Orthodontic treatment is a way of straightening or moving teeth, to improve the appearance of the teeth and how they work. It can also help to look after the long-term health of the teeth, gums and jaw joints, by spreading the biting pressure over all the teeth.
Many people have crowded or crooked teeth. Orthodontic treatment will straighten the teeth or move them into a better position. This can not only improve their appearance but also the way the teeth bite together, while also making them easier to clean.
In some patients the upper front teeth can stick out and look unsightly. These ‘prominent’ teeth are more likely to be damaged, but orthodontic treatment can move them back into line. In others, the way the upper and lower jaws meet can cause teeth to look unsightly and lead to an incorrect bite. Orthodontic treatment may be able to correct both.
When the teeth don’t meet correctly, this can put strain on the muscles of the jaw, causing jaw and joint problems and in some cases headaches. Orthodontic treatment can help you to bite more evenly and reduce the strain.
Orthodontic treatment is generally best carried out in children, but adults can have orthodontic treatment too – and more and more are doing. Age is less important than having the proper number of teeth. In children it may be necessary to wait for enough teeth to come through before starting treatment.
Any dentist may carry out orthodontic treatment. Or the dentist may send the person to a specialist who has extra qualifications. The specialist may be in a practice or in a hospital department, and is called an orthodontist.
The most important thing is to have a full examination. This will usually involve looking at your teeth, taking x-rays and making plaster models of your teeth.
Your dentist or orthodontist will then discuss what treatment is possible. Once you are sure you want to go ahead, the treatment can begin as soon as you have enough permanent teeth
You may not have enough room for all your permanent teeth and so it may be necessary to take out some permanent teeth to make space. Your dentist will tell you whether this is the case. Sometimes space can be created using other forms of treatment.
Orthodontic treatment can be done by many sorts of appliances, which most people know as ‘braces’.
Simple treatment may be carried out with a removable appliance (a plate that can be taken out to be cleaned). It has delicate wires and springs attached, which move the teeth using gentle pressure.
It is sometimes possible to change the way the jaws grow, using orthodontic appliances. These functional appliances use the power of your jaw muscles and can help with certain types of problem.
Often, teeth need to be guided more accurately than they can be using a removable plate. So fixed appliances are used. These have brackets and bands temporarily stuck to the teeth. A flexible wire joins all the brackets and allows the teeth to be moved. It is not possible for the patient to take the appliance out and so it is called a fixed appliance.
They are tough, clear plastic ‘aligners’ (moulds) that are used to straighten teeth. Several sets of specially moulded, slightly different aligners are made for each patient. Each set is worn for two weeks before being replaced with the next one. They are made from clear plastic, so they are nearly invisible. This means that no one need know you are straightening your teeth.
The aligners should be worn for 22 to 23 hours a day for the best results. They can be easily removed for eating, drinking, brushing and flossing. You need to have all your adult teeth before you can have this treatment
The length of treatment depends on how severe the problem is, and may take anything from a few months to two and a half years. Most people can be treated in one to two years.
If you decide to have treatment, the orthodontist will be able to estimate the cost of your treatment and give you details. It is always a good idea to discuss the cost fully before treatment and, if necessary, have the cost confirmed in writing to avoid any confusion.
It is important to continue to have your teeth checked by your dentist while having orthodontic treatment. You also need to take extra care of your teeth and mouth:
When treatment is finished the teeth need to be held in position for a time. This period is called retention, and the appliances that hold the teeth in place are called retainers.
The retainers hold newly straightened teeth in position while the surrounding gum and bone settles. The retainers can be removable or fixed depending on the original problem.
Orthodontic appliances usually need adjusting every 4 to 6 weeks. Your orthodontist will tell you how often your appliance will need adjusting.
Success depends on a partnership between the skills of the orthodontist, and the enthusiasm and help of patient and parents. It is important to attend regularly and carry out any instructions given by the orthodontist.
The success of the treatment also depends on the commitment of the patient. For children’s orthodontic treatment it is very important that the patient is as keen as the parent.
Even after retention, it is normal for minor tooth movements to happen throughout life, so no permanent guarantee can be given. However, it is unusual for teeth to alter enough to need further treatment.
The first thing to do is to go along to your own dentist and get his or her advice. Your dentist will know whether you need treatment and make the necessary arrangements.
Dr. Kamlesh Kothari is one of India's topmost Oral, Maxillofacial surgeon and Dental Implantologist...
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