The replacement of the baby teeth by the adult teeth occurs in two distinct phases: the first phase of replacement occurs between the ages of 5-7 years of age; the second phase between 11-14 years of age. During the first phase the permanent front teeth erupt in both the upper and lower jaws.
ABOVE: An Illustration of Baby Teeth
ABOVE: An Illustration of Adult Teeth
In the second phase, the side teeth (canines and bicuspids erupt). The two phases of eruption permit the child to eat more sophisticated food and allow facial growth to help accommodate the larger permanent teeth. Crowding of the permanent teeth can occur in either or both phases of tooth replacement. A first phase of treatment is designed to promote a more successful second phase of eruption. If all of the teeth have enough room to erupt on the bony arches of the jaws, then the adolescent time period (11-14 years) is the ideal time to initiate treatment. The reason to seek treatment during adolescence is to correct the following:
The width of the bite
The front to back relationships of the bite, and
Aligning the teeth
During this time period, traditional braces may be used to align the teeth. Rubber bands and the Herbst appliance may be selected to correct the bite relationship. The choice whether to use rubber bands or a Herbst depends on the severity of the bad bite. Rubber bands are used to correct the bite by moving teeth. The Herbst appliance relocates the lower jaw, and in doing so, corrects the bite. Rubber bands only effect the teeth and the Herbst appliance effects the bony arch to assist in bite correction. An added benefit of the Herbst appliance may be an improvement of the middle airway by positioning the tongue anteriorly. This movement of the tongue may enlarge the airway.
ABOVE: An illustration of the first phase of eruption of the permanent teeth (yellow). The baby teeth are designated by white color. Note that boundaries are set with the first phase of permanent teeth eruption (molars and incisors). The next phase of permanent teeth eruption either fit in this allocated room of the remaining baby teeth or space problems may occur.
ABOVE: An illustration showing the restriction placed on the second phase of eruption of the adult teeth by the first phase. The white lines indicate the zone that the second phase must fit or crowding will result.
ABOVE: A photograph of a young lady with crowding of the upper and lower teeth showing teeth erupting off the bony ridge of the arch.
ABOVE: A photograph of same young lady, with completed treatment.
I'm in my 60's and have braces and actually enjoy my appointments with Dr. Forbes and staff. Everyone is highly professional, and provides excellent personal attention to their patients. The team all love what they do, and it shows!
Glory of West Chicago, Illinois
Dr. Forbes and his staff are friendly, professional and always caring and compassionate. Always professional and fun!
Janice of Park Ridge, Illinois
This was our first visit to the office and it was a GREAT! Dr. Forbes is fantastic at explaining the current situation, what your options are, his experiences and recommendations. All in a way you can easily understand and by involving you in the process. I even put on a glove to feel the inside of my daughters gum/bone area. He is very knowledgable and has wonderful supportive visual aids for you to see what your discussing. He was also very good at including my kids in the discussion and education. His support staff was very friendly and caring. I highly recommend this office.
Frank of Downers Grove, Illinois
Doctor Forbes and his staff provide professional and efficient orthodontic services. I especially appreciate his collaborative approach with both my primary dental and periodontal providers. I highly recommend him for both adult and juvenile patients.
Donna of Carpentersville, Illinois
Completely phenomenal! All around this group is an A+++. When you walk in anywhere with three boys (16 to 8!) you are on eggshells. They handled them with ease, were very patient, understanding and took the time to explain everything (especially to the 8 year old!). The oldest is "special needs" and they treated him with kid-gloves and the utmost respect. Not a bad word to say during our first visit here...hoping to get my boys back (soon!).
Gail of Elmhurst, Illinois
From the polite text reminders regarding our appointment time to the coffee and cookies provided in the waiting room, Dr. Forbes' office is managed with client service in mind and it goes beyond conveniences. When my teenage son, John, and I were driving in for his consultation appointment, traffic was so congested that at 6 pm my GPS was telling me we still had 30 minutes to go so we were not going to make it on time for our 6:15 appointment. I called Dr. Forbes' office to let them know and asked whether they would still take us or whether we needed to reschedule. The response was overwhelmingly positive - they were more concerned about my stress than about us being 15 or 20 minutes late. Further, even though we were very late to our appointment, when Dr Forbes saw John he was not rushed in any way. Now to the heart of the matter; the fore-mentioned would just be irrelevant window-dressing if John's exam did not go well, but Dr Forbes' approach to John and his case was thorough, analytical and collaborative. He discussed the complexities of John's case bringing us along by showing us X-rays, bite models and photos from studies. Having managed John's treatment which includes two surgeries for over five years, I very much appreciate that Dr Forbes did not dictate what the next step should be but offered his expertise and knowledge of what the options are without any condescension or judgement. Also, John felt treated with compassion and respect; he has been through a lot so for him to even consider extending the timeline of treatment, not to mention putting braces back on, tells me that he trusts this doctor and John is quite discriminating in this area. John's case is a puzzle best solved by collaboration among many people and I can tell from our interaction with Dr Forbes and his staff that they will be positive additions to our team, effectively working with us to bring John to the best possible outcome...I have already made our next appointment.
Robin of Glen Ellyn, Illinois
Everyone is very, very friendly and make you feel comfortable. All the processes and procedures were explained in great detail, so I always knew what to expect. The office is very clean and I love the music!! The staff all seem to love what they do!!!.