Orthodontics is the branch of dentistry which specializes in the correction of malocclusion.
What is Orthodontics?
Orthodontics is the branch of dentistry which specializes in the correction of malocclusion. A malocclusion is simply a bad bite and come in many forms, however, they can usually be divided into two different categories.
The first category is called a skeletal malocclusion. These are caused by a bad relationship between the sizes of the upper and lower jaws e.g. a small lower jaw and a large upper jaw may create the appearance of a “chinless wonder”.
The other category is called a dental malocclusion because it is caused mainly by bad positioning of the teeth e.g. crowding. Some malocclusions are in fact a combination between skeletal and dental problems.
Why is Orthodontics Necessary?
Most patients seek orthodontic treatment because of the poor appearance of the teeth and/or face caused by the malocclusion. This may be very important especially in young children and teenagers where acceptance by peers and teachers may severely affect their entire outlook on, and approach to life.
There are also other very important reasons why one should have orthodontic treatment. In cases which have a lot of crowding some teeth may not be cleaned very well following routine tooth brushing; as a consequence, plaque, which is a white, gelatinous mixture of bacteria and sugar-like substances, may build up on the teeth and cause cavities or gum disease. This could seriously affect the longevity of the teeth.
Also, cases with bad bites may develop problems in the jaw joints (the temporomandibular joints or TMJs). This may not be evident until the middle years of life or later and may start as clicking sounds heard or felt in the joints and may progress to severe pain in the joints along with annoying headaches.
So, orthodontic treatment can be very important for the normal development, well being and general health of both children and adults.
What Causes Orthodontic Problems?
The root causes of many orthodontic problems are not well understood. It has been suggested that some of these problems are inherited e.g. a child who inherits small jaws from one parent and large teeth from another may have crowding of the teeth. The cause of some other orthodontic problems, however are easily identified.
One of these is thumb and finger sucking, which is in fact, a part of a whole group of habits which may cause malocclusions. Also included in this group are nail biting and tongue sucking or thrusting. The effect of these habits on the teeth will depend on how they are done, and how often. So one individual who sucks his or her thumb all day long may have a severe problem, while a child with an irregular habit may have little or no problem.
Another obvious cause of malocclusion is mouth breathing. Which may be just another habit, or, as is often the case may be caused by blocked nasal passages caused by long lasting colds and allergies. Sometimes, the nasal passages may be blocked by enlarged adenoids, which are tonsillar type tissues located at the back of the nose.
Other causes of malocclusion include cavities, gum disease, loss of permanent teeth and early loss of baby teeth. This shows the importance, once again, of good tooth brushing and care of the teeth to a healthy smile and bite.
At What Age Should Orthodontics be Started?
Orthodontics can be carried out on anyone at any age, providing that the teeth and gums are healthy. There are, however, some advantages to starting treatment at an early age; for instance in cases which are the result of poor growth of the jaws, treatment is best undertaken during the years of growth when it may be possible to alter the rate or direction of growth of the jaws.
The best age to start treatment for these children will be between the ages of seven and nine. A few cases may be started before seven years especially those involving habits and problems interfering with normal function.
Other causes of malocclusion include cavities, gum disease, loss of permanent teeth and early loss of baby teeth. This shows the importance, once again, of good tooth brushing and care of the teeth to a healthy smile and bite.
How is Orthodontics Accomplished?
Below we have outlined the basic steps involved in accomplishing orthodontic treatment.
Diagnostic Records
Before orthodontic treatment can be started it is important to have a full understanding of the problems that the patient has. This involves the taking and analysis of records on the patient. The records taken will include the following:
1. A detailed history of dental and medical problems.
2. Impressions of the teeth – these are molds of the teeth into which plaster will be poured to give
accurate models of the teeth.
3. X-rays of the teeth and skull to help identify hidden problems.
4. Pictures of the teeth and face so as to have a visual indication of what the teeth and gums look
like at the start of treatment.
