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Overbite or Overjet?

May 24th, 2023

The words “overbite” and “overjet” certainly sound similar. Both conditions concern your front teeth. Both conditions fall under the same category of bite problems—Class II malocclusions, if you want to be technical. So it’s not surprising that they’re often used interchangeably. But while there are similarities, overbite and overjet are also distinctly different.

  • Overbite/Overjet Geometry

In a healthy bite, the front top teeth project slightly beyond, and slightly overlap, the bottom teeth. The key word here is “slightly.” With a Class II malocclusion, the upper front teeth project further beyond the lower teeth than they should.

Of course, teeth and bites are as individual as we are, so there are variations in just how and just how much the overlap occurs. In diagnosing an overbite vs. an overjet, the difference comes down to a matter of vertical vs. horizontal.

An overbite, or deep bite, occurs when the top teeth vertically overlap the bottom teeth more than they should for a healthy bite. Generally, when a person’s top teeth cover more than a quarter of the bottom teeth when biting down, or more than two to three millimeters, that person is said to have an overbite.

An overjet, commonly known as protruding or buck teeth, is the result of a horizontal overlap that is broader than normal. This causes the top teeth to project outward toward the lips more than they do in a typical bite. An overjet is usually diagnosed when the horizontal distance between the top and bottom teeth exceeds two to three millimeters.

  • Overbite/Overjet Causes

The causes for both an overbite and an overjet might be dental (caused by tooth alignment), or skeletal (caused by bone development), or a combination of both. These bite problems can run in families. They are also affected by the size and position of the jaws and the shape and position of the teeth.

Early oral habits, such as prolonged and vigorous thumb-sucking or pacifier use, can also contribute to the development of a Class II malocclusion, particularly an overjet. Consistent pressure from thump or pacifier pushes the teeth outward as they erupt, which encourages them to protrude. These oral habits can affect the shape of the palate and jaw, too.

  • Overbite/Overjet Treatments

There are many types of treatment available to correct teeth and bite misalignments. Dr. Kevin Mancini will tailor your treatment to your specific malocclusion for the best orthodontic outcome.

If you have a mild malocclusion, and minor dental issues are the main cause of that malocclusion, either braces or clear aligners can be effective for an overjet or an overbite. Elastics (rubber bands) are often used as part of this treatment.

If the malocclusion is due to bite problems caused by uneven upper and lower jaw development, devices called functional appliances can be used with braces to help guide the growth of the jawbones while young patients’ bones are still forming. These include appliances that work inside the mouth to help the upper and lower jaws grow proportionally, and external appliances such as headgear.

In some cases, where the malocclusion is skeletal in nature as well as dental, surgical treatment might be necessary to reshape the jawbone itself. Orthodontic treatment is usually needed as well both before and after surgery.

  • Overbite/Overjet Consequences

Over time, a deep overbite can cause damaged gum tissue, worn enamel, and fractured teeth. When teeth protrude because of an overjet, they can lead to self-consciousness and are more at risk for injury. Both malocclusions share dental and medical consequences, including concerns about facial and jaw appearance, problems speaking or chewing, headaches, and face and jaw pain.

Class II malocclusions aren’t all the same, and orthodontic patients aren’t all the same either. You may have a minor malocclusion or a significant one. You may have an overbite, or an overjet, or a combination of different bite and alignment concerns. Your malocclusion may not bother you at all, or it may cause pain, discomfort, or self-consciousness.

That’s why every overbite or overjet should be evaluated by an orthodontist. When you visit our Hampstead, NC and Jacksonville, NC orthodontic office, Dr. Kevin Mancini will be able to diagnose the exact nature of your malocclusion, the reason for it, and your best individualized treatment plan. An overbite and an overjet are different malocclusions, but you and your orthodontist want the same outcome for each: a healthy, attractive, and confident smile!

Three Reasons We're Fans of Fluoride

May 17th, 2023

Why all the fuss about fluoride? Your dentist recommends it, your toothpaste is formulated with it, most of our drinking water contains it. Just what is it about this mineral that makes dental professionals sing its praises? Read on for three good reasons why fluoride is a healthy choice for healthier teeth.

  1. Fluoride Works!

Fluoride is an attractive option for protecting your teeth—and we mean that literally. Fluoride protects the surface of your teeth by working on a molecular level to attract minerals which strengthen enamel and help prevent cavities.

Our tooth enamel is mostly made from calcium and phosphate ions. These elements combine to form hydroxyapatite, strong crystals which make up about 95% of our enamel. Hydroxyapatite is so strong, in fact, that tooth enamel is the hardest part of our bodies. What can go wrong?

