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When we think orthodontics, we commonly think teeth. Naturally! Straight teeth and a beaming smile are everyone’s orthodontic goal. But orthodontics is a field which specializes in more than misaligned teeth. While your beautifully aligned teeth are the visible outcome of your orthodontic work, a properly aligned bite is the foundation for your healthy smile.

A malocclusion occurs when the teeth and jaws aren’t properly aligned—they don’t fit together the way they should when the mouth is closed. A malocclusion, or bad bite, affects many people to some degree, but not always in exactly the same way. Some of the different types of malocclusion include:

• Crossbite

A crossbite occurs when upper teeth fit inside lower teeth. An anterior crossbite refers to the front teeth, with one or more upper front teeth, or incisors, fitting behind lower front teeth. A posterior crossbite affects the back teeth, with upper teeth fitting inside the lower teeth on one or both sides of the jaw.

• Crowding

When the jaw is small and/or the teeth are large, lack of space can result in crowded, twisted, or crooked teeth.

• Open bite

An anterior open bite means that the front teeth don’t close when biting down, leaving an open space between the upper and lower teeth. A posterior open bite occurs when the back teeth don’t make contact when the front teeth close.

• Overbite

Our upper front teeth naturally overlap the lower ones a small bit when the teeth are closed. An overbite occurs when the upper teeth significantly overlap the lower teeth.

• Overjet

When the upper front teeth protrude too far forward over the bottom teeth, it’s called an overjet, or, sometimes, buck teeth. Where an overbite causes a vertical overlap, an overjet takes into account the horizontal relationship of the teeth.

• Spacing

A jaw that is large, teeth that are small, missing teeth—these conditions can lead to gaps between the teeth.

• Underbite

An underbite results when the lower teeth and jaw extend further forward than the upper teeth and jaw, causing the bottom teeth to overlap the top teeth.

If you have a malocclusion, what comes next? This depends.

Some malocclusions are so minor that no treatment is necessary. Some are the result of misaligned teeth. Some occur because the upper and lower jaws are growing at different rates. Some are a combination of teeth and jaw misalignments. Some are caused by genetics, while others are caused by injuries or habits like prolonged thumb sucking or tongue thrusting.

Because malocclusions are so varied, your treatment plan will be designed for your specific needs. Braces, aligners, appliances like the Herbst® appliance or the palatal expander, surgery for severe malocclusions—there is a larger variety of treatment options than ever before to help you achieve a healthy bite.

When teeth and jaws don’t fit together as they should, the consequences can be damaged teeth and enamel, problems with the temporomandibular joint, headaches and facial pain, and difficulty chewing, eating, and speaking.

The good news is that early intervention for children can help correct teeth and jaw problems before they become more serious, leading to easier orthodontic care in the teen years, and helping to avoid the possibility of surgery or extractions. This is why Drs. Schofield and Dad and our team recommend an orthodontic assessment at our Grapevine office for children around the age of seven.

If you’re an adult with concerns about your teeth or bite, there’s good news for you, too. Drs. Schofield and Dad can devise a treatment plan to improve your bite and your smile no matter what your age.

Of course, despite our title, there’s really no such thing as a “common malocclusion” when we’re talking about your dental health. Each person—and each smile—is unique. Drs. Schofield and Dad will diagnose your malocclusion and create a personalized plan carefully tailored to your exact needs, for an uncommonly attractive, confident, and healthy smile.

We’re all friends here, so if you sometimes feel a bit nervous before your orthodontic appointments, no judging! Ask us about any worries you might have. We are happy to explain procedures, equipment, and your orthodontic options so you know exactly what is going on during treatment. And if X-rays are a concern, we can put your mind at ease here as well.

What Exactly Are X-rays?

Sometimes patients feel reluctant about the process of imaging because X-rays are a kind of radiation. But the fact is, radiation is all around us. We are exposed to radiation naturally from our soil and water, sun and air, as well as from modern inventions such as cell phones, Wi-Fi, and air travel.

Why is radiation so common? Because matter throughout the universe constantly gives off energy, and the energy that is emitted is called radiation. This radiation takes two forms—as particles (which we don’t need to consider!) and as traveling rays. This second type is known as electromagnetic radiation, created by photons traveling in regular waves at the speed of light.

We are exposed to electromagnetic radiation every day, because, whether we can see them or not, these different wavelengths and frequencies create various forms of light. Radio waves, microwaves, infrared, visible, and ultraviolet light, X-rays, and gamma rays are all part of the electromagnetic light spectrum.

Different types of radiation on this spectrum have different wavelengths and different frequencies, and produce different amounts of energy. Longer wavelengths mean lower frequencies and less energy. Because X-rays have shorter wavelengths and higher frequencies than, for example, radio waves and visible light, they have more energy.

How Do Dental X-rays Work?

An X-ray machine produces a very narrow beam of X-ray photons. This beam passes through the body and captures images of our teeth and jaws on special film or digital sensors inside the mouth (intraoral X-rays), or on film or sensors located outside the mouth (extraoral X-rays). These X-ray images are also known as radiographs.

