Orthodontics is the branch of dentistry that corrects teeth and jaws that are positioned improperly. Crooked teeth and teeth that do not fit together correctly are harder to keep clean, are at risk of being lost early due to tooth decay and periodontal disease, and cause extra stress on the chewing muscles that can lead to headaches, TMJ syndrome and neck, shoulder and back pain. Teeth that are crooked or not in the right place can also detract from one's appearance.
The benefits of orthodontic treatment include a healthier mouth, a more pleasing appearance, and teeth that are more likely to last a lifetime.
A specialist in this field is called an orthodontist. Orthodontists receive three years of specialist education beyond their five years graduation in dental college in a DCI-approved orthodontic training program.
How do I Know if I Need Orthodontics?
Only your dentist or orthodontist can determine whether you can benefit from orthodontics. Based on diagnostic tools that include a full medical and dental health history, a clinical exam, plaster models of your teeth, and special X-rays and photographs, an orthodontist or dentist can decide whether orthodontics are recommended, and develop a treatment plan that's right for you.
If you have any of the following, you may be a candidate for orthodontic treatment:
Overbite, sometimes called "buck teeth" — where the upper front teeth lie too far forward (stick
out) over the lower teeth.
Underbite — a "bulldog" appearance where the lower teeth are too far forward or
the upper teeth too far back
Crossbite — when the upper teeth do not come down slightly in front of the lower teeth when biting together normally
Open bite — space between the biting surfaces of the front and/or side teeth when the back teeth bite together
Thumb sucking – Sucking the thumb (or fingers) can deform nearby teeth and supporting bone.
Spacing — gaps, or spaces, between the teeth as a result of missing teeth or teeth that do not "fill up" the mouth
Crowding — when there are too many teeth for the dental ridge to accommodate
Deep bite - The upper front teeth cover the lower teeth. A deep bite can cause excessive wear of the front teeth
and gum damage behind the upper front teeth
AT WHAT AGE ORTHODONTIC TREATMENT CAN BE STARTED
Orthodontic treatment can be started at any age. Many orthodontic problems are easier to correct if detected at an early age before jaw growth has slowed. Early treatment may mean that a patient can avoid surgery and more serious complications. The Indian Orthodontic society recommends that every child first visit an orthodontist by
age seven or earlier if a problem is detected by parents, the family dentist or the child's physician.
Braces for All Ages
Adults: Orthodontic treatment can be successful at any age, and adults especially appreciate the benefits of a beautiful smile. One of every five patients in orthodontic treatment is over 21. Jaw surgery is more often required for adult orthodontic patients because their jaws are not growing. Adults also may have experienced some breakdown or loss of their teeth and bone that supports the teeth and may require periodontal treatment before, during and/or after orthodontic treatment. Bone loss can also limit the amount and direction of tooth movement that is advisable.
Children: The Indian Orthodontic society recommends that every child first visit an orthodontist by the age of seven because your specialist can advise if orthodontic treatment is required and the best time for that patient to be treated. The first permanent molars and incisors have usually come in by that time and crossbites, crowding and other problems can be evaluated. When treatment is begun early, the orthodontist can guide the growth of the jaw and guide incoming permanent teeth. Early treatment can also regulate the width of the upper and lower dental arches, gain space for permanent teeth, avoid the need for permanent tooth extractions, reduce likelihood of impacted permanent teeth, correct thumb-sucking, and eliminate abnormal swallowing or speech problems. In other words, early treatment can simplify later treatment.
WOULD AN ADULT PATIENT BENEFIT FROM ORTHODONTIC TREATMENT?
Orthodontic treatment can be successful at any age. Everyone wants a beautiful and healthy smile. Twenty to twenty-five percent of orthodontic patients today are adults.
HOW LONG DOES ORTHODONTIC TREATMENT TAKE?
Treatment times vary on a case-by-case basis, but the average time is from one to three years for comprehensive treatment and can be as short as six months for short Phase procedures. Actual treatment time can be affected by growth and the severity of the problem. Patients grow at different rates and will respond variously to orthodontic treatment, so the time to case completion may differ from the original estimate. Treatment length is also dependent upon patient compliance.