Acids. Acids created by the bacteria in plaque and the acids in our diet strip away the calcium and phosphate ions in enamel, weakening the surface of the tooth. This process is called demineralization. Over time, weak spots become bigger as acids eat through enamel to the inner tooth, causing decay and cavities.

So, what can fluoride do?

First, fluoride helps remineralize tooth enamel. Fluoride is attracted to the tooth’s surface and bonds with its minerals. It also attracts the calcium and phosphate ions that are found in our saliva to restore any minerals that have been lost. This process helps repair any weak spots that might have begun to form.

But fluoride does more than restore and repair tooth strength—it improves it! Fluoride ions join with calcium and phosphate to form fluorapatite crystals, which are larger and stronger than hydroxyapatite crystals. Even better? These new crystals are more resistant to acids.

  1. Fluoride Is Doubly Effective

Fluoride works both externally and internally. We just looked at how fluoride helps keep teeth strong when applied to the outside of the teeth. This is called a topical application. Systemic benefits come the fluoride we consume in our diets.

Fluoride isn’t found in many foods, but it is found naturally in lakes, rivers, and other water sources. When the local water’s fluoride level is low, many communities add fluoride for its proven ability to prevent cavities. Water fluoridation is safe, has been studied for decades, and has been shown to reduce the risk of cavities by 25% or more for both children and adults.

Systemic fluoride was important when you were younger and still had your baby teeth. This is because fluoride joined with minerals in your adult teeth while they were growing and developing, creating stronger, more cavity-resistant teeth even before they erupted.

And now that your permanent teeth are here, you’re still in luck! When you drink fluoridated water, you’re increasing the amount of fluoride in your saliva. Just like fluoride toothpaste, saliva bathes your teeth with fluoride ions, remineralizing and strengthening the tooth surface and helping repair weak spots in your enamel.

  1. It’s Easy to Get Fluoride Protection

Because so much of our drinking water is fluoridated, most of us really don’t have to think about how to get the recommended amount of fluoride in our diet each day. If your community’s water is low in fluoride, Dr. Kevin Mancini can help you. Prescription fluoride rinses, gels, supplements, and other treatments are available at our Hampstead, NC and Jacksonville, NC orthodontic office to make sure that your teeth are well-protected, wherever you may live. We will let you know which products are best for you and how often to use them.

Most toothpastes are formulated with fluoride, so you’re getting the enamel-strengthening benefits of this mineral every time you brush. Keeping up with your brushing is especially important while you’re in orthodontic treatment.

Because wearing traditional braces can mean it’s harder to reach all the plaque on your teeth, especially behind wires and around your brackets, that demineralization we talked about earlier is a common problem during treatment. Demineralization often leads to discolored white spots on enamel and, eventually, cavities. If you need more protection than toothpaste alone provides, Dr. Kevin Mancini will suggest fluoride treatments to reduce the risk of demineralization and even reverse some of its effects.

Fluoride isn’t, of course, the only way to look out for your dental health. Proper brushing and flossing are still essential for removing plaque. And sealants for both kids and adults provide long-lasting protection for chewing surfaces. But when it comes to a proven cavity-fighter that’s simple to use, effective, and easily available—is it any wonder we’re big fans of fluoride?

New Ligatures? Some Things to Consider When You Choose Your Hues

May 17th, 2023

Colorful elastic ligatures (the official name for those tiny bands around your brackets) are often replaced when you come in to have your braces adjusted. Which is great! Now you have the opportunity to go with your team colors, or your school colors, or tones that work with your skin and eyes, or shades that represent your favorite holiday season. Today’s bands come in a wide variety of colors, so you never need to worry about becoming bored with your choices.

But are there certain hues that can be a bit more challenging to work with. Let’s look at some of those trickier tones.

  • Lunch Look-Alikes

If you don’t want kind friends constantly informing you that you have something stuck in your teeth, you might want to leave certain colors off your list. Dark greens and browns can sometimes give the appearance of food trapped in your braces. Have a look at the shades available, and see what is least likely to send you running for a mirror and a toothbrush.

  • Smile Dimmers

A blazing white band might seem like a good match to your blazing white teeth, but for many people, really light colors can make teeth look more yellow. And often bands in shades of yellow can bring out any yellow in your enamel. If you’re looking for a brighter smile, try some darker, richer tones for a gleaming contrast.

