Orthodontics is a branch of dentistry that treats malocclusion, a condition in which the teeth are not correctly positioned when the mouth is closed. This results in an improper bite. An orthodontist specializes in making the teeth straight. Treatment can be cosmetic, to improve a person’s appearance, but it often aims to improve oral function, too.
Types of treatment
Braces and other devices are used to straighten teeth.
An orthodontist can carry out work that aims to achieve the following:
- closing wide gaps between the teeth
- aligning the tips of the teeth
- straightening crooked teeth
- improving speech or chewing ability
- boosting the long-term health of gums and teeth
- preventing long-term excessive wear or trauma of the teeth
- treating an improper bite
Treatment can improve the appearance of the teeth, but it can also lead to better chewing and speech function and help protect teeth from damage or decay, in some cases. To achieve these goals, the orthodontist uses a range of medical dental devices, including headgear, plates, and braces.
Who should see an orthodontist?
If the jaws and teeth do not develop properly, malocclusion can result. The teeth will be crooked and misaligned, and the bottom and top sets of teeth may not line up. Malocclusion is not a disease and it does not affect physical health. It is a variation in the position of teeth. However, it may impact the shape of the face and the appearance of the teeth, resulting in embarrassment, a lack of self-confidence, and even depression.
Orthodontic treatment can help treat or improve the following:
- Protruding front teeth: Treatment can improve the appearance and protects the teeth from damage during sports injuries or falls.
- Crowding: In a narrow jaw, there may not be enough space for all the teeth. The orthodontist may remove one or more teeth to make room for the others.
- Impacted teeth: This can happen when adult tooth does not emerge from the gum or bone, or only emerges partially.
- Asymmetrical teeth: The upper and lower teeth do not match, especially when the mouth is closed but the teeth are showing.
- Deep bite, or overbite: When the teeth are clenched, the upper ones come down too far over the lower ones.
- Reverse bite: When the teeth are clenched, the upper teeth bite inside the lower ones.
- Open bite: When the teeth are clenched, there is an opening between the upper and lower teeth.
- Underbite: The upper teeth are too far back, or the lower teeth are too far forward.
- Crossbite: At least one of the upper teeth does not come down slightly in front of the lower teeth when the teeth are clenched. They are too near the cheek or the tongue.
- Spacing: There are gaps or spaces between the teeth, either because a tooth is missing, or the teeth do not fill-up the mouth. This is the opposite of crowding.
Physical & Psychological Benefits of orthodontics
Some Physical Benefits of Orthodontic Treatment:
Improved Oral Health
Both your teeth and gum health will significantly improve when you have straight teeth. Pieces of food that become lodged in crooked teeth can cause a proliferation of germs to accumulate, which often results in teeth becoming covered with plaque and leads to the formation of cavities, as well as increasing the size of any existing cavities.
An even more serious danger from having crowding and misaligned teeth is the possibility of gum disease and bone loss which could lead to tooth loss in severe cases.
Periodontal disease can lead to several serious health complications. If your gums are overly sensitive, recede, become swollen, foods are difficult to chew because your mouth hurts or you have bad breath, these are all symptoms of gum disease. Research shows that oral bacteria can even travel to the bloodstream and contribute to heart disease and premature births.
Jaw Problems and Solutions
With the recent proliferation of alternative orthodontic treatments that will straighten teeth but do not fix related dental problems, other features of healthy teeth might not be dealt with. A patient’s bite, for example, can be an important aspect of oral health. From the first day or treatment, the correct alignment of your upper and lower jaws will help prevent TMJ problems and jaw pain.
If the teeth are not correctly aligned, and there is an overbite or underbite, this can result in many problems in the future. This misalignment is called malocclusion, which can cause the teeth to be more difficult to keep clean, to wear at an uneven rate or make teeth weaker and more prone to breaking. Malocclusion can be treated with braces, extracting teeth or surgery, if necessary.
All of the pain and suffering that can result when teeth are misaligned can be avoided when you seek treatment. A comparison of healthy teeth and teeth with malocclusion clearly shows what can happen when problems are not treated. The symptoms of malocclusion can be as simple as difficulty when chewing certain foods. Proper alignment through treating this condition as quickly as possible will fix the bite and prevent damage to the teeth.
Protecting the teeth
Problems with tooth alignment and jaw growth can become apparent when a patient is very young. Early intervention can benefit the patient by correcting the growth of their upper and lower jaws and creating space for all their permanent teeth to erupt. That is why dentists recommend evaluation by an orthodontist by age 7. If problems are detected early on and treatment is rendered, in majority of cases you can avoid extraction of permanent teeth and complicated jaw surgery at a later date.
Not being able to bite and chew can even result in poor health, from undigested foods, and the body may not be absorbing all of the nutrients in foods. This can actually cause a person to become malnourished if the problem is not fixed. Tooth enamel can eventually wear away, and since food digestion begins in the mouth, treatment is imperative.
Since the health of a person can be compromised without timely orthodontic treatment, the solution is as near as your orthodontist’s office.
Some Psychological Benefits of Orthodontic Treatment:
Feeling awkward about one’s appearance sometimes causes people to attempt to hide their smiles and become withdrawn or unable to express simple joys. They may hide their mouths when they laugh or talk in public, and they might not even smile in photos. Getting orthodontic treatments can change their lives in many positive ways. The best time to begin treatment is in those early, formative years.
The Importance of Social Acceptance
Opportunities to fit in can be limited for people with an unattractive smile. Since orthodontic treatment can fix these problems, a person with the best possible smile will be able to reveal their emotions and personality, which can result in being more socially accepted and active in the world.
