Diagnostic

What is my problem?

Appropriate age

Children orthodontic appointment

We strongly recommend an early orthodontic treatment , when necessary, for our younger patients. Proper orthodontic care at a young age can facilitate a healthy smile and healthy gums, as well as the growth and development of a proportionally balanced face.


Taking the proper steps in early development can also dramatically reduce the duration of a treatment.. We try to avoid dental extractions whenever possible, which is another reason for early orthodontic intervention. There is never a wrong time for orthondontics. Adolescents and adults alike, are realizing the benefits of a beautiful and functional smile.

And now with so many aesthetic treatment options available, such as clear/ ceramic brackets and removable aligners, there has never been a better time for you to have the beautiful smile that you have always wanted.

Panoramic X-ray

Panoramic X-rays (also known as Panorex® or orthopantomograms) are wraparound pictures of the face and teeth. They offer a view that would otherwise be invisible to the naked eye. X-rays in general, expose hidden structures, such as wisdom teeth, reveal preliminary signs of cavities, and also show fractures and bone loss.


Panoramic X-rays are extraoral and simple to perform. Usually, dental X-rays involve the film being placed inside the mouth, but panoramic film is hidden inside a mechanism that rotates around the outside of the head.

Unlike bitewing X-rays that need to be taken every few years, panoramic X-rays are generally only taken on an as-needed basis. A panoramic X-ray is not conducted to give a detailed view of each tooth, but rather to provide a better view of the sinus areas, nasal areas and mandibular nerve. Panoramic X-rays are preferable to bitewing X-rays when a patient is in extreme pain, and when a sinus problem is suspected to have caused dental problems.

Panoramic X-rays are extremely versatile in dentistry, and are used to:

Assess patients with an extreme gag reflex.
Evaluate the progression of TMJ.
Expose cysts and abnormalities.
Expose impacted teeth.
Expose jawbone fractures.
Plan treatment (full and partial dentures, braces and implants).
Reveal gum disease and cavities.

How are panoramic X-rays taken?

The panoramic X-ray provides the dentist with an ear-to-ear two-dimensional view of both the upper and lower jaw. The most common uses for panoramic X-rays are to reveal the positioning of wisdom teeth and to check whether dental implants will affect the mandibular nerve (the nerve extending toward the lower lip).

The Panorex equipment consists of a rotating arm that holds the X-ray generator, and a moving film attachment that holds the pictures. The head is positioned between these two devices. The X-ray generator moves around the head taking pictures as orthogonally as possible. The positioning of the head and body is what determines how sharp, clear and useful the X-rays will be to the dentist. The pictures are magnified by as much as 30% to ensure that even the smallest detail will be noted.

Panoramic X-rays are an important diagnostic tool and are also valuable for planning future treatment. They are safer than other types of X-rays because less radiation enters the body.

If you have questions or concerns about panoramic X-rays, please contact our practice.

Cephalometric X-Rays

The cephalometric X-ray is a unique tool that enables the orthodontist to capture a complete radiographic image of the side of the face. X-rays in general offer the dentist a way to view the teeth, jawbone, and soft tissues beyond what can be seen with the naked eye.

Cephalometric X-rays are extraoral, meaning that no plates or film are inserted inside the mouth. Cephalometric and panoramic X-rays display the nasal and sinus passages, which are missed by intraoral bitewing X-rays.

An X-ray image receptor is exposed to ionizing radiation in order to provide the dentist with pictures of the entire oral structure. The advantage of both cephalometric and panoramic X-rays is that the body is exposed to less radiation.

Cephalometric X-rays are not as common as "full sets" or bitewing X-rays, but they serve several important functions:

  • Provide views of the side profile of the face.
  • Provide views of the jaw in relation to the cheekbone.
  • Provide information about "bad bites" or malocclusions.
  • Allow measurement of the teeth.
  • Identify fractures and other injuries to the teeth and jawbone.
  • Assists in orthodontic planning.

How are cephalometric X-rays taken?
Cephalometric X-rays are completely painless. The head is placed between the mechanical rotating arm and the film holder, which is placed on another arm. The arm rotates around the head capturing images of the face, mouth, and teeth. The clarity and sharpness of these images will depend on the positioning of the body. The images are usually magnified up to 30%, so any signs of decay, disease, or injury can be seen and treated.

After capturing cephalometric X-rays, the dentist will be able to see a complete side profile of the head. This can assist in orthodontic planning and allow an immediate evaluation of how braces might impact the facial profile and teeth. Another common use for this type of X-ray is to determine specific measurements prior to the creation and placement of dental implants.

If you have any questions or concerns about cephalometric X-rays, please ask your dentist. 

Classe II

Class II problems represent abnormal bite relationships in which the upper jaw and teeth project from the lower jaw called an "overjet". Class II patients usually exhibit a convex facial profile with a deficient chin prominence.

Typically, a Class II problem is inherited and results in a shorter than normal lower jaw. Other factors, such as persistent thumbsucking can aggravate these problems.

Correction of this disorder generally requires influencing facial growth to bring the upper and lower jaws and teeth into their proper position.

Classe III

Class III problems are also primarily genetic in origin.

In this instance, the lower jaw and teeth are displaced to the front of the upper jaw structures.
Facially,the appearance may give the impression that the lower jaw is excessively large, but in many cases the lack of upper jaw development is at fault.

Crowding

Posterior crossbites usually result from a constricted upper jaw or unusually wide lower jaw. A narrow upper jaw will often force a patient to move their lower jaw forward or to the side when closing into a stable bite. When closed into this accomodated position, the lower teeth are located outside the upper teeth.

This posturing may result in an incorrect functional position of the lower jaw with accompanying facial asymmetry.

Overlap

Crowding of the teeth is the most common problem associated with the need for orthodontic care.

Although many factors contribute to the dental crowding, this problem usually sterns from a discrepancy between space available in each jaw and the size of the teeth.

Aside from aesthetic considerations, poor alignment of teeth may be associated with periodontal problems and an increased risk of dental decay due to difficulty in maintaining proper oral hygiene.

Deep bite

Excessive vertical overlapping of incisor teeth called "overbite" is generally found in association with a discrepancy between the length of the upper and lower jaws. It usually results in excessive eruption of either the upper or lower incisors or both.

Associated problems include:

  • Excessive display of gum tissue
  • Lip protrusion or entrapment of the lower lip
  • Biting the roof of the mouth
  • Worn out incisors

Diastema

Spaces between teeth are another common problem associated with the need for orthodontic care.

Like crowding, spacing may be related to a tooth-to-jaw size disharmony. Gum tissue attachment called "frenae" are also a common cause of spacing between the front teeth. Excessive vertical overlap of the front teeth as well as incisor protrusion may lead to spacing.
Other contributing factors include atypical or unusually narrow teeth, and missing or impacted teeth.

Open bite

A lack of vertical overlap of the incisor teeth can usually be traced to jaw disharmony or persistent habits (i.e. thumb sucking habits and postureof the tongue between the front teeth) or excessive vertical growth of one or both jaws.

Early assessment and intervention with these disorders is critical to the overall success.