  • You’re So Over the Rainbow

If you are someone who loves a monochromatic look, perhaps any colors will be, well, just too colorful. In that case, there are ligatures for you! Silver or grey braces will blend with your metal brackets, and clear or tooth-colored bands will be less obvious with metal or ceramic brackets. Light colored bands can be more prone to staining, so keep that in mind if you’re going for invisibility or a close bracket match.

Now with all that being said, you be you! If you like a color, give it a go. It might be the perfect accessory for your smile and your personality. And, if it doesn’t work . . . no big deal! You can explore another part of the color palette on your very next adjustment to our Hampstead, NC and Jacksonville, NC office.

What’s the Function of Functional Appliances?

May 10th, 2023

Whenever we bite down, we’re applying force with our jaw muscles. Functional appliances direct these forces to create healthier tooth and jaw alignment. They’re used to help correct bite problems and to encourage symmetrical jaw growth.

Functional appliances aren’t always necessary. Because every child’s teeth and bite are different, orthodontic treatment at our Hampstead, NC and Jacksonville, NC office is carefully tailored to your child’s individual needs.

  • For the child with minor tooth misalignment, traditional braces or aligners might be all that’s needed.
  • For the child with a minor malocclusion, or bite problem, an orthodontist might use elastics (rubber bands) to bring teeth into healthy alignment.
  • For the child who has a more serious malocclusion, involving both tooth and jaw alignment, an orthodontist might recommend a functional appliance.

A severe Class II malocclusion can be caused when the upper jaw or teeth are positioned too far forward, and/or the lower jaw is too small or positioned too far back. Common Class II malocclusions include:

  • Open bite—the front teeth don’t touch when the back teeth bite down, or the back teeth don’t touch when the front teeth close.
  • Overbite—some overbite is normal. A deep overbite occurs when the upper teeth significantly overlap the lower teeth.
  • Overjet—the upper front teeth protrude further horizontally than they should.

Today’s functional appliances come in a variety of designs to treat Class II malocclusions. They can be fixed or removable. They can be used with or without braces. Some are designed to expand the upper palate to make sure there’s room for all the permanent teeth. What they all do is advance the position of the lower teeth and jaw to create a healthier, more comfortable bite.

Fixed devices are attached to the teeth and meant to be used full-time. These include the Forsus™ device, the Herbst® appliance, and the MARA appliance.

  • Forsus Device

This appliance works with braces. A spring coil rod is most often attached to bands on the first molars on the upper jaw. It’s then connected to the arch wire on the lower jaw. Just like elastics—but more effective!—these spring coil rods provide gentle forward pressure that encourages the lower jaw and teeth forward.  

  • Herbst Appliance

The Herbst appliance also applies forward pressure to the lower jaw using telescoping rods connecting the upper and lower teeth. The rods expand as the mouth opens, and telescope together as it closes, positioning the lower jaw further forward while the upper jaw is held back. The Herbst can be worn alone or with braces, and can also be used to expand the upper palate.

  • MARA Appliance

The MARA (Mandibular Anterior Repositioning Appliance) uses an adjustable “elbow” piece connecting bands on upper and lower molars to guide the lower jaw and teeth forward when the jaw closes.

Removable appliances such as Bionator and Twin Block appliances can also improve Class II malocclusions. They are meant to be worn for a specific number of hours each day, and can be taken out for sports or other activities as needed. Because it’s essential to get all the necessary hours in, removable appliances require commitment!

  • Bionators

A bionator is made of wire and acrylic, and it looks a lot like a retainer. The wire fits around the upper front teeth. It’s attached to a smooth piece of acrylic that sits behind the upper teeth and is shaped to guide the lower jaw forward when biting down. The bionator can also be adjusted to expand the upper palate.

  • Twin Block Appliance

The twin block appliance uses two separate pieces made of wire and smooth acrylic. Both pieces are modeled to fit precisely over the upper and lower arches. The acrylic “blocks” fit over the biting surfaces of the teeth, working together like a 3D puzzle. When your child bites down, the upper blocks slide into place behind the lower blocks, pushing the lower jaw and teeth forward. The top plate can also be adjusted to expand the upper palate if needed.

Because these appliances are best used while a child’s bones are still growing and developing, dentists and orthodontists recommend an orthodontic evaluation by age seven. Early treatment with a functional appliance can help correct serious bite problems before or together with braces. In some cases, functional appliances may reduce the need for headgear or surgery.

Todays’ orthodontic technology has made functional appliances more comfortable and efficient than ever before. Talk to Dr. Kevin Mancini to discover how an individualized treatment plan and a custom appliance can give your child a healthy bite and a lasting smile.