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 two or more years of education beyond their four years in dental school in an ADA-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
  • Misplaced midline — when the center of your upper front teeth does not line up with the center of your lower front teeth
  • 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
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.

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.

Metal Braces – A variety of orthodontic options exist today for people looking into getting braces. From traditional metal braces to Invisalign aligners, it can be a challenge to decide which choice is the best for your particular needs. Your dentist will likely refer you to an orthodontist who can work with you to explain the benefits of each type.

Advantages and Disadvantages of Metal Orthodontia

Traditional braces are more effective at treating extreme overcrowding than other options like clear braces or Invisalign aligners and are less expensive. They give your orthodontist the control he needs to move the teeth in small increments at a time. The main disadvantage of traditional braces is the metal mouth appearance. While less noticeable orthodontics like Invisalign may seem like a better choice for those who are conscious of their appearance, today’s braces are more visually appealing than in past years, with a range of color options for both the brackets and the elastics. Wearing these types of braces also means that you don’t have to worry about ever misplacing your aligners.

Taking Care of Your Braces

If you and your dentist decide that metal braces are the right choice for your orthodontic needs, some things to keep in mind include:

  • Avoid foods that aren’t braces-friendly. Avoid chewy foods, like caramels or other soft candies, as well as very hard or crunchy foods that could damage your braces. Certain fruits and vegetables can get stuck in your braces, and should be cut into small pieces. Your practitioner will likely give you a list of foods to avoid keeping your braces in good shape and decreasing your risk of cavities.
  •  Brush and floss appropriately. Taking proper care of your teeth is always important, but it is especially true when you have braces. Brushing and flossing regularly will keep your braces looking good and help you avoid staining to your teeth. Your dentist may recommend you use a special brush designed to get into the crevices and different surfaces in metal braces. It may take some practice to learn how to brush and floss around your braces, but it will get easier with time. Learn more about proper flossing techniques in the Colgate Oral Care resources.
  • Keep your follow-up appointments. Seeing your dentist and orthodontist regularly allows for any adjustments to the braces to be made and gives you an opportunity to have any questions or concerns addressed.

You will be wearing your braces for a fairly lengthy period, so it is important to follow your orthodontist’s instructions and care for them properly. While braces may seem like an inconvenience, once the treatment is over, your new smile will be all the reward you need.

Ceramic Braces
Ceramic braces are the same size and shape as metal braces, except that they have tooth-colored or clear brackets that blend in to teeth. Some even use tooth-colored wires to be even less noticeable.

Pros: Less noticeable than metal braces; move teeth much faster than clear plastic aligners (Invisalign)
Cons: More expensive than metal braces; Brackets can stain easily if patients don’t care for them well

Lingual Braces
Lingual braces are the same as traditional metal braces, except that the brackets and wires are placed on the inside of teeth.

Pros: Invisible from outside
Cons: Difficult to clean; more expensive; not appropriate for severe cases; can be more uncomfortable at first; regular adjustments take longer and are more difficult than with traditional braces

Invisalign
Invisalign consists of a series of 18 to 30 custom-made, mouth guard-like clear plastic aligners. The aligners are removable and are replaced every 2 weeks.

Pros: Almost invisible; Patients can eat and drink whatever they want
Cons: Will not work for serious dental problems; only available for adults and teens, not children; more expensive option; can be easily lost and costly to replace; treatment may potentially take longer.

Treatment Process

Your doctor will take x-rays, pictures and impressions of your teeth, which Invisalign will use to create a digital 3-D image of them. From these images your doctor will map out a precise treatment plan, including the exact movements of your teeth, and tell you the approximate length of treatment. Using the same technology your doctor will be able to show you a virtual representation of how your teeth will move with each stage of treatment. While every case is unique to each patient, treatment typically takes approximately a year for adults. For teens the length of treatments is comparable to that of braces.

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