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Orthodontics
is the branch of dentistry that specializes in the diagnosis, prevention
and treatment of problems in the alignment of teeth and jaws. The
technical term for these problems is malocclusion, which literally means
bad bite. Orthodontic treatment involves the design and use of
corrective appliances (such as braces, plates, headgears and functional
appliances) to bring the teeth and jaws into proper alignment.
Why
straighten teeth ?
People have
orthodontic treatment to improve the appearance, health and function of
their teeth. With good oral hygiene and regular dental care, your teeth
should last a lifetime. People aware of how teeth look and an attractive
smile will play an important role in enhancing self-confidence.
It is
generally more difficult to clean your teeth when they are crowded and
overlapping. Inadequate cleaning is a major factor in tooth decay, gum
disease and eventual tooth loss. Having your teeth straightened will
make it easier for you to look after them. Occasionally, bad bites can
lead to excessive wear and/ or uneven wear of the teeth. In cases of
severe deep bites, the lower front teeth can bite into the gums behind
the upper front teeth and cause serious gum damage (gingival stripping).
Difficulty
in Speaking
Some people
have difficulty speaking / eating properly because of alignment problems
with teeth and jaws. In most cases, orthodontic treatment is commenced
as soon as the last baby tooth has been shed. This usually occurs in the
early teens. However, orthodontic problems are usually apparent by the
age of nine. An early examination allows the orthodontist to detect and
evaluate problems and plan appropriate treatment. Some orthodontic
problems may be easier to correct if treated early. Early treatment may
also achieve results that are not possible once the face and jaws have
stopped growing.
Orthodontics for Adults
In the past,
orthodontic treatment was generally restricted to children. Since the
basic process involved in moving teeth is the same at any age,
orthodontic treatment is also successful in adults. As an adult's facial
bones are no longer growing, some severe malocclusions cannot be
corrected with braces alone. In such cases, orthodontic treatment
combined with jaw surgery can achieve dramatic improvements.
Orthodontic Treatment
During the
first visit, the patient is examined clinically. This enables the
orthodontist to give advice on the treatment options available, when
treatment should commence, the duration of treatment, and the
approximate cost. If the patient decides to proceed with treatment, an
appointment is made to collect records.
Records include:
- Impressions from which plaster models
of the teeth are constructed.
- Photographs of the teeth and face.
- Radiographs of the teeth and jaws.
Records allow
the orthodontist to analyze each case accurately. They are also used to
record the existing malocclusion for future reference.
Treatment
Planning
At this
visit, the orthodontist discusses the treatment plan(s) which have been
formulated using information obtained from the first consultation and
records. Arrangements are then made to commence treatment or, if it is
too early, to review the patient periodically until it is an appropriate
time to commence treatment. In certain cases, early treatment is
necessary to prevent functional problems (jaw shifts) or redirect
growth. These results are not possible once the face and jaws have
completed growth. Such treatment is known as interceptive treatment.
Functional appliances, face masks, headgears, bite plates and limited
fixed appliances are commonly used during interceptive treatment.
Functional
appliances are intra-oral removable appliances used for the purpose of
redirecting growth, while facemasks and headgears are extra-oval
appliances used for the same purpose. Bite plates are removable
appliances used to correct cross bites or reduce deep bites. It is often
necessary to remove teeth in order to alleviate crowing and/ or reduce
the proclination of teeth. Cavities should be filled and the teeth
cleaned before orthodontic treatment is started.
Braces
Braces may be
removable or fixed (cemented and/ or bonded to the teeth). Removable
appliances are usually made of acrylic and stainless steel wires. Fixed
appliances generally consist of stainless steel bands around the molars,
brackets on the anterior teeth and wires. Brackets can be metal, clear
or colored, depending on the patient's preference. In some cases,
brackets may be bonded behind the teeth (lingual braces). The wires used
are made of either stainless steel or of allows of nickel, titanium,
copper and cobalt.
Fitting the
braces usually involves 2-3 visits. Braces remain on the teeth for the
entire duration of treatment. Patients then attend sessions
approximately every 4-8 weeks for adjustments, wire changes, etc. During
treatment, patients may have to wear items such as rubber bands and/ or
headgear with their braces. These items provide important extra forces
for the correction of bite.
Treatment
Period
Orthodontic
treatment usually takes 12-36 months. Some cases may be completed
earlier while others take longer. The total treatment time depends on
the severity of the original malocclusion, the type of treatment carried
out, and the cooperation of the patient.
At the
completion of the active part of treatment, the braces are removed and
retaining appliances (retainers) are fitted to hold the teeth steady in
their new position. These appliances may be removable plates or wires
fitted behind the teeth. The retaining appliances are usually worn full
time for 6-12 months. The length of retention varies depending on the
original malocclusion and the type of treatment carried out.
Cost
No two
orthodontic problems are the same and the cost of orthodontic treatment
will depend on the severity of the problem and the orthodontist's fee
scale. For details, please consult your orthodontist. Most people have
some discomfort after their braces are first put on or when adjusted
during treatment. After the braces are placed, teeth may become sore and
may be tender to biting pressures for 3-5 days.
Patients can
usually manage this discomfort well with ordinary pain medication. The
lips, cheeks and tongue may also become irritated for one to two weeks
but the discomfort is usually short-lived as the soft tissues become
accustomed to the braces.
Avoid Hard
Foods
Patients with
braces must be careful to avoid hard and sticky foods. They must not
chew on pens, pencils or fingernails because chewing on hard things can
damage the braces. Damaged braces will prolong treatment and may
undesirably affect the outcome of treatment.
While
undergoing orthodontics, maintenance of good oral hygiene is extremely
important. Brushing requires more precision and time, and must be done
thoroughly and everyday if the teeth and gums are to remain healthy. In
addition, regular visits to the family dentist must continue during
orthodontic treatment. Although the treatment requires time, commitment
and consistent compliance, motivated patients will be rewarded with
healthy teeth and a beautiful smile that lasts a lifetime.
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