Orthodontics

Upper front teeth normally cover 2-3mm of the lower front teeth at the vertical level. A deep bite is defined as an excessive vertical overlap of the upper front teeth over the lower front teeth. Deep bites have negative impact on the jaw function, causing excessive tooth wear, biting of the gums on the roof of the mouth (palatal impingement) and affect negatively facial aesthetics. It is considered a traumatic occlusion and the problem becomes more severe with time, often requiring a multi-disciplinary treatment approach to orthodontically correct the deep bite and restore the worn dentition.

Negative overjet occurs when the lower front teeth extend beyond the upper front teeth horizontally. The lower jaw and chin are usually dominant creating a compromising profile. This is often due to skeletal discrepancy and is generally hereditary. It leads to speech and chewing difficulties and is often corrected with orthopedic treatment at early age (face-mask). In some cases, a second phase treatment is necessary when all the permanent teeth have erupted. In older patients depending on the severity of the problem it can be corrected with braces, and sometimes may require orthognathic surgery.

Crowding occurs when there is too little space for the teeth, which results in rotated or overlapping teeth. Crowding is generally hereditary but can also be the result of poor oral habits such as clenching, grinding, nail biting, or thumb sucking. In some cases, it is a result of early loss of a deciduous tooth, leading to drifting of the permanent teeth. It is very difficult to maintain good oral hygiene with crowded teeth, often leading to decay and gum disease. Crowding often compromises a person’s appearance. Braces can effectively straighten crowded teeth providing a nice smile and healthy bright teeth at any age.

Ideally, teeth have contacts with each other and have no spaces in between them. Spacing is observed when teeth have gaps between them and is exactly the opposite problem to crowding. Spacing occurs when there is a mismatch between the size of the teeth and the size of the jaw. Teeth that don’t have contact points, are susceptible to drifting causing occlusal problems. Spacing also results in food entrapment between teeth and compromises a person’s smile. Excess spacing is easily corrected with braces by closing the spaces between the teeth creating a nice smile and good occlusion.

A crossbite occurs when the upper arch is narrow and the upper teeth bite inside the lower teeth. Cross-bite can be found in one side (unilateral) or in both sides (bilateral). If not corrected in early age, it can cause uneven jaw growth and an unbalanced facial appearance with chin asymmetry. Maxillary expander and braces are used to successfully correct crossbites. Depending on the severity of the case, the age of the child and the level of cooperation, fixed or removable expanding appliances can be used. Maxillary expansion is more efficient when it’s performed under the age of 14-16 years old while the patient is still growing. The result is a nice broad smile and normal function.

Impacted teeth occur when the permanent teeth are developing in the wrong direction and usually never erupt in the mouth without intervention. The maxillary canine are the second most common teeth to become impacted after the wisdom teeth. The cause can be inadequate arch length and lack of space. If left untreated, it can lead to root resorption of the adjacent teeth. In some cases, a CBCT is required for diagnostic reasons and your orthodontist will advise you accordingly. Impacted teeth need to be surgically exposed by an Oral Surgeon and then orthodontically arranged into the mouth with braces. In severe cases the duration of the treatment may be extended.

Tooth agenesis is one of the most common hereditary anomalies of the human dentition, where one or more teeth are developmentally missing. Adjacent teeth may shift into the spaces left by the missing teeth causing possible occlusion problems. Missing teeth due to agenesis can be treated with several options. One way is to orthodontically close the spaces of the missing teeth. The alternative option is to create the space and conditions needed to replace the missing tooth/teeth by dental implants. In cases of several agenesis a combination of these treatment options can be the optimal approach.

In some cases when teeth are missing, the opposing tooth over-erupts into the space of the missing tooth, causing trauma of the gums and difficulties in chewing due to interferences. It is considered challenging to correct this kind of problems without the use of traditional braces. To overcome this limitation, Dr Economou treats each patient with segmented technique, usually with the use of mini-screws and custom-made orthodontic devices. The over-erupted tooth can be corrected with this orthodontic approach, avoiding the unnecessary use of full mouth braces. After the tooth’s position is corrected the dentist can then replace the opposing missing tooth by an implant or bridge.