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 cosmetics, to improve a person’s appearance, but it often aims to improve oral function too. 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.
Devices
Orthodontic devices can be fixed or removable.
Fixed appliances
These are the most common devices used in orthodontics. They are used when precision is important. A person can eat normally with fixed appliances, but some foods and drinks need to be avoided, such as carbonated drinks, hard candy, gum, and other sticky foods. Examples of fixed orthodontic appliances include:
Braces
These consist of brackets, wires, and bands. Bands are fixed firmly around the teeth and serve as anchors for the appliance, while brackets are usually connected to the front of the teeth. Wires in the shape of an arch pass through the brackets and are fixed to the bands. As the arch wire is tightened, tension is applied to the teeth. Over time, this moves them into the proper position.
Follow-up involves monthly visits (or visits every week) to adjust or tighten the braces. Treatment may last from several months to a number of years. Both clear and colored braces are available.
Fixed-space maintainers
If a child loses a baby tooth, a space maintainer will stop the two teeth at either side of the space from moving into it until the adult tooth comes through. A band is fixed to one of the teeth next to the space, and a wire goes from the band to the other tooth.
Removable space maintainers
These are an alternative to fixed-space maintainers.
Special fixed appliances
These can help control tongue thrusting or thumb sucking. They may be uncomfortable, especially when eating, and so they are only used if necessary.
Removable orthodontic appliances
These may be used to treat minor problems, such as preventing thumb sucking or correcting slightly crooked teeth. The appliance should only be taken out when cleaning, eating, or flossing. Sometimes, the orthodontist may advise the patient to remove them during certain activities, such as playing a wind instrument or cycling.
Examples of removable appliances include:
Aligners: This alternative to braces may be useful for adults. They are virtually unnoticeable by other people, and they can be removed to brush their teeth, floss, or eat. An aligner is used for 2 to 3 weeks and then changed for a tighter one.
Headgear: A strap around the back of the head is attached to a metal wire in the front, or face bow. The aim is to slow down upper jaw growth and keep the back teeth in position while the front ones are pulled back.
Lip and cheek bumpers: These are specially made to relieve the pressure of cheeks or lips on the teeth.
Palatal expander: This appliance is designed to make the arch of the upper jaw wider. It consists of a plastic plate with screws that are placed on the palate, or roof of the mouth. The screws put pressure on the joints in the bones, forcing them outward. This expands the size of the area on the roof of the mouth.
Retainers: These are used after treatment to stop the teeth from moving back to their original positions. If modified, they may also be used to stop children from sucking their thumbs.
There are two types of removable retainer:
A Hawley retainer is made of metal and acrylic. The acrylic fits on the roof of the mouth and the wire surrounds the anterior teeth. The other is made of clear plastic. It fits over the teeth and looks like an Invisalign aligner.
Permanent retainers are glued, or bonded, to the back of the teeth. It is usually recommended for lower anterior teeth because of the high risk of reverting back to their former position.
In some cases, orthodontists recommend both a fixed permanent one on the lower anterior teeth and the clear plastic aligner-type which then would fit over the entire lower arch.
Splints, or Jaw repositioning appliances
These are placed either in the top or lower jaw. They help the jaw close properly. Splints are commonly used for temporomandibular joint disorders (TMJ). TMJ disorder is a condition that can cause pain and dysfunction in the muscles that are involved in jaw movement.
Whatever your device or treatment, it is important to follow both the health professional’s instructions and oral hygiene guidelines with care, to ensure the best outcome.
When should you see an orthodontist?
If your 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 your face and the appearance of your teeth, resulting in embarrassment, a lack of self-confidence, and even depression. A severe malocclusion may affect eating, speech, and keeping the teeth clean.
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 your 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.
Cross Bite: 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.
Thumb or finger sucking can cause the teeth and supporting bone to become misshapen. To see a natural improvement, the thumb-sucking habit must first be.
Diagnosis
The orthodontist will assess the state of your teeth and predict how they are likely to develop without treatment. This assessment will involve:
- Taking a full medical and dental health history
- Carrying out a clinical examination
- Taking x-rays of the teeth and jaw
- Making plaster models of the teeth
How Long Will I Have to Wear Braces?
The time required for braces varies from person to person. It depends on:
- How severe your problem is
- The amount of room inside your mouth
- The distance your teeth must travel
- The health of the teeth, gums, and supporting bone
How closely do you follow instructions
On average, once braces go on, they usually remain in place for 1 to 3 years. After braces come off, most people need to wear a retainer all the time for the first 6 months. After that, you have to wear it only while you’re asleep, but you may do it for many years.
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