For example, the patient's diligent use of any prescribed rubber bands or headgear is an important factor in achieving the most efficient treatment. Maintaining good oral hygiene and keeping regular appointments are important in keeping treatment time on schedule.
How Does Orthodontic Treatment Work?
Many different types of appliances, both fixed and removable, are used to help move teeth, retrain muscles and affect the growth of the jaws. These appliances work by placing gentle pressure on the teeth and jaws. The severity of your problem will determine which orthodontic approach is likely to be the most effective.
Fixed appliances include:
Braces — The most common fixed appliances, braces consist of bands, wires and/or brackets. Bands are fixed around the teeth or tooth and used as anchors for the appliance, while brackets are most often bonded to the front of the tooth. Arch wires are passed through the brackets and attached to the bands. Tightening the arch wire puts tension on the teeth, gradually moving them to their proper position. Braces are usually adjusted monthly to bring about the desired results, which may be achieved within a few months to a few years.
Today's braces are smaller, lighter and show far less metal than in the past. They come in bright colors for kids as well as clear styles preferred by many adults. You can choose the color of the ties that hold the wire in brackets. Wires are also less noticeable than they used to be and the latest materials move teeth faster with less discomfort to patients.
Special fixed appliances — Used to control thumb sucking or tongue thrusting, these appliances are attached to the teeth by bands. Because they are very uncomfortable during meals, they should be used only as a last resort.
Fixed space maintainers — If a baby tooth is lost prematurely, a space maintainer is used to keep the space open until the permanent tooth erupts. A band is attached to the tooth next to the empty space, and a wire is extended to the tooth on the other side of the space.
Removable appliances include:
Removable space maintainers — These devices serve the same function as fixed space maintainers. They're made with an acrylic base that fits over the jaw, and have plastic or wire branches between specific teeth to keep the space between them open.
Jaw repositioning appliances — Also called splints, these devices are worn on either the top or lower jaw, and help train the jaw to close in a more favorable position. They may be used for temporomandibular joint disorders (TMJ).
Lip and cheek bumpers — These are designed to keep the lips or cheeks away from the teeth. Lip and cheek muscles can exert pressure on the teeth, and these bumpers help relieve that pressure.
Palatal expander — A device used to widen the arch of the upper jaw. It is a plastic plate that fits over the roof of the mouth. Outward pressure applied to the plate by screws force the joints in the bones of the palate to open lengthwise, widening the palatal area.
Removable retainers — Worn on the roof of the mouth, these devices prevent shifting of the teeth to their previous position after the fixed orthodontic treatment has been completed. They can also be modified and used to prevent thumb sucking.
Headgear — With this device, a strap is placed around the back of the head and attached to a metal wire in front, or face bow. Headgear slows the growth of the upper jaw, and holds the back teeth where they are while the front teeth are pulled back.
Why Straighten Teeth?
You may be surprised to learn that straight teeth are less prone to decay, gum disease and injury. Straight teeth collect less plaque, a colorless, sticky film composed of bacteria, food and saliva. Decay results when the bacteria in plaque feed on carbohydrates (sugar and starch) we eat or drink to produce acids that can cause cavities. Plaque also increases the risk for periodontal (gum) disease. When teeth are properly aligned, and less plaque collects, these risks decline. And when teeth are properly aligned it is easier to keep teeth clean. As for injuries to teeth, protruding upper teeth are more likely to be broken in an accident. When repositioned and aligned with other teeth, these teeth are most probably going to be at a decreased risk for fracture.
Untreated orthodontic problems may become worse. They may lead to tooth decay, gum disease, destruction of the bone that holds teeth in place, and chewing and digestive difficulties. Orthodontic problems can cause abnormal wear of tooth surfaces, inefficient chewing function, excessive stress on gum tissue and the bone that supports the teeth, or is alignment of the jaw joints (see photo above), sometimes leading to chronic headaches or pain in the face or neck.
Treatment by an orthodontist to correct a problem early may be less costly than the restorative dental care required to treat more serious problems that can develop in later years.