Crowding is a common orthodontic problem that compromises appearance, confidence and oral health. Difficulty cleaning crowded teeth can lead to gum disease (periodontal disease), resulting in gum recession, reduced bone support of the teeth and loss of teeth.
Protruded teeth (excessive overjet) are vulnerable to trauma and often associated with excessive gum display when smiling and talking. Speech is usually adversely affected and protrusion will also prevent the lips resting together, resulting in habitual mouth breathing, snoring and restless sleep.
Anterior Cross Bite
Normally the upper teeth bite closely against the outer surface of the corresponding lower teeth. Anterior cross bite is where the upper front teeth bite inside the lower front teeth which can result in worn teeth and gum recession if in close contact, or loss of chewing function, compromised appearance and speech problems if there is a gap with the lower front teeth forward of the upper teeth.
The side and back teeth (premolars and molars) can also be in cross bite affecting only one side, often associated with deviation of the lower jaw when biting together, or affecting both sides. These cross bites are usually due to a narrow upper jaw, sometimes associated with compromised nasal breathing, snoring and sleep apnoea.
An open bite is where some teeth don’t contact when unaffected teeth are biting together. Most open bite problems affect the front teeth and can be due to simple causes such as finger or thumb sucking habits, or more complex causes such as habitual mouth breathing due to nasal airway/allergy problems resulting in vertical (downward) lower jaw growth. Open bite affecting the side teeth can be due to abnormal tongue posture and function or ankylosed teeth (teeth fused to supporting bone).
A deep over bite is where there is too much overlap of the upper front teeth over the lower front teeth when biting together. A deep bite will cause excessive wear of the front teeth and can result in palatal impingement of the lower front teeth where they bite into the gum behind the upper front teeth. Deep bites can also result in jaw joint (TMJ) problems such as muscle pain, TMJ pain, headaches, clicking and locking.
Teeth are sometimes missing from birth (congenitally missing) or lost because of gum disease or decay. With orthodontic treatment we can either close space where teeth are missing, sometimes with the assistance of TADs (temporary implant anchorage), or alternatively, space can be co-ordinated for replacement teeth, usually involving dental implants.
Jaw Joint (TMJ) Problems
Treatment or management of TMJ dysfunction (clicking, locking, pain, headaches) can involve particular orthodontic protocols, sometimes in conjunction with splint therapy.
Cleft Palate Patients
We have extensive experience treating cleft palate patients including early orthodontic treatment prior to bone graft surgery.
Some bite discrepancies are due to an imbalance between upper and lower jaw development or position, particularly severe overjet, open bite and cross bite, that can’t be satisfactorily corrected by orthodontic treatment alone. For these more severe malocclusions we co-ordinate orthodontic treatment with orthognathic (jaw) surgery in conjunction with our Maxillo-Facial Surgery colleagues.