What is Orthodontics, what is involved?
Who Needs Orthodontic Treatment?
Orthodontic Treatment: Before, During and After
How do braces work?
The Basic Types of Braces
Deciding the Best Type of Brace for You
What is Orthodontics, what is involved?
Orthodontic treatment is becoming ever popular amongst children and adults. The lower cost of the treatment, and the rising awareness of the health benefits of properly aligned teeth, have resulted in ballooning orthodontic procedures these days. This article gives a simple overview of orthodontics and orthodontic braces.
Definition of Orthodontics
Orthodontics is a special branch of dentistry that deals with malocclusions (abnormal positions of teeth). Orthodontics also deals with problems of jaw growth and misalignment.
Orthodontics not only focuses on improving teeth alignment, but also on enhancing the facial appearance of the person. Orthodontists uphold the notion that when a person has a functional and normal bite, without disfiguring teeth or imbalanced facial features, he feels good about himself, and that would contribute to overall mental wellness.
Orthodontic treatment involves the application of fixed appliances such as braces and elastics, or removable appliances, to make teeth move to desired positions.
History of Orthodontics
Orthodontics was formerly known as orthodontia. The term was derived from the Greek word, orthos which means straight or proper, and dontos which literally means teeth. Orthodontics has been practised since the early times; archaeologists have discovered mummified people with metal brands wrapped around their teeth. Even Hippocrates and Aristotle in the 4th century BCE had postulated about ways to straighten teeth and manage other dental problems.
The father of modern orthodontics is Edward H. Angle. He started an orthodontic school in the 1900s in the U.S. He pioneered the use of ‘edgewise’ brackets that we still use today. He also invented several dental appliances.
Difference between Orthodontics and Cosmetic Dentistry
As mentioned previously, the goal of orthodontics is not only to align teeth but also to improve facial appearance. While orthodontics and cosmetic dentistry have some overlap, they are separate disciplines.
Specifically, orthodontics deals with misaligned, crooked teeth while cosmetic dentistry utilizes devices such as veneers to make teeth appear beautiful. For instance, braces are used in orthodontics to align teeth, whereas tooth-coloured bonded fillings or crowns are employed in cosmetic dentistry to improve the outward show of teeth.
The Job of an Orthodontist
An orthodontist is a dental specialist who is trained and certified to correct teeth misalignment and jaw deviations. The job of orthodontists focuses on cosmetic and functional treatment. Depending on the case, an orthodontist also carries out oral surgery to correct dental problems. Sometimes, an orthodontist works together with a dental surgeon to deal with complicated cases. Some orthodontists hire assistants to aid in dealing with extra tasks, for example, in taking X-ray pictures.
To become an orthodontist, he or she must possess expertise and special education in the area. He or she must undergo a 4-year training leading to a dental degree, and undergo up to 3 years of residency following the basic dental course.
Who Needs Orthodontic Treatment?
Anyone who has tooth misalignment or poor bite is a potential candidate for orthodontic treatment; it depends on the degree of severity. Orthodontic treatment sometimes involves tooth extraction and surgery.
There are two broad categories of orthodontic treatment, one using removable appliances, and the other, fixed appliances. Fixed appliances involve the application of brackets and wires that are glued onto the teeth. The goal of the orthodontic treatment depends on the extent of the dental disease and the person’s age, and the patient’s desires.
The most common dental problem encountered by this group is crowding, a form of malocclusion where there is insufficient room for the teeth. Space can be created in the mouth through jaw expansion or moving teeth backwards. Sometimes, extraction of teeth is required. The length of treatment can be about 2 years or more. After orthodontic treatment, retainers are worn for years to stabilize the teeth.
Sometimes, bad habits like thumb-sucking can result in crooked teeth and open bite. Lip biting also causes the upper teeth to protrude further. These bad habits have to be corrected early.
