Ronald C. Kobernick, DDS, MScD, PA
Periodontics
10601 Seminole Blvd, Largo, FL & 111 2nd Avenue NE, St. Petersburg, FL
727-397-8503

Orthodontic Treatment Information

Common Orthodontic Corrections in Adults: 

Orthodontics is the specialty of dentistry focused on the diagnosis and treatment of dental and associated facial irregularities. The results of orthodontic treatment can be dramatic — beautiful smiles, improved dental health, and an enhanced quality of life. Orthodontic problems, which can result from genetic and environmental factors, must be diagnosed before treatment begins. Proper diagnosis involves taking photographs, digital radiographs (x-rays), lateral skull radiographs (if indicated), and dental impressions. After studying the diagnostic information we gathered, Dr. Kobernick is able to make studied decisions about the optimum form of treatment necessary. He will share his findings and treatment recommendations with you at a subsequent treatment discussion appointment, including treatment time necessary, fees, and the extent of treatment necessary. If appropriate, options in treatment will be discussed.

Treatment typically lasts from 6 to 30 months in adult patients, depending on the severity of the orthodontic problems present. Outstanding results are also dependent on maximizing the coordination of care between you and our practice. We are committed to delivering the best possible service in order for you to achieve your orthodontic objectives.

Common problems for which treatment is considered are the corrections of:

Crossbites

Crossbites can occur in the front and/or the sides of the mouth. One or more upper teeth occlude (bite) on the inside of the lower teeth (their proper position is to occlude on the outside of the lower teeth). This can occur with a single tooth or multiple teeth. Some posterior (back) crossbites may not need correction if the occlusion (bite) is stabile and there are no TMJ symptoms.

Crossbites should be corrected when any of the following signs or symptoms are present:

  • premature wear of the teeth
  • gum disease, including recession of the tissues
  • dysfunctional chewing patterns, causing or accentuating TMJ symptoms
  • a compromised smile

How can a crossbite be orthodontically corrected?

If there is a single tooth crossbite, the tooth can be moved with braces into the correct position. In some cases, a retainer can be utilized. With multiple teeth in crossbite, the arch needs to be expanded with braces or a combination of orthodontics with jaw surgery.

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Openbite

Openbite is an insufficient vertical overlap of the teeth. It is caused by oral habits such as tongue thrust, or when the jaws don't grow evenly.

Open bite should be corrected because it can:

  • Potentiate aberrant toungue positioning and alter swallowing pattern.
  • Create significant wear of posterior teeth.
  • Create TMJ (jaw joint) symptoms of pain, joint sounds (popping or clicking), or dislocation.
  • Make your smile less attractive.

How can an openbite be orthodontically corrected in an adult?

Openbite can be corrected through eruption (extrusion) of the anterior (front) teeth, and in some cases in combining orthodontic treatment with surgical correction of the jaws.

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Overbite

Overbite occurs when the upper front teeth extend significantly over the lower front teeth vertically. Often you cannot see the lower incisors (front teeth) due to the extent of the overlap. Overbite is due to a disproportionate amount of eruption of front teeth or over development of the bone that supports the teeth and a front to back discrepancy in the growth of the upper or lower jaw (Class II Relationship). Overbite is also known as a deep bite.

Overbite should be corrected because it can:

  • cause improper functioning of your front teeth
  • result in the lower front teeth biting into the gum tissue of the upper palate leading to tissue problems (recession of the soft tissues or pockets).
  • unusual wear of the lower front teeth
  • create TMJ (jaw joint) symptoms of pain, joint sounds (popping or clicking), or dislocation.
  • make your smile less attractive

How can an overbite be orthodontically corrected?

Overbite can be corrected through intruding the front teeth (moving them “up”) and/or bringing the back teeth together, which will "open" the bite so the teeth are properly aligned and the deep bite is eliminated.

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Overjet

Overjet is also known as protrusion of the upper incisors. In this case, the lower teeth are too far behind the upper front teeth, and an excessive horizontal space exists between the upper and lower incisors. This can be caused by an improper alignment of the molars (Class II Relationship), a skeletal imbalance of the upper and lower jaw; flared upper incisors, missing lower teeth, improper lower incisor positioning (retrusion), or a combination of all the above.

Overjet should be corrected because it can:

  • prevent proper functioning of the front teeth, creating interferences of the back teeth
  • lead to premature wear of teeth
  • make your smile less attractive  

How can overjet be orthodontically corrected?

Overjet can be corrected through the removal of two upper teeth (one on each side), or a combination of orthodontic treatment and jaw surgery to reduce the skeletal imbalance. In a mild overjet situation, interproximal reduction (IPR) to minimally reduce the dimension of some upper teeth can create enough space to allow retraction of the upper front teeth.