Treatment
The first important decision to be made by the orthodontist is whether or not teeth need to be extracted to correct the orthodontic problem. If extractions are necessary the decision is then made on which teeth to extract. Patients are usually sent back to their general dentist or to an oral surgeon to have these extractions.
Appliances are then selected by the orthodontist to move the teeth into the desired positions. These appliances are generally called braces by layman and consist of several components. Removable appliances can be taken out of the mouth by the patient and usually have a portion made of acrylic into which the wires which move the teeth are inserted.
All of the appliances are custom designed by the orthodontist to do specific jobs and all require a great deal of care by the patient. Braces often make it difficult to remove food and plaque from the teeth and the patients must brush their teeth carefully many times a day. Removable appliances must also be kept free of plaque and debris and the orthodontist’s instructions must be followed carefully in order to get the desired effects.
After removal – Retention
After appliances are removed it is normal for the teeth to tend to move towards their old positions . To prevent this, retainers are given to the patients at the time of the removal of the braces, these retainers are usually removable or consist of a thin wire stuck to the backs of the teeth. Retention is usually carried out for a period of at least one year, but the specific length of retention will be different from case to case.
The Results?
The end result of orthodontic treatment is teeth which are well aligned and appear pleasing to the eye. In addition the lower face, the lips and the chin should be well related to the rest of the face so that the best possible appearance is realised.
Also, the function of the jaws, the tongue and the cheeks should be improved so as to reduce the possibility of joint and gum problems.
To attain the best possible results, it is important that the patient co-operate to the greatest possible extent. The patient must report for appointments on time, the patient must wear all appliances and accessories as instructed by the orthodontist and the patient must take care to keep teeth and appliances impeccably clean. All of these are as important for a good result as the work that the orthodontist will do in his office.
Common Problems Corrected With Orthodontics?
OPEN BITE – This malocclusion (bad bite) occurs most often with the front teeth, which in this instance are unable to meet when biting on the back teeth. This kind of bad bite is mainly caused by poor oral habits that are practiced in childhood. These habits often continue into adolescence and at times into adulthood.
Such habits include:• Finger sucking.
• Tongue sucking.
• Tongue Thrusting while swallowing.
• Poor tongue posture (tongue lying between the front teeth and sticking forward.)
• Mouth breathing.
Cross Bite
CROSSBITE – This describes when the upper and lower teeth are biting in reverse position. For example, the lower teeth biting in front of the upper teeth. This kind of “reverse bite” can also occur at the sides. Crossbites mainly occur due to delayed loss of baby teeth, which causes the permanent teeth to erupt out of position. All types of crossbites can adversely affect jaw function, cause gum and bone breakdown as well as jaw joint (TMJ) disorder.
CROWDING – Crooked, rotated and overlapped teeth result when there is not enough space available in the jaws to comfortably hold the teeth. The main causes for crowding are:
• Genetic transmission.
• Early or even late loss of some primary teeth.
Besides being unattractive, crowded teeth are very difficult to brush and floss effectively, this in turn causes caries (cavities) as well as the build up of plaque and calculus. All these problems can cause the breakdown of the supporting gum and bone and can eventually lead to tooth loss.
Spacing
SPACING – Spacing between the teeth occurs as a result of:
• Small teeth or conversely relatively large jaws.
• Abnormal oral habits: finger sucking, tongue sucking etc.
• Abnormal tongue posture as well as tongue thrusting during swallowing.
Spacing also occurs if a permanent tooth is extracted and is not replaced with a bridge or an implant. The teeth start to drift into the open space. This can cause an unstable bite and orthodontic treatment is required to correct the bite.
How Long Will My Orthodontic Treatment Last?
We expect your treatment time to last from 12 to 30 months depending on your individual case. Your cooperation in keeping appointments, proper hygiene and care of braces may allow us to finish your orthodontic treatment early.
Informed Consent Form
In keeping with modern practices, we want to present you with all of the possible risks of having Orthodontic treatment before treatment has started. Click here to view the Informed Consent Form which details the possible risks of having Orthodontic treatment.