What is an Orthodontist?
In much the same way as doctors choose to specialize in areas such as cardiology and neurology, dentists can also choose to specialize. Orthodontics is a dental specialty which aims to prevent, diagnose and treat facial and dental irregularities, such as malocclusions (bad bites). Many orthodontic practices are limited to dentofacial orthopedics and general orthodontics but can successfully treat patients of any age.
Orthodontists are fully qualified dentists who embark on a further three years of university-based study and gain extensive clinical experience in an orthodontic residency program. The American Association of Orthodontists (AAO) is the regulating body for this branch of dentistry. Selecting an orthodontist who is a member of this organization adds the assurance that treatment is being administered by an individual with specialty education in oral biology and biomechanics. The AAO recommends that children should first be examined by the orthodontist around the age of seven, to ensure that jaw and tooth irregularities are not beginning to form.
What does an orthodontist do?
Orthodontists are experts in correcting misalignments of the teeth and jaw. There are many debilitating problems associated with misalignment, for example, speech defects, difficulties chewing and difficulty maintaining adequate oral hygiene.
Here is a brief overview of some of the most common issues an orthodontist can successfully treat:
- Anteroposterior deviations – Common examples of anteroposterior deviations include underbite (the lower teeth are positioned further forward than upper teeth) and overbite (the upper teeth are positioned further forward than the lower teeth). Both of these deviations can cause difficulty articulating and chewing.
- Overcrowding – Overcrowding is one of the most common problems orthodontists treat. On occasion, lack of jawbone space means adult teeth cannot erupt in alignment with existing teeth. The orthodontist is able to realign the teeth using a number of unobtrusive devices and treatments.
- Aesthetic issues – In some cases, the shape of the whole face is negatively impacted by malocclusions or a bad bite. The orthodontist can restructure and realign the jaw, lips and teeth to create a beautiful, even smile.
How does an orthodontist realign jaws and teeth?
Initially, the orthodontist conducts a thorough examination of the jaw and teeth. Panoramic x-rays and study models (bite impressions) will be taken prior to the orthodontist making treatment recommendations. The orthodontist will recommend the best treatment plan for the patient’s particular condition.
Here is a brief overview of some of the treatments orthodontists may use:
- Dental braces – The combination of brackets (which are affixed to each individual tooth), and an archwire (which connects each bracket) are commonly placed to gently train the teeth into proper alignment. Dental braces can be made of metal, ceramics or clear (“invisible”) materials.
- Headgear and facemasks – These devices are generally used to correct a developmental problem, such as an overbite or an underbite. In addition to the dental braces, the orthodontist will design the headgear and/or facemask which fit around the head and attaches to the braces. This structure will further encourage the teeth and jawbone into alignment.
- Retainers – After the orthodontist has realigned the teeth using dental braces, removable devices or a headgear, a retainer may then be provided to ensure that the teeth do not begin to move back toward their original positions. Retainers are generally worn until the underlying bone has reformed into the correct position.
If you have any questions about orthodontists and the treatments they provide, please contact our office.
Who Can Benefit From Orthodontics?
Orthodontics is a specialized branch of dentistry that is concerned with diagnosing, treating and preventing malocclusions (bad bites) and other irregularities in the jaw region and face. Orthodontists are specially trained to correct these problems and to restore health, functionality and a beautiful aesthetic appearance to the smile. Though orthodontics was originally aimed at treating children and teenagers, almost one third of orthodontic patients are now adults. A person of any age can be successfully treated by an orthodontist.
A malocclusion (improper bite) can affect anyone at any age, and can significantly impact the individual’s clarity of speech, chewing ability and facial symmetry. In addition, a severe malocclusion can also contribute to several serious dental and physical conditions such as digestive difficulties, TMJ, periodontal disease and severe tooth decay. It is important to seek orthodontic treatment early to avoid expensive restorative procedures in the future.
What problems can orthodontics treat?
Orthodontics can treat a wide range of dental problems and in most cases, completely realign the teeth. Orthodontists may work alone, or in combination with a maxillofacial surgeon.
