Dental disorders we work with
Class I Malocclusion
Class II Malocclusion
Class III Malocclusion
Crowding / Crooked Teeth
Crowding may also occur due to environmental factors such as premature loss of deciduous (baby) teeth either from decay, extraction or sometimes, early natural loss. This allows the permanent teeth in the back part of the mouth to crowd forward resulting in a lack of space for other permanent teeth. Just as there is early loss of deciduous teeth, prolonged retention of the primary teeth can deflect the permanent teeth from their normal eruption path, resulting in crowding.
This may affect either the front or the back teeth.
In the growing child these crossbites may affect the growth pattern of either jaw and may cause a permanent skeletal change.
The cause of crossbites may result from a number of factors:
hereditary factors or individual growth patterns; environmental factors such as the early loss or prolonged retention of deciduous (baby) teeth, thumb sucking or trauma may result in these functional bite disturbances.
Sometimes, however, the permanent teeth loose their normal path of eruption into the mouth and track off in an abnormal direction, where they fail to erupt. These are termed “impacted”. The end result is a failure of the baby tooth to be lost and the permanent successor remains under the gum. The unerupted (impacted) tooth then has the potential to dissolve the roots of the tooth it comes in contact with and not uncommonly this is an adjacent permanent tooth, with drastic results.
Impacted teeth can be a genetic trait with the incidence more common in females than males 2:1 and are closely associated with missing or very small lateral incisor teeth (the second upper front tooth).
The most common impacted tooth is the upper ‘eye’ or cuspid tooth.
Various factors can result in a midline shift such as the premature loss of baby teeth, retained baby teeth, crowding and missing teeth.
In cases of missing anterior (front) teeth, symmetry plays an important role in whether it is best to have a missing tooth/teeth replaced or the space of the missing tooth closed.
Missing teeth may result from hereditary causes (quite common) or environmental factors such as decay, accidents where teeth may have been knocked out, or the failure of teeth to erupt and become “impacted”.
An unusual overbite may result from a variety of factors: hereditary factors or individual growth pattern; environmental influences such as thumb sucking, mouth breathing, premature loss of deciduous (baby) teeth or lack of contact between the upper and lower front teeth may affect the amount of overbite present.
The increase in overjet may result from a number of factors: hereditary factors or the individual growth pattern; environmental factors such as thumb sucking; or lower lip sucking, and trauma to either the teeth or jaws may affect the amount of overjet present.
This space between the upper and lower front teeth may be as a result of the top teeth (jaw) being too far forward, or the lower teeth (jaw) being too far back (retrusive), or a combination of both.
A diastema is often found in association with a fibrous band of tissue call a frenum. The frenum attaches itself from the inner surface of the lip, cheek or tongue, to the lingual (inside) surface of the mouth. In some cases this fibrous band is quite thick and contributes to the spacing of the teeth. A fraenectomy (removal of frenum tissue) can be performed to remove this fibrous band sometimes resulting in the closure of diastema. The use of orthodontic appliances may also be required.
Supernumerary (extra) Tooth
Commonly found in the anterior (front) section of either the upper or lower jaws.
The excessive spacing may result from a number of factors.
Normal sized teeth in large jaws or small teeth in normal sized jaws may cause excessive spacing. If there are missing teeth, excessive spacing is also likely.
It is believed to be a genetic trait and very little is known why lateral incisors develop in this unusual shape and why it is mainly lateral incisor teeth which are affected. Peg laterals can be modified by the dentist making the peg tooth/teeth more realistic to the normal dimensions.
Rotated teeth (rotations)
Apart from being unsightly they may create gum problems, as food will trap into the unusual areas/spaces created between the teeth.
Incorrect angulations may be caused by lack of space for the tooth to erupt or it may mean that something in the jaw is causing the tooth to tilt. Some examples of this would be a retained baby tooth, an extra tooth or a cyst.
Submerged primary teeth
This can become severe enough for the baby teeth to eventually be covered by gum tissue. If this occurs, the adjacent permanent teeth may tilt over the submerged baby tooth/teeth and create localized crowding.
An openbite refers to a vertical open space when the upper teeth do not overlap the lower teeth at all. Ideally the upper front teeth should overlap the lower teeth by 1.5 – 2 mm.
Openbites may result from environmental factors such as thumb/finger sucking, tongue thrust swallowing, mouth breathing and pacifiers.
Retruded lower jaw
Correction of this problem can involve a growth modifying appliance which promotes growth in the lower jaw allowing it to “catch up” with the upper jaw.
In a non-growing patient, correction often involves jaw surgery.
Prominent lower jaw
Correction of this problem can involve a growth modifying appliance which slows down or holds the growth in the lower jaw allowing it to “catch up” with the upper jaw. In a non-growing patient, correction often involves jaw surgery.