These days, more and more adults have taken up orthodontic treatment. Gone are the days when silver bands were placed around the teeth; that was how Dr Angle treated his cases in the 1900s. Nowadays, there are many brace designs to choose from, as a result of modern innovations. Besides teeth problems, a proportion of adults experience jaw discrepancy. Jaw discrepancy can cause bite problems, and the only way to treat it is by surgery or orthodontic treatment with fixed braces using temporary implant screws.
As we age, our cellular activity is diminished, so tooth movement will be slower. Because the bone structure in adults is denser than in children, orthodontic treatment in adults takes longer to complete, especially when teeth have to be extracted.
When to see an Orthodontist?
There is no upper age limit for orthodontic treatment. Anyone who experiences the following conditions should see a dentist:
- Difficulty in biting, swallowing or chewing
- Delayed loss of baby teeth, excessive teeth, missing teeth
- Oral habits such as thumb sucking, lip biting.
- Jaw problems such as deviated jaw
- Crowding and protruding teeth
- Facial asymmetry
- Traumatic bite, migration or shifting of teeth
Do I need braces?
Generally, it is a matter of personal choice if it were just a matter of aesthetics. However, in more severe cases, crooked teeth can make it difficult to clean your teeth, exposing you to risks of tooth decay and gum disease. Over-protruded teeth can put your teeth at risk of damage from trauma due to falls. Thumb-sucking and lip biting can result in teeth becoming displaced and growing in the wrong direction, resulting in an unhealthy and dysfunctional oral health system.
Other than providing pretty smiles, orthodontic treatment also promotes health and wellness. Moreover, it eliminates bad chewing habits, and improves lip seal, thereby helping to maintain good gum health. Orthodontic treatment can be a worthy investment for long-lasting benefits.
Orthodontic Treatment: Before, During and After
Orthodontic treatment is not performed by just any dentist. The science of orthodontics is a highly specialized area. Complex orthodontic problems should be dealt with by a competent orthodontist. The orthodontic procedure is a long, progressive course that follows a step by step process.
Before the Treatment
The first step involves a consultation with an orthodontist. At this stage, the doctor closely examines the patient’s mouth and face. This is the time when the client can ask questions, such as the length of the course of the treatment, and the expected cost.
As a general rule, a person should have good oral health as evidenced by healthy gums and absence of caries prior to the start of the treatment. Any decayed teeth should be properly restored, to prevent further progression of caries. As part of the treatment, dental impressions, photographs, lateral skull view and panoramic X-rays are taken.
The cost of orthodontic treatment depends on many factors such as the type of brace system used, and the length of treatment.
During the Treatment
When good oral health is established, the orthodontist will then proceed with the treatment. The type of orthodontic plan would depend on the client’s malocclusion, overbite, jaw problems, age, etc.
The active phase of orthodontic treatment could run for 1 – 2 years. This means that braces will be kept attached to the teeth for some time. For simpler orthodontic problems, treatment takes less than a year. For the duration of active phase, regular appointments with the doctor are expected about once a month.
One may experience soreness, tenderness, discomfort and sometimes mouth ulceration in the first few weeks of brace cementation. Good oral hygiene should be maintained by brushing the teeth properly and regularly. It is recommended to only consume soft foods and avoid the hard ones, to avoid breaking the braces. Sweet foods and drinks should be curtailed to prevent tooth decay.
After the Treatment
After the orthodontic treatment is completed, the braces will be removed with special pliers, and replaced a few days later with retainers. The purpose of the retainer is to stabilize the teeth and prevent them from shifting around. Depending on the doctor’s advice, retainers may be worn for a few months, or in some cases, for life.
Retainers should be used regularly, and they must be cleaned with a tooth brush. Clean retainers by brushing them after meals. When engaging in sports, take them out and keep retainers in a secured container.
How do braces work?
Have you ever thought about how braces can give you a happy smile? Isn’t it amazing that by only attaching little brackets on your teeth and applying gentle pressure, teeth can move and shift in a precise manner? Let us delve into the process of orthodontic treatment and find out how braces really work.