The typical irregularities requiring orthodontic treatment are as follows:
- Overcrowding – An overcrowded mouth means there is insufficient space within the jaw for all of the adult teeth to fit naturally. Overcrowding may lead to displaced, rotated or completely misaligned teeth.
- Overbite – An overbite refers to the protrusion of the maxilla (upper jaw) relative to the mandible (lower jaw). An overbite gives the smile a “toothy” appearance and the chin looks like it has receded.
- Underbite – An underbite, also known as a negative underjet, refers to the protrusion of the mandible (lower jaw) in relation to the maxilla (upper jaw). An underbite makes the chin look overly prominent. Developmental delays and genetic factors generally cause underbites and overbites.
How can orthodontics help?
Orthodontic dentistry offers techniques which will realign the teeth and revitalize the smile. There are several treatments the orthodontist may use, depending on the results of panoramic x-rays, study models (bite impressions) and a thorough visual examination.
Fixed dental braces can be used to expediently correct even the most severe case of misalignment. These braces consist of metal or ceramic brackets which are affixed to each tooth and an archwire which is used to gradually move the teeth through the duration of the treatment.
Removable appliances include headgear (which consists of a metal wire device attached to customized braces), retainers, Invisalign® aligners (which are almost invisible to the naked eye), palate expanders and tooth movers. Faceguards are generally used to correct developmental delays in both the upper and lower jaw, and palate expanders are used to combat overcrowding.
Whatever the dental irregularity or the age of the individual, orthodontic appliances can properly realign the teeth and create a beautiful smile.
If you have any questions or concerns about orthodontic treatments or how they can benefit you, please contact our office.
Orthodontic Treatment (Braces)
The benefits of orthodontic treatment often go beyond the obvious physical changes of an improved bite and straighter teeth; it’s also a great way to improve a person’s overall self-image. While having beautiful straight teeth is important, even more important is the need to alleviate any potential health problems associated with the teeth or jaw. Crooked teeth or jaw problems may contribute to improper cleaning of teeth, leading to tooth decay and, possibly, gum disease or total tooth loss. Orthodontic problems that go untreated can lead to chewing and digestion difficulties, speech impairments, and abnormal wear of tooth surfaces. Over time, excessive strain on gum tissue and the bone that supports the teeth can affect the jaw joints leading to problems such as headaches or face and neck pain.
The American Association of Orthodontics recommends that children get an orthodontic evaluation no later than age 7. Though orthodontic treatment can be done at any age, timely treatment ensures maximum dental health.
With all of the recent advancements in orthodontics, wearing braces has never been easier. State-of-the-art appliances and treatments are now available, from traditional metal braces, to clear and tooth colored brackets, to NASA type wires that are heat activated and require fewer adjustments! Some patients may even be candidates for treatment with Invisalign, a revolutionary way to straighten teeth using clear, retainer type aligners that require no braces or wires!
If treatment is necessary, we will thoroughly discuss which treatment option is best suited for you!
Reasons for orthodontic treatment (braces) adults & children:
- Breathing or swallowing problems – Mouth breathing can lead to snoring and sleep apnea.
Crossbite – One or more upper teeth bite inside the lower teeth (towards the tongue).
Crowding – Involving extra teeth or malpositioned teeth.
Deep Overbite – The lower front teeth bite into the upper tissue of the upper teeth.
Disfiguring of the face & mouth – Affects the development of the jaw and position of the teeth.
Jaw & jaw joint pain
Missing or extra teeth – Due to tooth decay, injuries, or inherited problems.
Overjet (protruding upper teeth) – Upper teeth that protrude beyond normal and are usually associated with a short lower jaw.
Self-image – An attractive smile can boost a person’s self-image and confidence.
Spacing between teeth – Teeth are missing or may be too small or too large.
Speech, chewing or biting problems
Underbite (lower jaw protrusion) – Lower jaw is longer than the upper jaw.
