Why are some orthodontic treatments done in two separate stages?

As mentioned above there a number of situations in which early treatment would be advantageous.  The one disadvantage of early treatment is that due to the fact that this treatment is often accomplished prior to the eruption of all of the permanent teeth we cannot align all of the teeth.  A second phase of treatment is most often necessary to complete the dental alignment and to fine tune the bite.  This is not to say that the treatment is being done over, or done twice.  There are a limited set of objectives that can be achieved in the first phase of treatment and a second set of objectives are then accomplished in the second phase of treatment.  As with any treatment the advantages and benefits of the treatment need to be weighed against the disadvantages.  A two stage approach is only considered if the advantages (such as improved final result, reduced risk for complications, or less necessary treatment at an older age) outweigh the disadvantage of the need for two separate phases of treatment.

The persistence of a thumb sucking habit may adversely affect the positions of the teeth and the bite.  This is usually dependent on the intensity of the habit and the number of hours during the day/night  that the habit is present.   A habit that is present only as a child is falling asleep may not cause shifting of the teeth whereas if the thumb habit is present day and night a significant alteration in the alignment of the teeth and jaws may occur.  Around age 6 the presence of a strong habit becomes a concern from a dental perspective since it is at that time that the upper front teeth are erupting and will be most influenced.  If a child is trying to eliminate the habit but cannot seem to do it on their own there are effective orthodontic appliances that will be of help.  Prior to the use of appliances simple home remedies may be attempted such as placing a band-aid on the finger or thumb or wearing a wooly glove.  If these measures are not successful and the child would like to stop his/her habit then orthodontic appliances should be considered.  It is generally accepted that intervention should not be considered if a child does not desire to eliminate the habit.  Such intervention will most likely be unsuccessful and possibly psychologically damaging to the child.  It is often not until a child reaches school age, often due to embarrassment,  that a child will become interested in eliminating the habit.

What causes bite problems such as overbite and underbite?

Orthodontic problems may be caused by  genetic or inheritance factors and/or  environmental factors such as finger habits, mouth breathing, tongue thrusting, jaw posturing, early loss of baby teeth, etc.  Generally a combination of these factors is involved.  

What causes the occurrence of extra or missing teeth?

This is a genetic problem.  Extra teeth may occur anywhere within the upper and lower jaws but the most common sites are in the front area of the upper jaw, in the bicuspid areas (middle of the jaw) and in the 3rd molar (wisdom tooth) area. Other than wisdom teeth the most commonly missing teeth are the upper lateral incisors (2nd tooth from the midline) and the lower second bicuspids (just in front of the 6year molars).  Undersized teeth are often a lesser expression of the same genetic problem. 

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Last modified: December 24, 2009