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Anterior Crossbite (Underbite)

The lower front teeth protrude past the upper front teeth. An anterior crossbite is usually caused by undergrowth of the upper jaw, overgrowth of the lower jaw, or a combination of the two (Class III Relationship). Anterior crossbites can also be caused by retrusive (retracted) upper incisors, flared lower front teeth, or a combination of the two.

Anterior crossbites should be corrected because it can:

  • prevent proper functioning of the front teeth or molars which can lead to premature wear of the teeth
  • cause chewing or eating problems
  • cause jaw or joint problems
  • make your smile less attractive

How can an anterior crossbite be orthodontically corrected?

In the adult, anterior crossbites can be corrected through extraction of lower teeth, the advancement of the upper incisors, and in some cases, through a combination of orthodontic treatment and surgical correction of jaw position.

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Impacted teeth

Impactions can be caused by improper positioning of the developing tooth bud. This can cause the tooth to fail to erupt into the mouth. Impactions can also be caused by early loss of primary teeth or crowding of teeth. The impaction of teeth other than wisom teeth creates the need for orthodontic treatment to position the teeth in the mouth. Upper cuspids (canines) are the most frequently impacted teeth, although other teeth can be impacted as well.

This problem should be corrected because it can:

  • cause damage to the root structure of adjacent teeth
  • leave unwanted spaces
  • lead to improper functioning of the teeth
  • cause asymmetric alignment of the teeth
  • create esthetic compromise

How can impacted teeth be orthodontically corrected?

The impacted tooth is surgically exposed in our office using local anesthetic. The surgical procedure Dr. Kobernick uses protects adjacent teeth during the exposure and creates stabile tissue over the impacted tooth as it is moved. An orthodontic bracket is bonded (cemented) to the exposed tooth to create a “handle” to allow proper forces to be applied to the tooth. Slowly, over the course several months, the exposed tooth is directed into the correct position in the mouth.

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Missing teeth

The absence of a tooth or teeth that should normally be present. This can be caused by trauma, a genetic lack of development, or premature loss of the tooth created by extensive caries (decay) or periodontal disease.

This problem should be corrected because it can:

  • create periodontal problems
  • cause improper functioning of teeth
  • cause premature wear of teeth
  • cause asymmetric alignment of the teeth
  • make your smile less attractive

How can missing teeth be orthodontically corrected?

Depending upon the situation, the space can be closed with braces or opened for tooth replacement. A bridge or dental implant are restorative options if a space is created.

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Tipping of teeth, especially lower back teeth

Often times when a back tooth is prematurely lost, teeth in the area of the missing tooth shift into unstable positions. Teeth behind the missing tooth often tip forward, and the opposing tooth in the opposite arch will frequently extrude (become longer).

Tipping should be corrected because it can:

  • compromise periodontal health
  • compromise stability of the occlusion

How can tipping be orthodontically corrected?

Limited numbers of brackets (braces) are placed, applying mild force systems to upright the tipped tooth and level involved opposing teeth.

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Crowding of the Teeth

Crowding is the lack of space for all the teeth to fit normally within the jaws. The teeth may be twisted or displaced. Crowding occurs when there is disharmony in the tooth to jaw size relationship or when the teeth are larger than the available space. Crowding can be caused by improper eruption of teeth and early or late loss of primary teeth.

Crowding should be corrected because it can:

  • prevent proper cleaning of all the surfaces of your teeth
  • increase the potential for dental decay and periodontal disease
  • prevent proper functioning of teeth
  • make your smile less attractive

How can crowding be orthodontically corrected?

Extra space can be created by extraction of teeth or interproximal reduction (IPR), reducing the width of a tooth by “thinning” it slightly. Once space is created, fixed braces or Invisalign (depending on the severity of the situation) will eliminate the crowding and align the teeth. Correction of crowding may help prevent dental decay and periodontal disease by improving your ability to remove plaque from the teeth.

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Spacing of the Teeth

An excess of space between the teeth which results in gaps between your teeth. This generally occurs when the teeth are smaller than the available space. Spacing can also be caused by protrusive teeth, missing teeth, impacted teeth or abnormal tissue attachments to the gums.

Spacing should be corrected because it can:

  • prevent proper functioning of the teeth
  • make your smile less attractive

How can spacing of the teeth be orthodontically corrected?

The spaces can be closed by moving the teeth together and properly aligning them within the arch.

10601 Seminole Blvd., Largo, FL 33778 P: 727-397-8503 F: 727-398-2679

390 4th Street North, St. Petersburg, FL 33701 P: 727-397-8503