After the braces are cemented and the wire has been tied into place, the teeth will begin to loosen and move after several days. This is due to the pressure created by the arch wire, and elastics. During orthodontic treatment, the bones in the gum line also start moving, making the teeth easy to manipulate. When the teeth become straighter, the pressure is released, and they move about less.
It should be mentioned that orthodontic treatment is a slow and gradual process. If the process happens too quickly, the person could experience a lot of pain.
Parts of orthodontic appliances
The following are the basic parts of fixed orthodontic appliances:
Brackets. These rectangular metal or ceramic pads are attached to every tooth using a bonding material. Each bracket has a groove or channel, where the wire sits.
Arch Wire. This is a thin piece of wire positioned over the brackets. The arch wire creates pressure on the teeth making them move into alignment.
O-Rings. These are colourful, circular elastics which are responsible for tightening the braces and holding the wire within the bracket groove. They are available in different colours, and you can change them at each visit.
Elastics. These are optional auxiliary orthodontic aids; not everyone needs them. Elastics work by adding pressure and tension to teeth. They are often used in overbite and underbite cases.
The basic types of Braces
The reasons for orthodontic treatment are many and varied. Almost always, orthodontic treatment is indicated for individuals with bad bite problems. These can be protruding, crowded or misaligned teeth. Nowadays, there are many types of braces suitable for both children and adults.
The type of braces chosen is based on the severity of misalignment and goals of treatment.
These are the most common type of braces. They are the most recommended and most effective way to align teeth. In the case of metal braces, a bracket is cemented on each tooth. A fine wire then links these brackets. The only drawback of fixed braces is that they are visible. The brackets in fixed braces are attached and remain unchanged throughout the treatment.
The brackets are made of stainless steel which means they are strong and tough, and will not rust. Metal braces have improved over the years; the modern ones are made smaller, more attractive and more affordable.
Ceramic braces are also called “tooth-coloured braces” because they are colourless or translucent, blending well with the colour of teeth, so they go almost unnoticed. They are discreet types of braces and are often worn by celebrities, TV personalities, business executives, and those who want to conceal the appliances. The problem with ceramic braces is that they are fragile since they are made of ceramic. They are also more expensive. Ceramic brackets are more difficult to remove than metal brackets. They are more delicate and not as robust as metal brackets.
These are made of clear thermoplastic material that covers the teeth. They are used to treat minor misalignment of teeth. Invisible aligners are indicated for those who have minor relapse following previous orthodontic treatment. One boon of this type of brace is that the appliances are not so visible, blending well with the teeth and giving a discreet appearance. However, the disadvantage of using invisible aligners is that they cannot be highly effective because the pressure on teeth is reduced due to a lack of grip. Sometimes, tooth-coloured cement is bonded onto the teeth to improve the grip of the aligners. Since the aligners are removable for tooth-brushing, there is little risk of caries.
One of the traditional types of braces is removable braces. This type of brace makes use of “springs” to fix misalignment of teeth. Worn on the upper or lower teeth, removable braces are used to correct mild to moderate dental problems. Removable braces are often used in young children.
Functional appliances are specially-designed removable braces for individuals with problems like excessively protruded teeth, overbite problems, or problems with jaw growth. These functional appliances are effective in correcting misalignment by improving biting and jaw position.
Lingual braces are braces applied inside the mouth, on the hidden surfaces of the teeth. The good thing about them is that they are concealed appliances. Individuals who feel embarrassed wearing metal braces can resort to lingual types. One drawback of lingual braces is that they are very expensive. Lingual braces can be very difficult to adjust. They are difficult to remove, difficult to clean, and can be annoying to the tongue.
Choosing the best type of brace for yourself
There are many options for orthodontic braces both for adults and children and they can be very confusing when you do not know their pros and cons. A discussion with the orthodontist will help you choose one that suits your malocclusion and lifestyle.