Why are X-rays able to take pictures inside our bodies? Remember that higher energy we talked about earlier? This energy enables X-rays to pass through the softer, less dense parts of our bodies, which are seen as gray background in a radiograph. But some substances in our bodies absorb X-rays, such as the calcium found in our bones and teeth. This is why they show up as sharp white images in radiographs. 

There are many different types of dental X-rays used in orthodontics, including:

• Occlusal X-rays, which show the entire arch of teeth in the upper or lower jaw.
• Panoramic X-rays, which use a special machine to rotate around the head to create a complete two-dimensional picture of teeth and jaws.
• Cephalometric X-rays, which show the patient’s entire profile, and the position and development of the teeth and jaws.
• Cone Beam Computed Tomography, an external device which uses digital images to create a three-dimensional picture of the teeth and jaws.

Why Do We Need X-rays?

You might have noticed that these X-rays, unlike, for example, typical bitewing X-rays, don’t take images of individual teeth. That is because orthodontists deal with the teeth in relationship to each other and to the structures around them.

Beautifully aligned teeth and a healthy bite are the visible result of your orthodontic work, but there’s a lot going on above and below the surface that needs to be discovered and taken into account before your treatment even begins. X-rays help us evaluate:

• The size, shape, and position of your teeth, including impacted teeth and wisdom teeth
• The size, position, and health of your roots throughout treatment
• The size and shape of your jaw bones, and how they affect your teeth alignment and bite
• Your progress during different phases of treatment

How Do Orthodontists Make Sure Your X-rays Are As Safe As They Can Be?

First of all, the amount of radiation you are exposed to with a dental X-ray is very small. In fact, a typical panoramic X-ray provides roughly the same amount of radiation we are exposed to through our natural surroundings in just one day. Even so, Drs. Schofield and Dad and our team are committed to making sure patients are exposed to as little radiation as possible.

Radiologists, the physicians who specialize in imaging procedures and diagnoses, recommend that all dentists and doctors follow the safety principal known as ALARA: “As Low As Reasonably Achievable.” This means using the lowest X-ray exposure necessary to achieve precise diagnostic results for all dental and medical patients.

The guidelines recommended for X-rays and other imaging have been designed to make sure all patients have the safest experience possible whenever they visit the dentist or the doctor. We ensure that imaging is safe and effective in a number of ways:

• We take X-rays only when they are necessary.
• We provide protective gear, such as apron shields and thyroid collars, whenever needed.
• We make use of modern X-ray equipment, for both traditional X-rays and digital X-rays, which exposes patients to a lower amount of radiation than ever before.
• When treating children, we set exposure times based on each child’s size and age.

And now that we’ve talked about some things you might like to know,

Please Let Us Know If . . .

• You are changing orthodontists and have had previous orthodontic X-rays taken. Ask to have your older X-rays sent to our office so we have a complete record of your orthodontic history. (With digital X-ray technology, this transfer can be accomplished with e-mail!)
• You’re pregnant, or think you might be pregnant. Even though radiation exposure is very low with dental radiographs, unless there is a dental emergency, dentists and doctors recommend against X-rays for pregnant patients.

X-rays play an important part in helping us make sure your orthodontic treatment provides you with a lifetime of beautiful and healthy smiles. If you have any concerns, contact our Grapevine office. When it comes to making sure you’re comfortable with all of our procedures, including any X-rays that might be necessary, we’re happy to give you all the inside information!

Children’s baby teeth generally start to fall out when the adult teeth underneath them are ready to arrive. Visits from the Tooth Fairy begin around the age of six, and continue until the last baby molar is gone.

But sometimes, we can’t wait for nature to take its course, and children need a dentist’s assistance to remove a primary tooth before it falls out on its own. Here are some common situations where extracting a baby tooth is best for a child’s present—and future—dental health.

• Serious Decay

Dentists make every effort to save teeth, and this includes baby teeth. A filling or even the baby tooth version of a root canal can be used to save little teeth when a cavity appears.

But severe decay could mean that there’s not enough healthy tooth structure left to fill. Or that bacteria have caused infection inside the tooth. Left untreated, infections can spread to other tissues in the body and can become quite serious. When a primary tooth is seriously decayed or infected, an extraction is often the healthiest choice.

• Trauma

Sometimes a baby tooth will recover on its own if it’s been jarred by an impact. Sometimes an injured tooth can be repaired with treatment. If there’s serious damage, though, a baby tooth is at risk for abscess and infection, and, sometimes, can cause harm to the adult tooth beneath it. In cases like these, an extraction is the safest option.

When an injury causes a broken or dislodged tooth, call Drs. Schofield and Dad immediately. Whether the tooth can be saved or should be extracted depends on how serious the injury is and how soon you can get your child to the dentist’s office or the emergency room.

Whenever a child loses a primary tooth early, a pediatric dentist will be on the lookout for potential orthodontic problems. Remaining baby teeth tend to shift to fill any empty spot. Without the proper space to come in, the adult tooth can erupt out of place or at an awkward angle. Drs. Schofield and Dad  might recommend a space maintainer to keep baby teeth aligned properly and to make sure the right spot stays open for the permanent tooth when it’s ready to erupt.

