The primary goals of orthodontic treatment are to improve the occlusion (bite), facial balance, and general oral health. Patients tend to focus on dental alignment and want "straight teeth" and a "great smile."

While one of the goals of orthodontic treatment is an improved appearance, Dr. Carlson knows the critical importance of providing the best possible occlusion that is in harmony with jaw joint function.

Psychological benefits are also associated with orthodontic treatment, and one should not underestimate the value of an attractive smile. A pleasing appearance is vital to one's self-confidence.

The following conditions are goals of orthodontic treatment:

1. Proper dental alignment and a proper bite, providing straight teeth and a pleasing smile.
2. Healthy gingiva (gums) that have normal contours around the tooth crowns.
3. Proper bone levels and contours around the tooth roots.
4. A pleasing, balanced facial profile.
5. A normal, physiologic relationship of the lower jaw in the temporomandibular joints (jaw joints) when the patient closes into their bite. This relationship is called "centric relation." The way to determine if this goal has been achieved is to prepare dental models with proper instruments and techniques. Limitations in orthodontic treatment make this a difficult goal to attain, and a realistic goal is to get as close as is possible.
6. Jaw movements for various purposes result in contact of some teeth and a lack of contact of other teeth.
   • The back teeth should contact only in straight, vertical biting.
   • The back teeth should never contact when you bite to the front or to either side.
   • When biting to the front, only the front teeth should be in contact.
   • When biting to the right or the left, only the cuspids ("canines," or "eye-teeth") on the side toward which your lower jaw is moving should be in contact.
   • The term, "anterior guidance" means that when your lower jaw slides forward, your front teeth contact to bite, but the back teeth are apart.
     

     Anterior Guidance- Patient has moved lower jaw forward and only front teeth contact

     
     
   • Conversely, the term "lateral guidance" means that when the lower jaw is moved to the right or the left, only the cuspids on the side toward which the lower jaw is moved should be in contact.
     

     Right Lateral Guidance-The lower jaw has moved to the patients right.
     Left Lateral Guidance-The lower jaw has moved to the patients left.

   
   
   • While there are some other occlusal schemes that are reasonable, there is a consensus of opinion in the profession that supports the above biting patterns. The two "guidance" factors described are extremely important considerations.
   • Again, limitations in orthodontic treatment sometimes make this goal one that is difficult to attain.

Copyright © 2001 Dr. Gary Carlson. All rights reserved.