What is a distal bite: how can adults correct occlusion with treatment?

• Signs of correct bite
• Types of malocclusion
• Why do you need to correct your bite?
• Until what age can a bite be corrected?
• Ways to correct a bite

• Aligners
• Trainers
• Veneers
• Bracket system
• Types of braces

• Which braces system should you choose?
• How long does it take to correct a bite?
• How to care for braces?

Malocclusion occurs in almost 80% of the Russian population. In a third of cases it requires orthodontic treatment. And it’s not just a matter of aesthetics - if you are often bothered by headaches, earaches and dizziness, then perhaps it’s a malocclusion. An orthodontist deals with the correction and prevention of malocclusions.

The most common misconception about bite is related to age. Many people think that it can only be corrected in childhood, but today, with the advent of new technologies, this can be done at any age.

In this article we will look at the causes and types of malocclusion and why it needs to be corrected. We will also tell you about treatment methods and dispel the most common fears. Orthodontist Olesya Milagina comments on current issues of orthodontic treatment for us.

Signs of correct bite

To begin with, we will show what a normal bite looks like and list the signs by which you can understand that it is normal.

• The main distinguishing feature of a correct bite is the tight contact of the upper and lower jaws when they close. The upper front teeth cover the crowns of the lower ones by a third, that is, the lower incisors come into contact with the palatine tubercles of the upper ones. There is no distance between the upper and lower chewing teeth, and during chewing they are in constant contact.
• Correct bite affects the harmony of facial proportions: the lower and upper jaws are symmetrical.
• There are no speech defects.
• Food is comfortable to bite and chew.
• There is no discomfort or clicking in the jaw joint.

Causes

In young children, distal occlusion is a physiological norm. The upper jaw protrudes above the lower jaw by a distance of 1 to 10 mm. This is necessary for sucking the mother's breast. Gradually, the distal bite becomes orthognathic.

Reasons for the development of prognathia:

• Vitamin D deficiency. Causes rickets at an early age, the consequence of which is distal or mesial occlusion.
• Premature loss of baby teeth or their removal.
• Genetic factor.
• Calcium and fluoride deficiency in the body of a pregnant woman causes prognathism in the child.
• The influence of external factors - the use of a pacifier, sucking of fingers and other objects in childhood.
• Chronic pathologies of the respiratory system, causing disruption of normal nasal breathing. This leads to improper jaw development.
• Poor posture. A bent back and a head down provoke the development of jaw pathology.
• Injuries that damage the jaw bones.
• Some types of speech defects, due to which distal occlusion develops.

Types of malocclusion

How can you tell if your bite is wrong? Essentially, these are all deviations from the norm that nature has established.

Malocclusion occurs:

• distal - the upper jaw is pushed forward more than the lower jaw;
• mesial - the lower jaw is pushed forward more than the upper jaw;
• deep - the upper teeth overlap the lower ones by more than half their length;
• open - most of the teeth of the upper and lower jaws do not meet;
• cross - the left and right sides of the upper dentition protrude forward unevenly, and the upper and lower teeth meet with cutting edges.

Prognosis and prevention

The most effective results in correcting malocclusion are achieved during the mixed or primary dentition. If you choose the right treatment method, it is possible to achieve high-quality jaw alignment in adulthood, but it will take more time.

The formation of the bite in infancy plays an important role. It is important to monitor the correctness of breastfeeding, the position of the child during sleep, and prevent the formation of bad oral habits. Timely treatment of disorders that slow down or impair the growth of jaw bones and dental correction is also required.

Why do you need to correct your bite?

1. Increased abrasion, caries and tooth loss.
   Normally, when chewing, the load is evenly distributed across all teeth. When there is a malocclusion, the load on some teeth increases, while on others there is practically no load. On teeth that “work for two,” the enamel wears off faster, chips appear, and the teeth themselves become loose. Teeth that are “resting” are more vulnerable to caries.
2. Gum diseases.
   With an incorrect bite, the teeth can be tilted inward or, conversely, turned toward the lips. Eating or even normal conversation can injure the inside of the cheeks and tongue. The gums also suffer: the volume of tissue gradually decreases, exposing the roots of the teeth.
3. Diseases of the temporomandibular joint.
   Incorrect positioning of the incisors over time leads to displacement of the jaw joints relative to each other. The pathology is accompanied by muscle spasms, bruxism, crunching and clicking while eating or talking.
4. Diseases of the food tract.
   The bite is responsible for chewing and swallowing, and defects in the bite disrupt this process. Poorly chopped products are an additional burden on the gastrointestinal tract, which provokes gastritis, enterocolitis and problems with stool.
5. Breathing problems and ENT diseases.
   The accumulation of bacteria in the mouth during an open bite can cause sinusitis, sinusitis, otitis media, and sore throat.
6. Communication problems and complexes.

For 60% of patients, braces are aesthetics; for the remaining 40%, it is either the functionality of the masticatory apparatus, or a solution to a problem with the temporomandibular joint, or a preparatory stage before prosthetics.

