Orthodontics and dentofacial orthopedics is the formal name of the dental specialty concerned with the diagnosis, prevention, interception, guidance and correction of bad bites. The purpose of orthodontic treatment is to create a healthy bite—straight teeth that properly meet opposing teeth in the opposite jaw. A good bite makes it easier for you to bite, chew and speak.
Types of treatment
If your teeth are crowded, protrusive, spaced too far apart, meet in an abnormal way, or do not meet at all, correction may be recommended. Braces and aligners are the “appliances” orthodontists most commonly use to guide your teeth into their proper positions. Retainers preserve and stabilize the results of your orthodontic treatment.
In the past, orthodontic treatment was associated with children and teens, but today many adults seek orthodontic treatment to correct long-standing problems, or problems that stem from maturational changes. Orthodontists can help people of any age achieve a healthy and beautiful smile.
An orthodontist can carry out work that aims to achieve the following:
- closing wide gaps between the teeth
- aligning the tips of the teeth
- straightening crooked teeth
- improving speech or chewing ability
- boosting the long-term health of gums and teeth
- preventing long-term excessive wear or trauma of the teeth
- treating an improper bite
Treatment can improve the appearance of the teeth, but it can also lead to better chewing and speech function and help protect teeth from damage or decay, in some cases.
To achieve these goals, the orthodontist uses a range of medical dental devices, including headgear, plates, and braces.
Orthodontic devices can be fixed or removable.
These are the most common devices used in orthodontics. They are used when precision is important.
A person can eat normally with fixed appliances, but some foods and drinks need to be avoided, such as carbonated drinks, hard candy, gum, and other sticky foods.
People who participate in contact sports need to tell their orthodontist, as they may need special gum shields.
Examples of fixed orthodontic appliances include:
These consist of brackets, wires, and bands. Bands are fixed firmly around the teeth and serve as anchors for the appliance, while brackets are usually connected to the front of the teeth.
Wires in the shape of an arch pass through the brackets and are fixed to the bands. As the arch wire is tightened, tension is applied to the teeth. Over time, this moves them into proper position.
Follow-up involves monthly visits to adjust or tighten the braces. Treatment may last from several months to a number of years.
Both clear and colored braces are available.
If a child loses a baby tooth, a space maintainer will stop the two teeth at either side of the spaces from moving into it until the adult tooth comes through. A band is fixed to one of the teeth next to the space, and a wire goes from the band to the other tooth.
Removable space maintainers
These are an alternative to fixed-space maintainers.
Special fixed appliances
These can help control tongue thrusting or thumb sucking. They may be uncomfortable, especially when eating, and so they are only used if necessary.
Removable orthodontic appliances
These may be used to treat minor problems, such as preventing thumb sucking or correcting slightly crooked teeth.
The appliance should only be taken out when cleaning, eating, or flossing. Sometimes, the orthodontist may advice the patient to remove them during certain activities, such as playing a wind instrument or cycling.
Examples of removable appliances include:
This alternative to braces may be useful for adults. They are virtually unnoticeable by other people, and they can be removed to brush the teeth, floss, or eat. An aligner is used for 2 to 3 weeks, then changed for a tigher one.
A strap around the back of the head is attached to a metal wire in the front, or face bow. The aim is to slow down upper jaw growth, and keeping the back teeth in position while the front ones are pulled back.
Lip and cheek bumpers:
These are specially made to relieve the pressure of cheeks or lips on the teeth.
This appliance is designed to make the arch of the upper jaw wider. It consists of a plastic plate with screws that is placed on the palate, or roof of the mouth. The screws put pressure on the joints in the bones, forcing them outward. This expands the size of the area in the roof of mouth.
These are used after treatment to stop the teeth from moving back to their original positions. If modified, they may also be used to stop children from sucking their thumbs.
There are two types of removable retainer:
1.A Hawley retainer is made of metal and acrylic. The acrylic fits on the roof of the mouth and the wire surrounds the anterior teeth.
2.The other is made of clear plastic. It fits over the teeth and looks like an Invisalign aligner.
Permanent retainers are glued, or bonded, to the back of the teeth. It is usually recommended for lower anterior teeth because of the high risk of reverting back to their former position.
In some cases, orthodontists recommend both a fixed permanent one on the lower anterior teeth and the clear plastic aligner-type which then would fit over the entire lower arch.
Splints, or jaw repositioning appliances
These are placed either in the top or lower jaw. They help the jaw close properly. Splints are commonly used for temporomandibular joint disorder (TMJ). TMJ is a condition that can cause pain and dysfunction in the muscles that are involve in jaw movement.
Whatever your device or treatment, it is important to follow both the health professional's instructions and oral hygiene guidelines with care, to ensure the best outcome.