Orthodontic Treatment Is Either Tooth Alignment, Or It Is Tooth Alignment And Bite Correction.
There is a distinct difference, not only in the goals of treatment, but in almost every aspect of practice. Tooth alignment is cosmetic only; bite correction brings health care into the picture.
Virtually all authorities on bite correction stress the critical relationship between teeth and jaw joints.
Attractive smiles are certainly important, but the smile probably won’t last without bite correction. Many long term problems of decline and degeneration in the chewing system can be avoided if the bite relationship is corrected during orthodontics.
We treat many patients (usually adults) who must have treatment a second time to correct the bite. Often these situations could have been avoided had the first orthodontic treatment provided more than tooth alignment.
Even if an attractive smile is your only desire, the bite correction orthodontist can design a treatment plan for you that will achieve the smile while providing post treatment retainers that help protect the long term health of your chewing system.
LOOK FOR A BITE CORRECTION ORTHODONTIST!
How a healthy chewing system functions:
Healthy Jaw Function
The chewing system consists of the teeth, the two temporormandibular joints (just in front of the ear), and the muscles. Here is an example of a healthy jaw joint. Ideally, the muscles position the ball of the temporomandibular joint all the way up into the front part of the socket. This is the healthiest and most stable joint position, and should be maintained when the jaws are closed and the teeth come together. There is a cartilage-like disc (red) that normally fits snugly on top of the ball. If this disc is displaced, it can lead to significant TMJ problems. A conflict in the functional relationship between the teeth and jaw joint can cause disc displacement.
The animation shows one example of how improperly positioned teeth can interfere with normal function.
As the jaw is closed and the teeth are brought together, the ball is distracted away from its healthy position by the last molar tooth. This, in turn, may cause forward displacement of the disc (green), and loss of joint stability. The resulting condition causes adverse changes in the joint, and often the entire chewing system.
Do you know anyone with a “clicking jaw”? A displaced disc is a common cause of clicking and locking jaws.
The teeth are dominant over the joints. The main goal of the brain is to chew food and nourish the body regardless of ill affects to components of the chewing system. So the nerves and muscles are profoundly programmed to direct the jaw to the best tooth fit, making it extremely difficult (often impossible) to identify any tooth-joint discrepancy by just looking in the mouth. Thus, certain instruments and precautions must be used to truly identify (diagnose) and treat the problem. If chewing system problems are not diagnosed and treated, over time they can cause many problems and injury to the components.
Thus the teeth “get in the way” of healthy jaw function, which can lead to breakdown of the system.
It is possible, indeed common, to have straight teeth and a beautiful smile without having a healthy functioning system.
FIRST VISIT:
A bite correction orthodontist will do a thorough examination of the chewing system (including the jaw joints). After the examination s/he may recommend diagnostic records. The records are part of the data needed for an individualized diagnosis and treatment plan. Usually, records will include the articulator mounted models, photographs, and x-rays (or digital images). Typically, x-rays include a cephalometic view (for study of the skeletal pattern and positions of the teeth in the jaws), along with dental, and often, joint x-rays.
A bite correction orthodontist will need to take the time to study the diagnostic data !! This is a very important step, and certainly in the best interests of the patient. It simply is not possible to do a complete, individualized, diagnosis and treatment plan at the chair during the first visit.
The popular “one-step initial visit” recommended by most orthodontic business consultants, where the examination, diagnosis, and placement of initial appliances all occurs at the first visit, can miss significant problems.
SECOND VISIT (THE CONSULTATION):
At this visit it is explained to the patient and/or parents what the orthodontist learned by taking the time to study the diagnostic data. What are the problems? What will be the goals of treatment? In some cases not all the ideal goals can be met. What are the treatment choices? What are the advantages and disadvantages of each? What are all the factors that might be involved with treatment? After the consultation you will have the necessary information to make the decision that is best for you.
TREATMENT:
In comprehensive treatment, a bite correction orthodontist will place braces on all of the teeth, including the upper and lower second molars. The second molars are the teeth furthest back in the jaw. Thus they are closest to the jaw joint and the powerful chewing muscles. These teeth have a profound affect on healthy function of the joints and muscles, and must be properly positioned if the bite is to be corrected. Thus the time to begin treatment for the growing patient becomes especially important. For example, if treatment is started too soon, the second molars will not have erupted during the course of treatment, making bite correction unlikely.
Detailing tooth positions and monitoring treatment are important to the bite correction orthodontist.
In our office, the clinical assistants do not direct patient treatment. Dr. Amar Ravjiani sees every patient at every visit, he makes all treatment decisions, and he does all critical procedures himself. For example- Dr. Amar Ravjiani always positions the braces on the teeth. In a practice shooting for functional excellence, the positioning of the bracket on the tooth is crucial, and cannot be delegated (sometimes it is done in the laboratory using an “indirect” process). In fact, it is nearly always necessary for Dr. Amar Ravjiani to remove and reposition brackets in the final, detailing stages of treatment.
A bite correction orthodontist is constantly monitoring the health and stability of the jaw joints.
A patient may develop TMJ pain, popping, or other symptoms of dysfunction before, during, or after orthodontic treatment. Dr. Amar Ravjiani knows how to handle these problems without having to send the patient out to another specialist.
POST TREATMENT: In our practice, nearly every patient has a post treatment consultation. Here all aspects of the treatment and results are reviewed with the patient/parent. How difficult was the problem? Did we accomplish all the goals of treatment? If not, why not, and what to do about it? Where do we go from here? What about wisdom teeth? What steps need to be taken to ensure that the patient has a healthy and attractive smile all their life? How long are retainers worn? Should restorative work by the dentist be started right away, or should we wait?
A GOOD WAY TO FIND A BITE CORRECTION ORTHODONTIST IS TO ASK IF HE OR SHE IS A CERTIFIED GRADUATE OF THE ROTH/WILLIAMS SCHOOL.