Specific to children:
- Finger or thumb sucking – These habits can cause protrusion of the upper incisor teeth, and mouth breathing.
- Teeth erupting out of position – Can be guided to proper alignment.
What does orthodontic treatment involve?
Orthodontic treatment involves three phases:
1. Planning Phase – Your first couple of visits may include the following:
- A medical and dental history evaluation.
- Castings or “molds” of your teeth.
- Computer generated photograph of the head and neck that will aid in planning.
- Photographs of your face and mouth.
- X-rays of the teeth and jaws.
After careful planning, your orthodontist will design and apply braces or fabricate custom-made appliances for you.
2. Active Phase – Active treatment involves visiting your orthodontist on a regular basis for adjustments and following specific treatment requirements to ensure successful treatment.
3. Retention Phase – When treatment is completed, the braces and/or appliances are removed and a new appliance is made. Usually these retainers are removable and will maintain the changes made to your teeth if worn continuously until the teeth and bone are stabilized in their new positions.
Treatment and retention times vary depending on each individual case. Your orthodontist will ensure you have a successful treatment for a beautiful smile that can last a lifetime.
Orthodontics can not only help straighten your teeth, giving you an appealing smile, but can greatly contribute to the health of your jaw, teeth and sometimes your overall health.
Care Following Orthodontics – Retainers
When braces are finally removed, the “retention” phase begins for most individuals. The objective of this phase is to ensure the teeth do not regress back to their previous position. A retainer will be used to maintain the improved position of the teeth. A retainer is a fixed or removable dental appliance which has been custom-made by the orthodontist to fit the teeth. Retainers are generally made from transparent plastic and thin wires to optimize the comfort of the patient.
Retainers are worn for varying amounts of time, depending on the type of orthodontic treatment and the age of the patient. Perseverance and commitment are required to make this final stage of treatment successful. If the retainer is not worn as directed by the orthodontist, treatment can fail or take much longer than anticipated.
What types of retainer are available?
There are a variety of retainers available; each one geared towards treating a different kind of dental problem. The orthodontist will make a retainer recommendation depending on the nature of the original diagnosis and the orthodontic treatment plan.
The following are some of the most common types of retainers:
- Hawley retainer – The Hawley retainer consists of a metal wire on an acrylic arch. The metal wire may be periodically adjusted by the orthodontist to ensure the teeth stay in the desired position. The acrylic arch is designed to fit comfortably on the lingual walls or palate of the mouth.
- Essix – The Essix retainer is the most commonly used vacuum formed retainer (VFR). A mold is initially made of the teeth in their new alignment, and then clear PVC trays are created to fit over the arch in its entirety. VFR’s are much cheaper than many other types of retainers and also do not affect the aesthetic appearance of the smile in the same way as the Hawley retainer. The disadvantage of VFR’s is that they break and scratch more easily than other types of retainers.
- Fixed retainers – A fixed retainer is somewhat similar to a lingual brace in that it is affixed to the tongue side of a few teeth. Usually, a fixed retainer is used in cases where there has been either rapid or substantial movement of the teeth. It usually consists of a single wire. The inclination of the teeth to move rapidly means they are also more likely to regress back to their previous position if a fixed retainer is not placed.
What do I need to consider when using a retainer?
There are a few basic things to consider for proper use and maintenance of your retainer.
Don’t lose the appliance – Removable retainers are very easy to lose. It is advisable to place your retainer in the case it came in while eating, drinking and brushing. Leaving a retainer folded in a napkin at a restaurant or in a public restroom can be very costly if lost because a replacement must be created. A brightly colored case serves as a great reminder.
Don’t drink while wearing a retainer – It is tempting to drink while wearing a retainer because of the unobtrusive nature of the device. However, excess liquid trapped under the trays can vastly intensify acid exposure to teeth, increasing the probability of tooth decay.
Don’t eat while wearing a retainer – It can be difficult and awkward to eat while wearing a removable retainer and it can also damage the device. Food can get trapped around a Hawley retainer wire or underneath the palate, causing bad breath. When worn on the upper and lower arches simultaneously, VFR retainers do not allow the teeth to meet. This means that chewing is almost impossible.