We’ve talked about primary teeth which are lost early, but it’s also problematic . . .

• When a Baby Tooth Doesn’t Fall Out

Usually, a wiggly baby tooth is a clue that the adult tooth underneath has started pushing its way up and out. The baby tooth’s root is gradually absorbed as the adult tooth moves into place. Without an intact root to hold it in place, the baby tooth grows looser and looser until it falls out. Now the permanent tooth has the perfect open space ready for its arrival.

But when baby teeth don’t fall out on their own, this can be another source of orthodontic difficulties.

Stubborn baby teeth can mean adult teeth erupt behind them, creating a double row of teeth (colorfully known as “shark teeth”) and risking crowding and misalignment. Or a baby tooth can block an adult tooth from erupting at all. When that baby tooth just isn’t budging, an extraction will create space for the permanent tooth to erupt.

If an extraction is scheduled, consult with Drs. Schofield and Dad about these important topics in advance:

• Preparing for the Procedure

A pediatric dentist is an expert not just in caring for little teeth, but in caring for little patients as well. Because extractions can be scary for children, talk to our Grapevine dental team to learn how to prepare your child for the procedure in an informative, comforting, and age-appropriate way.

• Sedation Options

A local anesthetic could be all that’s necessary for a simple extraction. If sedation is recommended for an extraction, or if you feel sedation is better for your child’s needs, discuss nitrous oxide, oral medication, and other options with your dentist.

• Aftercare

Whether it’s how to protect the area around the extraction, which foods and drinks are best over the days following, or how to treat pain and swelling, you’ll be given clear instructions by your pediatric dental team to help your child recover comfortably and quickly.

Little teeth can take different paths on their way to the Tooth Fairy. Your pediatric dentist is an expert both in treating children’s dental needs and in making sure their oral development is on schedule. If your dentist has recommended an extraction, it’s because this is the very best way to protect your child’s immediate oral health while ensuring a healthy future adult smile.

It’s a new year! A blank calendar! A traditional time to make a few changes that could change your life for the better.

And while we applaud big goals like learning a new language, practicing more between lessons, or finally cleaning out that locker, Drs. Schofield and Dad would like to start small with a few simple, proactive dental resolutions which will help keep your smile healthy and your orthodontic treatment right on schedule.

1. Floss Every Day

Yes, we know we talk a lot about flossing. That’s because flossing can be a game-changer when it comes to healthy teeth and gums.

Proper flossing removes the plaque from spots your brush often misses—between the teeth and near the gum line. When you floss, you accomplish two goals: you help prevent cavities and you help prevent gum disease. And once each day is all it takes—as long as you take your time and floss correctly.

If you’re having trouble flossing properly (a very common problem even without braces!), don’t hesitate to talk with Drs. Schofield and Dad to discover the best techniques and products to make your flossing experience as effective as possible. Floss threaders, specially designed orthodontic floss, or a water flosser can help keep your teeth and braces free of plaque and food debris.

2. Retire Your Brush

Brushes work hard—that’s why they should be replaced after a few months of use. Bristles start to fray over weeks of brushing, which means you aren’t getting the full benefit of your great brushing technique.

Switch out your brush every three to four months, or earlier if you notice any bristle damage, and you’ll enjoy cleaner teeth without changing your normal brushing habits.

3. Protect Your Smile

Take some simple, everyday precautions to protect your teeth and your smile.

• If you haven’t already, be sure to buy a soft-bristled brush when you replace your old one. Soft bristles are strong enough to brush away plaque while protecting your tooth enamel and gum tissue from abrasion.
• Use a mouthguard when you enjoy any sports or activities where you might make contact with an object or person or the ground. If you wear braces, a custom mouthguard can be fabricated at our Grapevine office to protect both your mouth and your braces.
• Protect and strengthen your tooth enamel with fluoride, a proven cavity-fighter. Fluoride toothpaste? Yes, please!

4. Keep Up the Good Work

Your orthodontic treatment will go smoothly when you do your part! This means:

• Eating a braces friendly diet. Avoid all those difficult crunchy, sticky, chewy foods that can dislodge your brackets or wires.
• If you’re supposed to wear bands, headgear, or other appliances, be sure to follow your orthodontist’s instructions on how and how long to wear them each day.
• If you wear aligners, wear them for the hours required so you’ll be ready for your next set right on schedule.
• If you have a retainer, wear it as directed. These first months with your retainer are especially important while your teeth grow stable in their new positions. And wearing your retainer after your treatment is complete will keep that beautiful smile picture-perfect for years to come.

5. See Your Dentist Regularly

Most people benefit from seeing their dentists twice a year for a complete oral examination and a professional cleaning. Regular visits to your dentist are especially important now.

Your dentist and hygienist will let you know if you’ve been doing a good job cleaning around your braces, and where and how you might do more. You’ve been doing a great job with your orthodontic schedule, and you don’t want to delay your treatment with a cavity!

Start the new year off right. These five small adjustments to your daily routine can have a big impact on your oral health while helping to keep your orthodontic treatment right on track. Be proactive now, and enjoy a new year filled with healthy smiles.