Common Malocclusions

March 23rd, 2022

When we think orthodontics, we commonly think teeth. Naturally! Straight teeth and a beaming smile are everyone’s orthodontic goal. But orthodontics is a field which specializes in more than misaligned teeth. While your beautifully aligned teeth are the visible outcome of your orthodontic work, a properly aligned bite is the foundation for your healthy smile.

A malocclusion occurs when the teeth and jaws aren’t properly aligned—they don’t fit together the way they should when the mouth is closed. A malocclusion, or bad bite, affects many people to some degree, but not always in exactly the same way. Some of the different types of malocclusion include:

  • Crossbite

A crossbite occurs when upper teeth fit inside lower teeth. An anterior crossbite refers to the front teeth, with one or more upper front teeth, or incisors, fitting behind lower front teeth. A posterior crossbite affects the back teeth, with upper teeth fitting inside the lower teeth on one or both sides of the jaw.

  • Crowding

When the jaw is small and/or the teeth are large, lack of space can result in crowded, twisted, or crooked teeth.

  • Open bite

An anterior open bite means that the front teeth don’t close when biting down, leaving an open space between the upper and lower teeth. A posterior open bite occurs when the back teeth don’t make contact when the front teeth close.

  • Overbite

Our upper front teeth naturally overlap the lower ones a small bit when the teeth are closed. An overbite occurs when the upper teeth significantly overlap the lower teeth.

  • Overjet

When the upper front teeth protrude too far forward over the bottom teeth, it’s called an overjet, or, sometimes, buck teeth. Where an overbite causes a vertical overlap, an overjet takes into account the horizontal relationship of the teeth.

  • Spacing

A jaw that is large, teeth that are small, missing teeth—these conditions can lead to gaps between the teeth.

  • Underbite

An underbite results when the lower teeth and jaw extend further forward than the upper teeth and jaw, causing the bottom teeth to overlap the top teeth.

If you have a malocclusion, what comes next? This depends.

Some malocclusions are so minor that no treatment is necessary. Some are the result of misaligned teeth. Some occur because the upper and lower jaws are growing at different rates. Some are a combination of teeth and jaw misalignments. Some are caused by genetics, while others are caused by injuries or habits like prolonged thumb sucking or tongue thrusting.

Because malocclusions are so varied, your treatment plan will be designed for your specific needs. Braces, aligners, appliances like the Herbst® appliance or the palatal expander, surgery for severe malocclusions—there is a larger variety of treatment options than ever before to help you achieve a healthy bite.

When teeth and jaws don’t fit together as they should, the consequences can be damaged teeth and enamel, problems with the temporomandibular joint, headaches and facial pain, and difficulty chewing, eating, and speaking.

The good news is that early intervention for children can help correct teeth and jaw problems before they become more serious, leading to easier orthodontic care in the teen years, and helping to avoid the possibility of surgery or extractions. This is why Dr. Joseph Brogan and our team recommend an orthodontic assessment at our Philadelphia, PA office for children around the age of seven.

If you’re an adult with concerns about your teeth or bite, there’s good news for you, too. Dr. Joseph Brogan can devise a treatment plan to improve your bite and your smile no matter what your age.

Of course, despite our title, there’s really no such thing as a “common malocclusion” when we’re talking about your dental health. Each person—and each smile—is unique. Dr. Joseph Brogan will diagnose your malocclusion and create a personalized plan carefully tailored to your exact needs, for an uncommonly attractive, confident, and healthy smile.

The Twin Block Appliance

March 16th, 2022

Orthodontic treatment involves a lot more than just straightening your teeth. For a healthy smile, your bite must be healthy as well! This means that the upper and lower jaws need to fit together properly and comfortably.

If your bite is out of alignment because of jaw misalignment, orthodontic treatment can help correct the shape and position of your jaws with devices called functional appliances. These appliances are most often used for young patients whose bones are still growing, and are designed to treat malocclusions, or bite problems.

Common malocclusions such as overbites and overjets can occur when the upper teeth protrude further than they should, or the lower jaw is positioned too far back, or both. The Twin Block appliance can be used in such cases to help move your lower jaw and teeth into alignment with your upper jaw.

Why “Twin”? Because the Twin Block appliance is two separate pieces, each made of wire and smooth acrylic. Both pieces are crafted to fit precisely over your upper and lower arches and can be adjusted as your treatment progresses. The top plate can also be adjusted, if necessary, to widen the upper palate.

