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Most people think braces are all about their teeth. While it is true orthodontics is meant to move your teeth into proper position, there's more to it than that. To safely move your teeth with braces, you're going to need healthy and stable gums (or periodontium—the tissues that support your teeth).

For this reason it's critical to have your periodontal health evaluated prior to getting braces. This applies particularly to adults, since a 2013 study by the Center For Disease Control found that an estimated 47.2% of adults 30 years of age and older had periodontitis (gum disease). If you do have periodontitis, moving your teeth with braces will only make things worse.

Conversely, there is also risk for periodontal disease if you don't get orthodontic treatment. Malocclusion, as well as crooked and spaced teeth, can all contribute to periodontal disease. In these situations your teeth and gums are more difficult to clean and become breeding grounds for disease causing bacteria. Bad oral hygiene combined with these traits can greatly contribute to the development of periodontitis.

So, periodontics and braces have a tricky relationship. On one hand, you shouldn't get braces if you show signs of developing or have periodontitis, while on the other hand, braces can help prevent the possibility of developing periodontitis by correcting the bite and straightening the teeth.

If you are 30 years of age or older and are considering getting braces, it would be wise to first:

• Let Dr. Douglas and Larry Harte know about your desire to get braces
• Get an exam to make sure you're in good periodontal health and a good candidate for braces
• If you are a good candidate, keep an eye on your teeth and gums and get regular dental checkups throughout your entire course of treatment.

If you are in any doubt about the status of your teeth and gums, it's always best to get them checked before embarking with braces treatment. For more information or to have your periodontal health assessed for braces treatment, please contact our Sparta or Livingston, NJ office.

The term malocclusion refers to misalignment of teeth. You may have been born with malocclusion, so your teeth simply grew in crooked, or the misalignment and crowding of your teeth occurred over a period of time. Either way, not only can malocclusion pose cosmetic issues, but it can have a negative effect on your speaking and eating abilities as well.

Types of Malocclusion

Malocclusion encompasses multiple types and classifications of misalignment issues, including twisting or rotation of the teeth and molars that do not meet when you bite down. In some cases, the top front teeth are pushed outward in an upper protrusion.

In other cases, a misplaced midline results when the front top teeth don’t meet with the front bottom teeth. Transposition occurs when teeth protrude through the gums in a position where another tooth is supposed to be.

Practically any type of crowding or spacing issues, rotation or twisting of the teeth, or bite problem – including overbite, underbite, open bite, or crossbite – is included under the umbrella of malocclusion.

Malocclusion Classifications

There are three classifications of bite or misalignment problem.

• Class 1 malocclusion: While the bite may be normal, the upper teeth overlap the lower teeth slightly. This is the most common type.

• Class 2 malocclusion: Known as overbite or retrognathism, class 2 involves a severe overlap of the upper teeth and jaw over the bottom teeth and jaw.

• Class 3 malocclusion: Known as underbite or prognathism, class 3 occurs when the lower teeth and jaw overlap the upper teeth and jaw. Thus, the lower jaw juts forward.

Causes of Malocclusion

The most common cause of malocclusion is genetics. However, there may be other causes, including the development of abnormally-shaped teeth, lost teeth, or impacted teeth; thumb sucking or overuse of a pacifier as a small child; having fillings or crowns that do not fit correctly; a serious injury that causes misalignment of the jaw; or developing a tumor of the mouth or jaw.

Treating Malocclusion

Orthodontic care at Harte Orthodontics with Dr. Douglas and Larry Harte is the main treatment available for malocclusion, which includes getting braces, Invisalign, or other corrective treatments. Treatment is ideal not just to have your smile improved, but because it makes the teeth easier to clean and maintain, lowers the risk of gum disease and tooth decay, and can even take pressure off the jaw and teeth.

Think about orthodontic treatment if you (or your child) display any signs of malocclusion. Early treatment of malocclusion during childhood can lessen expensive treatment later on.

The average age of individuals who get braces is between nine and 14, although it is appropriate for younger children to visit Harte Orthodontics for a consultation with Dr. Douglas and Larry Harte. While parents may be concerned about the efficacy of early orthodontics, research suggests that early intervention can prevent greater dental health problems later in life.

What types of conditions require early intervention?

According to the American Association of Orthodontists, 3.7 million children under the age of 17 receive orthodontic treatment each year. Early intervention may be appropriate for younger children with crooked teeth, jaw misalignment, and other common issues. Early orthodontic treatment may be of use for several types of problems:

• Class I malocclusion. This condition is very common. It features crooked teeth or those that protrude at abnormal angles. In general, early treatment for Class I malocclusion occurs in two phases, each two years long.
• Class III malocclusion. Known as an underbite, in which the lower jaw is too big or the upper jaw too small, Class III malocclusion requires early intervention. Because treatment involves changing growth patterns, starting as early as age seven is a smart choice for this dental problem.
• Crossbite. Crossbite occurs when the upper and lower jaws are not properly aligned. An orthodontic device called a palatal expander widens the upper jaw, allowing teeth to align properly. Research suggests that early treatment may be beneficial in crossbite cases, especially when the jaw must shift laterally to correct the problem.
• Tooth extraction. That mouthful of crooked baby teeth can cause problems when your child’s permanent teeth erupt. For kids with especially full mouths, extracting baby teeth and even permanent premolars can help adult teeth grow in straight.

Considerations when thinking about early intervention

Early intervention isn’t helpful for all conditions. For example, research suggests that there is little benefit to early orthodontics for Class II malocclusion (commonly known as an overbite). Instead, your child should wait until adolescence to begin treatment. Scheduling a visit to our Sparta or Livingston, NJ office when your child is around age seven is a smart way to create an individualized treatment plan that addresses unique orthodontic needs.

Invisalign, which we happily provide at Harte Orthodontics, is a great alternative to traditional orthodontic treatment if you've been apprehensive about the thought of metal braces. During your initial visit, the first thing we do is take an impression of your teeth as they are now and digitize it. Using special software, we look at the current positioning of your teeth and compare it to the way your teeth should look.

Invisalign treatment, which consists of a series of aligners that you switch out approximately every couple of weeks, can help patients with crowded teeth, crossbites, overbites, underbites and more. Invisalign gradually shifts your teeth into place, creating the dazzling smile you’ve always wanted. During treatment with Dr. Douglas and Larry Harte, patients wear the aligners all day and night, except for during meals and when they’re brushing and flossing; cleaning your teeth and eating are a snap since you can easily remove your aligners! And because they’re clear, no one will know that your teeth are steadily straightening!

To find out if you are the right candidate for Invisalign treatment, we invite you to give us a call at our convenient Sparta or Livingston, NJ office and schedule a consultation.