When this occurs, they may erupt toward the lip (fangs).  Even though this is not very attractive, it is relatively easy to correct.  More often, the cuspids will turn toward the midline and move within the bone into the palate – behind the front teeth.  Palatally impacted cuspids almost always require surgical exposure in addition to orthodontics.  This usually adds 6-10 months to the treatment time.  Adding to the problem is these impactions may not be discovered until the patient is a sophomore or older, after waiting (in vain) for the primary cuspids to fall out.  Believe me, no orthodontist really wants to be starting treatment late in high school.

The best preventative measure is Early Detection.  The American Association of Orthodontics strongly recommends your child’s first orthodontic screening appointment at age 7.  With a simple panoramic x-ray, blocked cuspids can easily be seen.  If necessary, we will recommend early treatment measures such as expansion to prevent or correct this problem.

What does that really mean? It sounds like a lot of hard work, but in reality, it is quite simple to do – AND Very beneficial.

Since I have been in practice for over 30 years, I get to see a lot of former patients as adults. The ones who have continued to wear their retainers still have straight teeth; the ones who decided that retainers weren’t important (like my own daughter) often have some relapse – re-crowding; spacing, etc.

Here is the reason. As humans age, our teeth are genetically programmed to move forward through out life. Straight teeth are like “bricks in a wall” and are more apt to remain straight on their own. However, often they will begin to re-crowd or move. This movement can be large – (severe relapse,) or small. This forward movement will occur even if your wisdom teeth have been removed and whether or not you have worn braces. In fact the only way you can prevent relapse is to continue to wear your retainer (at some level) throughout life.

Sounds difficult, but take a look at a typical schedule I have outlined below.

==> First 3-4 years after brace removal: Every night.

==> Next 5 years: 2-3 nights a week.

==> Indefinitely: Once or twice a month.

Q: If you are on a “now & then” schedule and you retainer starts to feel tight – What should you DO???

A: Wear it more – and/or see an Orthodontist.

Q: If your retainer is lost or broken – What should you do??

A: Get is replaced A.S.A.P.

If you ever have questions please call me anytime and thank you for reading my blog!

Dr. Rosenberg

These include:

• Creating of more space so that the permanent teeth have room to erupt.
• Widening the upper jaw (palate) to change a constructed “V” shaped upper arch into a rounder-more natural – “U” shape.
• To give the lips more support as your child ages into adult hood.
• To prevent permanent cuspids from migrating and becoming impacted.
• To aid in airway problems such as mouth breathing.
• To provide room for the tongue to assume a more natural position during rest and swallowing.

The best age for expansion is early – i.e. 7-11.  The palatal suture (and opening between the right and left halves of the palate, fuses – at the onset of puberty.  If expansion is done early, it is safe, rapid (usually 3-4 weeks) and pain free.
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