Why “Block”? Acrylic blocks cover the biting surfaces of several of your upper and lower teeth. These blocks fit together like a 3D puzzle. When you bite down, the upper blocks interlock with the lower blocks, pushing the lower blocks forward just a bit before you can bite down completely. Over time, bit by bit (and bite by bite), the Twin Block appliance advances your lower jaw and teeth to create a balanced, comfortable bite.

For the quickest and best results, you should wear your Twin Block appliance as directed. It’s made to be worn comfortably while you sleep, eat, and otherwise go about your day. (It’s a good idea to check with our Philadelphia, PA orthodontic team to see about removing it when you’re active, especially for swimming and contact sports.) When it’s time to brush, the Twin Block appliance is removable. This means that you can clean your teeth and your appliance easily.

And, while it’s made to work hard for you, it’s not indestructible. Don’t expose your appliance to heat or hot water, as the plastic may warp. Use the cleaning methods we recommend. Finally, when your appliance is out of your mouth, keep it in its case! You don’t want your appliance to end up carefully wrapped in a napkin in the nearby recycling bin. Or, even worse, in your dog’s mouth instead of yours.

The Twin Block appliance might fit together like a puzzle, but there’s nothing puzzling about how to achieve your best and fastest results. Your success really depends on you. Follow Dr. Joseph Brogan and our team’s advice, wear your appliance as directed, and you’ll be on your way to a healthy, comfortable bite and an attractive, confident smile!

Overbite Overview

March 9th, 2022

An overbite is one of the most common malocclusions. If Dr. Joseph Brogan and our team have diagnosed you with an overbite, you probably have lots of questions. Let’s try to answer some of them!

Just what is an “overbite”?

A malocclusion is another way of saying that you have a problem with your bite, which is the way your jaws and teeth fit together when you bite down. In a healthy bite, the front top teeth project slightly beyond, and slightly overlap, the bottom teeth. A normal overlap is generally considered one or two millimeters.

An overbite is a Class II malocclusion, and means that the upper front teeth cover more of the lower teeth than they should. But that’s a very general definition, and we will diagnose and treat your own, very specific, bite and teeth alignment.

Because overbites aren’t all alike. They might be barely noticeable. Upper teeth might overlap lowers by an extra millimeter or two. In more severe overbites, the upper teeth might cover the lower teeth completely. The amount of overlap and the cause of the overbite will determine your treatment.

What causes an overbite?

Overbites can be dental, caused by tooth alignment, or skeletal, caused by bone development, or a combination of both. They are usually hereditary, so, most often, an overbite is something you’re born with.

The size and position of your jaws, the shape and position of your teeth, all affect your bite alignment. But early oral habits, such as prolonged and vigorous thumb-sucking or pacifier use can contribute to overbite development. Missing teeth and bruxism, or tooth grinding, can also affect the alignment of your bite.

How do we treat an overbite?

There are many types of treatment available. Dr. Joseph Brogan will recommend a treatment plan based on the type and severity of your overbite. Because some treatments are effective while bones are still growing, your age plays a part as well.

  • Braces and Aligners

If dental issues are the main reason for your overbite, braces or clear aligners can be very effective. Rubber bands are commonly used to help bring teeth and jaw into alignment.

  • Functional Appliances

If the overbite is caused by a problem with upper and lower jaw development, devices called functional appliances can be used to help guide the growth of the jawbones while a child’s bones are still forming.

For young patients, there are several appliances that can help correct an overbite. Some, like the Herbst appliance, work inside the mouth, while others, like headgear, are worn externally. Your orthodontist will recommend the most effective appliance for your needs.

  • Surgical treatment

In some cases, where the problem is skeletal rather than dental, surgical treatment might be necessary to reshape the jawbone itself. This is especially true for adults, whose bones have finished forming.

If we recommend surgery, oral and maxillofacial surgeons are experts in surgical procedures designed to create a healthy and symmetrical jaw alignment. Dr. Joseph Brogan will work with your surgeon to design a treatment plan, which will usually include braces or other appliances following surgery.

Why treat your overbite?

Sometimes, a very slight overbite won’t require treatment. A serious, moderate, or even mild overbite, though, can lead to many dental and medical problems, including:

  • Crooked, crowded teeth
  • Worn teeth and enamel
  • Problems speaking or chewing
  • Difficulty sleeping
  • Headaches, facial, and temporomandibular (jaw) joint pain

When you work with our Philadelphia, PA team to correct your overbite, you’ll not only prevent these unpleasant consequences, but you’ll achieve major benefits as well—a healthy, comfortable bite, and an attractive, confident smile. If you’d like more than an overbite overview, Dr. Joseph Brogan can provide the specific information and treatment plan you need to make that healthy bite and that confident smile a reality!  

Overbite or Overjet?

March 2nd, 2022

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!

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