How to independently determine whether it is good or not. Who can check

Usually, an incorrect bite is immediately visible because it can negatively affect a person’s face. If you have at least one friend or acquaintance with incorrectly positioned teeth, you know that such people often have difficulty speaking or biting food, and they develop a variety of speech defects. But, alas, only obvious violations are obvious to the average person.

It is important to understand that a correct bite is a complex of characteristics of your dentition. Even if you have a nice smile and your front teeth are nice and neat, there is no guarantee that everything is actually perfect. Meanwhile, this is fraught: miss one problem, and it will lead to large expenses for the treatment of damaged teeth.

You can imagine what a correct bite should be like in an adult or child, but only an experienced doctor can make a diagnosis.

Ways to correct a bite

Today there are four ways to correct a bite and one way to carefully disguise the problem.

• Aligners
• Trainers
• Bracket systems
• Surgical intervention

We have listed these methods in order from easiest to most difficult. You must understand that each case is individual, and depending on this, the doctor will select the optimal bite correction system. You can hide an unaesthetic bite with the help of veneers - we will also talk about them.

Aligners

Removable aligners that are created from dental impressions. The most modern way to correct a bite, which is suitable for the treatment of simple disorders.

After drawing up a treatment plan, the patient receives 3–5 sets of aligners of varying stiffness. The mouth guard is designed to last for two weeks, and then it needs to be changed to the next one, and so on until the final result. The course of treatment lasts on average 4–8 weeks.

Aligners need to be worn 24 hours a day, and this may not be comfortable for everyone. They are not suitable for deep bites. The mouthguard is designed so that it is “one step” ahead of the current position of the teeth in the dentition. Therefore, after putting it on, pressure is felt, which is evenly distributed throughout the jaw. Aligners consist of an elastic transparent material, so they are invisible to others, unlike braces.

Trainers

Removable silicone mouth guards for two jaws, which help correct a simple bite or consolidate the result. You need to wear the trainer during sleep and during the day for up to 4 hours.

Veneers

The characteristics are similar to crowns, but they are installed only on the front surface of the tooth in the form of a thin plate on a special dental glue.

Veneers can be composite, ceramic or zirconium. The first two types last about 10 years. Products made of zirconium dioxide with external porcelain coating - up to 15 years.

Veneers eliminate defects that arise as a result of cracks or damage to the integrity of teeth. A visually straight dentition is formed.

For the patient, the result of orthodontic treatment is aesthetics, and for the doctor, it is functionality. If your teeth are just crooked and your bite is perfect, you can get veneers or crowns. In other cases, you cannot do without braces: veneers do not correct the position of the teeth, but only mask their external imperfections.

Bracket system

Braces are small clasps that are attached to the teeth with a special composite glue. A metal arch is placed in the grooves of the braces - the most important element of the braces system. The arch has the shape of a regular dentition. She pulls her teeth, setting them in the correct position. In order for the bracket system to successfully complete its work, it is important to periodically change the arches to more elastic ones.

The doctor fixes the arch on the braces with special rubber bands - ligatures. Depending on the task at hand and the required force that will act on each tooth and jaw as a whole, the orthodontist can choose metal or elastic ligatures. The latter have a clear advantage - when they are changed, you can get rid of the bacteria accumulated under them.

Increased salivation in the first days after installation is a good reaction of the body. The tongue contains sensory neurons that, when food appears in the mouth, send signals to the brain to turn it into a food bolus. When braces are put on your teeth, at first the brain perceives them as food. This is the body’s reflex that there is something in the mouth, which means it needs to be treated with saliva in order to then swallow it. After some time, the salivary glands will get used to it.

Does it hurt to wear braces?

The first days are unusual, but not painful. But if braces scratch your lips and cheeks, you shouldn’t tolerate it. “ Make an appointment with your orthodontist. Sharp elements can be corrected with special materials and filled with special wax

“, our expert advises.

The same applies to tooth sensitivity: sign up for a diagnosis. It is possible that areas of demineralization have appeared. Depending on what the teeth react to, further treatment will depend.

Types of braces

Braces are classified according to the following criteria:

• material (metal, plastic, ceramic and sapphire);
• technique (classical and self-ligating, without ligatures);
• Place of installation (on the outer surface of the teeth - vestibular, on the inner surface - lingual).

Metal braces

Despite the fact that these are the oldest braces systems, they are still popular, and not only because they are the cheapest. Their main advantage is the minimal friction force between the groove and the arc, the magnitude of which largely determines the duration of the entire treatment.

The only negative is that such braces are noticeable on the teeth. However, modern designs differ from their ancestors - they are smaller and more convenient.

Plastic braces

Second after metal ones in the price range. Since plastic itself is not strong enough, the design has metal grooves. Their disadvantage is that such braces are stained by coffee, tea and other coloring products. They are also more fragile than others. However, plastic braces come in a variety of colors and shapes and are therefore popular in pediatric orthodontics.

Ceramic braces

More expensive, but stronger than plastic ones. The color matches the color of the teeth, which makes them almost invisible. Their disadvantage is higher friction between the arch and the bracket slot, which can increase the duration of treatment.

Sapphire braces

Artificial sapphires are used to make them. They are transparent and shimmer beautifully in certain lighting. This design will appeal to those who are sensitive to aesthetics.