When a person has a misaligned bite, they could have trouble biting and chewing some foods and any damaged teeth can hurt the inside of their mouth. Along with making oral care and daily hygiene more difficult, crooked teeth can also cause speech problems. For patients with protruded teeth, there is always the danger of trauma to the front teeth and permanent loss of their teeth in case of a fall.
Procedure for Dental Braces
Initial Consultation and Examination
The first step for dental braces is for a patient to be referred to an orthodontist due to concerns about the positioning of the teeth in the jaw. In the first orthodontist appointment, the teeth should be examined manually and with X-rays images. It is also important to discuss the dental history with the patient, which will help to guide the treatment decisions.
If from the initial consultation it is deemed that treatment with dental braces is appropriate for the patient’s situation, further decisions such as the type of braces and the duration of treatment will need to be decided.
Fitting of Dental Braces
A cheek retractor is used to make sure that the teeth remain dry and visible throughout the procedure to place dental braces. The teeth should be polished well, conditioned, air-dried and primed before the brackets are placed to help the bonds to form properly.
Dental cement is used to hold the brackets in place on the teeth, in the exact position that was determined during the initial examinations. Any excess dental cement can then be removed, and the bonding of the brackets to the teeth is strengthened with a high-intensity light.
Once the dental braces are in place as desired, the cheek retractor can be removed and dental arch wires can be put in place. The complete placement process is relatively fast and typically takes less than 20 minutes.
Adjustment of Dental Braces
Regular appointments to adjust the dental wires are needed to ensure that the repositioning of the teeth continues throughout the process. These appointments are necessary because elastic ties that hold the wires in place stretch and become weaker with time so that the pressure is reduced.
During each adjustment appointment, the movement of teeth and progress so far with the dental braces should be evaluated, which helps to make ongoing decisions. The elastic ties that hold the braces in place and arch wires are removed, and new ties and wires are then placed.
Most patients will feel some tightness or soreness in their mouth shortly after each orthodontist appointment, which typically presents four to six hours after the appointment and may last for several days. This occurs due to the change in position of the teeth as they react to the pressure created by the dental wire on the braces. Simple analgesic medications such as paracetamol or ibuprofen may be beneficial for pain relief; this is particularly true as eating can be painful during this time.
There should be a period of at least three weeks between each adjustment appointment to allow time for the teeth to move. The frequency of appointments will depend on the intended movement of the teeth and the type of dental wire that is being used.
When your orthodontist determines that your treatment is complete, your braces will be removed with a simple and relatively painless process. The bond between the brackets and your teeth is safely and gently broken. When the bases of the brackets are squeezed, the adhesive bond releases, and the brackets are removed. During this process, the adhesive is left on the teeth to prevent damage to the enamel and tooth structure.
Once all brackets are removed, the remaining bonding cement is removed using a dental hand piece. This hand piece is typically the same tool that would be used for repairing a cavity, but pain is minimal because no tooth structure is being removed. After all bonding cement removed, your gums may be slightly inflamed, but this will usually subside in a few days with good brushing and flossing.
Recovery & Aftercare
About one to two weeks after dental braces have been removed, an appointment is made for retainer placement. Sometimes, however, retainers can be fabricated and placed at the braces removal appointment.
Retainers are removable orthodontic appliances which are necessary during the “retention period” of orthodontic treatment. During this stage of treatment, the teeth are relatively unstable and must be retained to provide proper completion of treatment.
The retainer is specifically made for your mouth. During the first six months following the removal of dental braces, it is often necessary for someone to wear the retainer full time. After this period, the retainer may only need to be worn at night, but this time is determined at the orthodontist’s discretion.
Once your braces are removed, you should see your regular dentist for a teeth cleaning. Your orthodontist will clean any left-over adhesive off your teeth and the area where the braces were, but it is important to have a thorough oral cleaning after removal.
Teeth whitening also may be considered, since there may be a noticeable difference in color between where the brackets were bonded and the enamel surface. Although you can whiten your teeth with braces in place using gels or tooth pastes, it is recommended that you wait until the dental braces are removed to prevent any mismatches in color or possible damage to the orthodontic components.
Is it too late to start?
It’s never too late to start! Whether you’re thinking of braces for you or your child! Most orthodontic problems can be successfully treated in the early teens since they are still growing at that time. In fact healthy teeth, bones, and gums respond well to orthodontic treatment at any age. Thus many orthodontic problems can be treated during adulthood also. Thanks to the various esthetic treatment options now available, you’ve more choice than ever!
How long does orthodontic treatment take?
Treatment times vary depending on a number of factors including age of the patient, the severity of the case, type of brace used, and compliance during treatment. Treatment times can take anywhere between 6 to 30 months; however, most standard treatments take about 22 months.
Do braces hurt?
In general, not really! Having you brace fitted is generally painless. Usually most patients feel some discomfort for a couple of days afterwards once your teeth, gums and mouth get used to the new braces and as the brace is adjusted. Over-the-counter pain medication can be used to improve any discomfort, but are usually unnecessary.
How much will it cost?
Treatment costs vary according to the length of treatment and the type of brace used, but remember that orthodontic treatment is an investment in your health and wellbeing. All fees for treatment are constructed based on a case assessment and vary depending on the types of braces and requirements, in consultation with the patient.
If I have braces, do I still need dental checkups every six months?
Absolutely! In fact, it’s more important than ever to see your dentist regularly for check ups to ensure your teeth stay clean and healthy throughout your brace treatment.
Will I need to have any teeth out?
Perhaps. Sometimes it is necessary to have teeth removed to create enough space to straighten your teeth and achieve the best result. Your doctor will discuss this with you and determine whether it is required. The majority of adults are treated without the need for extractions.
Will my speech be affected?
In most patients, No! But this does depend on what type of brace you have. Some braces can affect your speech more than others for example braces on the inside of your teeth (lingual braces). However this is usually only for a few days until your tongue gets used to the brace.