Orthodontics
Orthodontics is a branch of dentistry that deals with problems relating to your ‘bite’ or ‘malocclusion’. If you find that you have crooked or misaligned teeth; or that there are too many teeth in your jaw (overcrowding) then you will need some form of corrective device known as a brace.
This can also form part of a ‘smile makeover’.
If you have temporomandibular joint disorder (TMJD) then you may require oral surgery as well as a brace. Your orthodontist will discuss this further with you.
There are many different types of braces which include Invisalign, Damon, Lingual and ‘Six Month Braces’.
You may think of braces as those ugly looking wire-metal devices worn only by children and teenagers. However, technology has moved on and the more modern types of braces are both comfortable and visually appealing. For example, there is an innovative form of brace called ‘invisible braces’ or ‘Invisalign’ which is a transparent type of brace that is comfortable to wear and unobtrusive. Often known as ‘clear braces’.
To learn more visit our Invisalign braces section.
And, braces are increasingly worn by adults as well as young people. If you are an adult who has put up with crooked teeth or have problem with your ‘bite’ (the opening and closing action of your jaws) then a brace can help. However, it is still the case that this type of treatment is most effective for children rather than adults.
Why? The teeth are still growing in a child or pre-teen which makes them more responsive to this treatment as compared to an adult. But, adults can still benefit from having a brace fitted although the corrective process takes longer than that for a child.
If you have any problems with your ‘bite’, have crooked or misshapen teeth or find it difficult to chew your food then you probably require orthodontic treatment. As this is a specialised form of dentistry your local dentist will refer you to an orthodontist for diagnosis and a treatment plan.
What is a ‘Damon brace?’ What are ‘6 month smiles?’ What does the treatment involve? These are just a few of the many questions patients have about orthodontics.
What is an orthodontist?
An orthodontist is a specialist type of dentist who treats irregularities of the teeth in order to improve their appearance. If you have misaligned teeth, overcrowding (too many teeth) or a poorly functioning jaw then orthodontic treatment can help.
Your own local dentist will be the first one to notice any problems with your ‘bite’ or teeth alignment and will then refer you to an orthodontist.
What is ‘malocclusion?’
Malocclusion is the technical name for a ‘bad bite’ and refers to problems with talking, chewing, biting and swallowing food. It can also affect your facial appearance.
Your ‘bite’ is the name given to the action of opening and closing your jaws. Your jaws are connected via a small joint which acts in a similar manner to a hinge and enables them to work in a smooth, co-ordinated manner.
But problems can occur with your jaw, such as temporomandibular joint disorder (TMJ) which can be both painful and distressing. Treatment for this can include the fitting of a corrective brace.
Problems with your bite can also include an ‘underbite’ or an ‘overbite’: an underbite occurs when your lower jaw and teeth protrude forward which means that they close in front of your upper teeth. An ‘overbite’ is where the opposite happens: when you close your jaws you notice that your upper teeth protrude in front of your lower teeth.
What causes malocclusion? There are a variety of factors which cause this which include:
Accident or injury: teeth can be broken or knocked out especially during childhood. If this happens during childhood then the replacement tooth will often fuse with the surrounding bone. This results in an irregular line up of the teeth.
Thumb sucking: many children suck their thumb which can cause the upper teeth to stick out over the lower teeth.
Tongue thrusting: some children get into the habit of thrusting their tongue against their teeth which can result in the upper teeth protruding over the lower teeth.
Small mouth: a small mouth can mean limited space for the teeth to grow which can lead to overcrowding.
Too many teeth: you can have too many teeth or not enough which then cause problems with your bite.
Jaw disorders: a misaligned jaw or TMJ disorder can lead to malocclusion. This is characterised by pain in your jaw and popping or clicking sounds.
If you have malocclusion then treatment is required to reduce the risk of tooth decay and premature wearing down of the teeth.
