably noticed that your bristles can’t . . . quite . . . reach all the enamel between your teeth (especially between your molars!) when you’re brushing. This means that food particles and plaque have an easier time sticking around. And when the bacteria in plaque are left undisturbed, especially with a banquet of food particles available, they produce acids which gradually eat away at the enamel covering our teeth, creating a cavity.

Here’s where we work in some specific dental vocabulary. “Interproximal” means between the adjoining, or touching, surfaces of the teeth. And an interproximal cavity is a cavity that develops on one of those side surfaces of your teeth.

• Preventing Interproximal Cavities

Fortunately, prevention is about as basic as it can be—brushing and flossing effectively. Dentists recommend brushing for two minutes at least twice a day and flossing once each day. While most of us are good about keeping up with brushing, sometimes that daily flossing is more a goal than a reality.

But it’s flossing which really does the trick when it comes to interproximal cleaning. If you floss correctly, food particles and plaque are removed from between the teeth and around the gum line—places where bristles just can’t reach.

When you wear braces, though, flossing isn’t quite so basic. Getting that floss just where it needs to be in between brackets and wires and in between teeth can be a challenge!

The good news is there are many products designed just to make flossing easier while you’re in orthodontic treatment:

• Floss threaders are flexible hoops that help you thread floss behind your wires easily.
• Precut floss strands use a stiff tip at one end for threading floss through wires.
• Interproximal brushes are tiny, cone-shaped brushes which can fit between your teeth and braces for precise cleaning.
• Water flossers eliminate floss altogether, using a pulsing stream of water to clean between and around teeth and braces.

During your next visit to our Philadelphia, PA office, Dr. Joseph Brogan can give you tips on how to use any of these tools effectively for cleaner teeth and cleaner braces.

Preventing cavities on the exterior surfaces of your teeth is probably pretty much automatic by now, but don’t forget the potential for stealth decay! If we find signs of erosion on the sides of your teeth, or if your hygienist lets you know that you’ve got a lot of interproximal plaque buildup, work with your dental team to make sure “interproximal cavity” doesn’t become a working part of your dental vocabulary.