Combined braces

Consist of several materials. In the smile area it can be ceramics or sapphires, and in the chewing area it can be metal.

Lingual braces

They are attached to the inside of the teeth and are invisible to others. Their main disadvantage is their high cost. Also, at first they may interfere with diction, but after 2-3 weeks the language adapts and the problem goes away.

Diagnostics

To determine the cause of the pathology and assess its severity, the orthodontist conducts an examination. During the initial examination, doctors at our clinic evaluate the functioning of the joint, the patient’s posture, and whether nasal breathing is impaired. Analysis of TRG of the skull in the lateral surface reveals all skeletal abnormalities. Using a 3D skull model, you can understand how the teeth and jaws are positioned. By analyzing plaster casts of the jaws, you can find out their size and how the jaws close. All this is needed to understand how to correct a distal bite.

Which braces system should you choose?

The least expensive and most proven option is metal braces. Plastic ones are also inexpensive, but they are inferior in strength to metal ones. If aesthetics are more important to you, opt for more expensive ceramic, sapphire or lingual braces.

As for “internal” braces, their only difference from all others is the aesthetic factor. One of the inconveniences is that such braces change the diction, they are more difficult to care for and they are not suitable for everyone. You need to have an almost perfect bite: just “uneven teeth.”

Orthodontic dentistry

How long does it take to correct a bite?

Each case is individual, so without visiting a doctor it is impossible to say how long treatment will take.

The minimum treatment takes a year for the bone to grow and the teeth not to come back. The result needs to be stabilized. Patients often tell me after two months of wearing braces: “I want to take them off, everything is already straight for me!” But this is appearance. The jaw bones must anchor the teeth into their new position.

The duration of treatment also depends on the patient. The orthodontist puts a certain force into the braces, which weakens by the next visit. That is why it is important to strictly visit the doctor once a month so that you do not have to prolong the course of treatment.

My teeth began to loosen. Something is going wrong?

Loose teeth after installation should not scare you. The teeth will be in motion throughout the treatment period. Essentially, we move our teeth: somewhere the bone dissolves, somewhere it appears. Six months after treatment, the teeth will return to normal.

The purpose of braces is to change the position of hard and soft tissues adjacent to the tooth. But this is not enough to correct the bite. Teeth may move back apart some time after braces are removed if a retention device is not in place. After correction, retainers must be installed to keep the teeth stable in their new position. If this is not done, the effect of wearing braces will gradually disappear.

Duration of treatment

The duration of correction is largely determined by the age of the patient. However, you must immediately prepare yourself for several months of wearing orthodontic structures. During the period of mixed dentition, children will have to wear special devices for a year and a half. In adults, wearing braces may take several years to obtain lasting results. However, a person quickly gets used to any devices and stops feeling them. And you shouldn’t refuse correction, since prognathia can lead to serious problems in the foreseeable future.

How to care for braces?

Caring for braces requires care and discipline. We talked about it in more detail in a separate article. After installing braces, the doctor will tell you how to live now. We will indicate the most important things.

1. Always have brushes and a single-tuft brush on hand.
2. Add a waterpik to your arsenal.
3. If you are not sure that you have brushed your teeth well, use an indicator tablet. After brushing your teeth, the tablet must be dissolved in your mouth. The areas where plaque remains will turn blue. These areas need to be cleaned again.
4. Avoid very hot and very cold drinks. Braces, like enamel, do not like sudden temperature changes.
5. To prevent braces from coming off, follow a diet. Eliminate nuts, toffees, seeds, and flour from your diet. Apples and other hard fruits should not be bitten off, but cut into small pieces and placed on the chewing teeth.

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pediatric dentistry, orthodontics, topic articles: Herbst apparatus, distal bite, bite correction, face bow, face mask, mesial bite, microimplants, palatal clasp, palatal expander

Conclusions. Expert advice

There are many different types of overbite. Correct is an arrangement of teeth that does not interfere with chewing or speech. If the teeth are not closed properly, excessive stress is placed on the teeth and they are destroyed faster. The bite is preserved even in the absence of teeth. Removing a wisdom tooth does not disrupt the bite and is not mandatory, but may be recommended in case of correction of damaged dentition.

Even if you know what a correct bite looks like , you will not be able to make a correct diagnosis. But you can appreciate the importance of correct bite and the global nature of the problems that its violation causes. This is a good motivation to visit the dentist. The doctor will make a diagnosis and offer modern methods of correcting the bite: installing braces, wearing a mouth guard or other methods. On average, treatment takes from one to 3 years, depending on the complexity of your case.

Mouth guards

Mouthguards, or aligners, are removable plastic or silicone transparent covers on the teeth. Made individually for a specific patient. They are worn constantly and are removed only for eating and hygiene procedures.

They are practically invisible, so they do not cause moral discomfort. The therapeutic effect is determined by a soft force effect on the dental elements, causing them to move in a given direction. The main disadvantage is the inability to eliminate particularly complex defects.

Important: the effectiveness of mouth guards for correcting malocclusion depends not only on the severity of the clinical case, but also on strict self-discipline. Failure to comply with the orthodontist's instructions will negate all efforts made.