An orthodontic problem is called a malocclusion or ‘bad bite’. Some examples of causes of malocclusion include crowded teeth, extra teeth, missing teeth or misaligned jaws. Most malocclusions are inherited, although some can be acquired. Acquired malocclusions can be caused by accidents, early or late loss of baby teeth, or thumb-sucking over a long period of time.
Patients of almost any age can benefit from treatment for orthodontic problems. Typically, braces are worn between the ages of 10 and 14; this is the period of development in which the head and mouth are still growing and teeth are more accessible to straightening. If you have been advised that your child needs braces, make sure you discuss it thoroughly with them. Having braces can be quite traumatic. These days, more and more adults are also wearing braces to correct minor problems and to improve their smiles. Tom Cruise got his braces at 39!
Orthodontics is a dental specialty concerned with aligning the teeth and jaws to improve your smile and oral health. The specialist dentists who carry out this work are called orthodontists. They are best known by their tools of the trade – braces.
There are several different kinds of braces, which are metal or plastic brackets bonded to the teeth. They don’t have to be bonded to the front of teeth, although that usually works best. Lingual braces are brackets that attach to the back of teeth, hidden from view. Bands are the old-fashioned type of braces that cover most of your teeth with metal strips that wrap around the teeth. Invisalign is a more modern option. It uses thermoplastic aligners to straighten teeth. Most braces use wires to move the teeth into the desired position.
Every child should have an orthodontic evaluation by age 7. If your child needs treatment, it is better to do it before adulthood as the treatment takes longer for adults. Also, since an adult’s bones are no longer growing, some corrections cannot be accomplished with braces alone.
Orthodontia is a multi-stage process:
- Pre-treatment records are made to make an accurate diagnosis. They include medical/dental history, clinical examination, plaster study models of teeth, photos of your face and teeth and X-rays of your mouth and head. This information will be used to decide on the best treatment.
- A custom treatment plan is made which includes recommendations for a specific treatment appliance best suited to correct your orthodontic problem. There are a variety of different orthodontic appliances that may be used.
- The active treatment phase. Orthodontic appliances are in place. Appliances are adjusted periodically so that the teeth are moved correctly and efficiently. The time required for orthodontic treatment varies from person to person. An important factor in how long a patient wears braces is how well he or she cooperates during treatment. Following instructions is the most effective way to shorten treatment time!
- Retention phase. The patient typically wears a retainer so that the teeth stay in their new positions.
Note that for severe orthodontic problems, surgery may be necessary.
Children have always hated braces, not only because of the pain and discomfort, but also because of the dreaded ‘metal mouth’ taunts. Fortunately, modern braces are less noticeable than their predecessors. Brackets, the part of the braces that hold the wires, are bonded to the front of the teeth. These brackets can be metal, clear, or tooth-coloured. Wires that are used for braces today are also less noticeable. Today’s wires are made of ‘space age’ materials that exert a steady, gentle pressure on the teeth, making the tooth-moving process faster and more comfortable for patients. In some cases, brackets may be put on the back of the teeth.
Patients typically wear braces for about 24 months, although this varies based on the severity of the problem, the health of the teeth, gums and supporting bone and how closely the patient follows instructions. Usually, adult treatment takes a little longer.
During the treatment phase of orthodontia, it is necessary to periodically re-tighten the interconnecting wires. This causes mild pressure on the brackets or bands to shift teeth or jaws gradually into a desired position. Your teeth and jaws may feel slightly sore after such a visit, but the discomfort is short-lived.
If you wear braces, you must avoid certain foods. These include sweets, chips and soft drink. Sugary and starchy foods generate acids and plaque that can cause tooth decay and promote gum disease. Cut healthy, hard foods like carrots or apples into smaller pieces. Al all cost avoid sticky, chewy sweets such as caramel, which can cause wire damage and loosen brackets. Also to be avoided are hard and crunchy snacks such as popcorn, nuts and hard lollies because these can break braces.
Oral hygiene is extremely important during the treatment phase of orthodontia. Insufficient cleaning while wearing braces can cause enamel staining around brackets or bands. Braces have tiny spaces where food particles and plaque get trapped. Brush carefully after every meal with fluoride toothpaste and a soft-bristled toothbrush. Rinse thoroughly and check your teeth in the mirror to make sure they’re clean. Floss between braces and under wires with the help of a floss threader.
Have your teeth cleaned professionally at least every six months to keep your gums and teeth healthy.
Space Maintainers – avoiding orthodontic treatment
Space maintainers can be very important to your child’s long-term oral health. If your child loses a baby tooth early through decay or injury, his or her other teeth could shift and begin to fill the vacant space. When your child’s permanent teeth emerge, there’s not enough room for them. The result is crooked or crowded teeth and difficulties with chewing or speaking.
Space maintainers are used to hold the spot left by the lost tooth until the permanent tooth emerges. The space maintainer might be a band or a temporary crown attached to one side of the vacant space. Later, as the permanent tooth emerges, the device is removed. This simple precautionary measure can eliminate the need for braces years down the track.
This is a new way to straighten teeth using almost invisible, removable clear appliances. To see a video about this procedure click here.