Why orthodontic treatment?
f you are suffering from malocclusion (bad bite) then orthodontic treatment is needed to prevent any long term problems. Misaligned teeth, especially the back teeth can become excessively worn down as a result of misalignment or overcrowding.
Problems with your bite can also affect your ability to speak as well as the appearance of your jaw line. From a cosmetic perspective it also affects your smile.
Another factor in this is the risk of tooth decay: a regular dental hygiene routine can help to look after your teeth and reduce this risk. But, if your teeth are out of position, misshapen or there are simply too many of them then this will affect your ability to keep them clean. A poor or irregular oral hygiene routine increases the risk of dental decay.
Corrective orthodontic treatment can help to deal with any of these as well as giving you a better looking smile.
Can adults have orthodontic treatment?
Many people assume that orthodontic treatment is geared towards children but this is not always the case.
Adults can benefit from this type of treatment although the process will take longer. Adults may also find that they require oral surgery either before or as part of the treatment process.
Children are the best candidates as their teeth are still growing and are more flexible than adult teeth. However, adults tend to be better at following treatment instructions than children.
Wearing a brace means looking after it on a regular basis and this is something adults find easier to do than children.
The ages of 7 to 14 are the best time for treatment.
What is a brace?
A brace is a form of corrective device, often made from wire and metal which helps to straighten misaligned teeth. They can be worn on either the upper or lower teeth, or both and force the teeth to move in a direction which will improve their overall position.
This will also correct any problems with your bite (malocclusion) or jaw misalignment.
A brace can be worn from 6 weeks to several years, depending on the extent of the treatment.
What does a brace do? It can straighten crooked or misaligned teeth, widen the jaws (small mouth) and create spaces between the teeth to relieve overcrowding.
There are two types of brace: fixed and removable.
A fixed brace is as the name says: it is worn 24 hours a day, 7 days a week until otherwise directed.
The removable type of brace can be removed and cleaned as and where necessary.
You may be given a ‘retainer’ type brace to wear following this period of treatment which helps to keep your newly aligned teeth in place.
There are several varieties of brace within these two categories:
Metal or plastic braces
These include the traditional stainless steel variety as well as sapphire braces, ceramic braces, gold and silver plated braces.
Invisible braces– see Invisalign, Simpli5 and Clearstep. These are made of a transparent material and are ideal for patients with mild occlusion.
Lingual braces: these are made from metal but are attached to the rear surfaces of your teeth.
Bands: these wrap around most of the teeth.
Inman Aligners: this is made of a semi-transparent material and works on a coiled spring system which pushes or pulls the teeth into place.
Damon braces: these too are made from a semi-transparent material. They are a combination of stainless steel and a ceramic reinforced composite material and use a sliding mechanism to hold the archwire in place.
Invu braces: these are made from a white ceramic material and use natural coloured bands to attach the brackets to the archwire.
Six month braces: this is the name given to a treatment process which aims to correct crooked or badly shaped teeth. It uses special braces to do so.
What does orthodontic treatment involve?
Treatment starts with the initial diagnosis by the orthodontist. He or she will examine your teeth before recommending a course of treatment. This visit will include x-rays and the taking of an ‘impression’ of your teeth. This impression enables him/her to get a precise idea of the position of your teeth and the amount of correction needed.
The orthodontist will make a mould of your teeth in which you will be asked to bite down into ‘dental putty’. This leaves an impression of your teeth which is then used to produce a cast. The cast will be made from plaster and is used as a blueprint for the brace.
The treatment itself takes two stages:
The fitting of a brace
The retainer
A brace is comprised of a series of individual ‘brackets’ which fasten to each tooth. These look like small handles and contain the ‘archwire’: this is a special wire that runs through the brace and helps to move the teeth. This wire is held in place either by elastic or metal bands.
The brace procedure involves the following:
The orthodontist applies a special etching material to your teeth which helps to secure each bracket to each tooth.
He or she will fasten these brackets to your teeth using dental cement. He/she will then use a special lamp, which emits a light beam that will harden the cement.
The archwire is threaded between these brackets and secured via metal bands or coloured rubber ones.
The orthodontist will adjust the brace at intervals which helps with moving the teeth into the desired position. He/she will adjust the brace, remove the coloured metal bands and replace the archwire. This is followed by him/her fixing new elastic bands to the brackets.
There is another type of brace which is made of a clear, transparent material that is almost invisible to the naked eye. These ‘invisible braces’ or ‘Invisalign’ are becoming a popular choice for people who don’t want the wire-metal variety.
The brace is designed to be worn for a set period of time. Once this has passed the orthodontist will replace this with a ‘retainer’. A retainer takes the form of an acrylic plate with metal hooks attached which fit around the teeth. The plate fits neatly into your palate and the hooks will attach themselves to your teeth.
The retainer can be removed as and when necessary.
The orthodontist will advise you as to how long you have to wear this retainer and how to look after it.
You will have a series of follow up visits, every 4 to 6 weeks, in which your brace will be adjusted.
This is more commonly known as the ’active’ phase.
Will I have to have teeth removed?
If you have too many teeth in your jaw – known as ‘overcrowding’ then the orthodontist may recommend that these be removed before the fitting of a brace.
If this thought worries you then you may find that he/she can suggest other ways of spacing out your teeth.
How long does the Orthodontics treatment take?
This depends on the extent of the problem. Every patient is different, with differing needs and this is discussed at the initial consultation. The orthodontist will draw up a treatment plan that can range from several weeks to 3 years or so.
The more severe the problem the longer it will take. Some patients find that their teeth can be corrected in a matter of weeks whereas others will require a longer period of time.
Does Orthodontics treatment hurt?
You are likely to experience some pain and/or discomfort after the brace has been fitted. It can take a few days to get used to wearing a brace and in that time, you may find that your teeth feel sore.
The brackets and archwire can irritate your tongue, lips and inside your mouth and you may find that, generally, your mouth feels uncomfortable. Persist with the brace as any discomfort will ease after a week or so and your mouth will become accustomed to wearing it.
You may also find it painful each time you have the brace adjusted. If this is the case then painkillers can help to deal with this.
How do I care for my brace or retainer?
This means following a daily dental hygiene routine which includes brushing and flossing your teeth, using a mouthwash and reducing your sugar intake.
If you have a fixed brace then you will have to ensure that your gum area and the areas around your brace are cleaned on a regular basis.
If you have a removable brace or retainer then this can be taken out of your mouth to be cleaned. There are special toothbrushes and tools to do so. Food particles can become trapped underneath the brackets or the archwire and it is important that these are removed as soon as possible.
These toothbrushes include interdental brushes, dental floss, electric toothbrushes and antiseptic mouthwashes.
A good way of cleaning your brace is to hold it carefully over a sink full of water and brush away any debris. Then rinse it after this brushing.
And, don’t forget to visit your dentist for regular check ups.
What is headgear for braces?
This is a type of device worn with a brace which helps with the repositioning of the teeth. It needs to be worn for quite a few hours each day but its use is declining as orthodontists prefer to use temporary implants instead.
It consists of 3 elements:
The facebow: this is a wire component with two parts which include ‘inner arms’ that fit inside the mouth and outer arms which fit outside the mouth, over the cheeks. This acts as an attachment for the headcap.
A headcap: this is worn on the head and is attached to the facebow via a series of straps or springs.
Rubber bands or springs: these join these together.
The headcap acts a cushioning pad for the facebow and straps. These straps are fastened to the facebow and go round the back of the head or neck. This helps to straighten the teeth.
It tends to be worn in the evening and night only as it is both cumbersome and restrictive. If a child or teenager has to wear headgear then there is the risk of teasing or bullying as a result of this.
It is a useful corrective device but requires the wearer to stick to a routine and be disciplined about wearing it.