Clean the retainer properly – Removable retainers can become breeding grounds for calculus and bacteria. It is essential to clean the inside and outside thoroughly as often as possible. Hawley retainers can be cleaned with a toothbrush. Because harsh bristles can damage the PVC surface of a VFR, denture cleaner or a specialized retainer cleaner is recommended for this type of device.
Wear the retainer as directed – This phase of treatment is critical. The hard work has been done, the braces are off and now it is tempting not to wear the retainer as often as the orthodontist recommends. Retainers are needed to give the muscles, tissues and bones time to stabilize the teeth in their new alignment. Failure to wear the retainer as directed can have regrettable consequences, such as teeth returning to their original position, added expense and lost time.
If you have any questions or concerns about retainers, please contact our office.
One of the primary concerns people often have about dental braces is the aesthetic impact of the metalwork on their smile. Especially for adults, the prospect of wearing unattractive metal braces for long periods of time can be very discouraging. Invisalign® offers an almost invisible aligning system that straightens teeth fast and contains no metal.
Invisalign® treatment consists of a series of custom-made aligning trays. The dentist changes the trays every several weeks to fit the new tooth configuration. In addition to the reduced visual impact, Invisalign® aligning trays can be temporarily removed for important occasions – meaning that treatment duration is patient-controlled. A great number of people report complete satisfaction with both the Invisalign® treatment and the stunning results.
What kind of bite problems can Invisalign® correct?
Invisalign® corrects the same dental problems as traditional metal braces; the only difference is that Invisalign® trays are almost invisible to the naked eye, and can be removed at will.
Here are some problems that are commonly corrected with Invisalign®:
- Overcrowding – This occurs when there is too little space for the teeth to align normally in the mouth. Overcrowding can cause tooth decay and increase the likelihood of gum disease.
- Large gaps between teeth – This can sometimes occur because teeth are missing or because the jaw continues to grow abnormally.
- Crossbite – This common dental problem occurs when one or multiple upper teeth bite inside the lower teeth. As a consequence, uneven wear can lead to bone erosion and gum disease.
- Overbite – This problem occurs when the upper teeth project further than, or completely cover, the lower teeth. Eventually, jaw pain and TMJ may occur.
- Underbite – This is the inverse of the overbite; the lower teeth project further than, or completely cover, the upper teeth. Eventually, jaw pain and TMJ can occur.
What advantages does Invisalign® offer over traditional braces and veneers?
Traditional dental braces, Invisalign® aligning trays and dental veneers are three different ways to perfect the alignment of the teeth. There are many different considerations to make when considering which treatment will be best, and each of these options works better in certain situations.
Invisalign® differs from traditional braces in that the aligning trays are fully removable. This means that more discipline and commitment is required from the patient. This is not usually a problem since the trays are comfortable and nearly invisible. Almost identical results can be obtained by using either treatment.
Invisalign® is preferable to veneers in many cases because unlike veneers, Invisalign® actually straightens the teeth. Veneers are thin covers that the dentist permanently affixes to the teeth. Teeth must be etched beforehand, meaning that to remove dental veneers, an alternative covering must be constructed. In addition to being somewhat expensive, veneers can break and often last for less than 20 years.
What does Invisalign® treatment involve?
First, the dentist needs to devise an initial treatment plan before creating the special aligning trays. Three-dimensional digital images are taken of the entire jaw. These images allow the dentist to move specific teeth on the screen, view the jaw from different angles, and also foresee what the face might look like in years to come. In essence, this technology can show how Invisalign® trays will change the facial aesthetics.
Once planning is complete, a unique set of aligners is made. The total amount of aligners required varies with each individual case, but 20-29 sets per arch is typical.
What are some considerations when wearing Invisalign® trays?
Life with Invisalign® aligning trays may take several weeks to get used to. The trays should be worn constantly, except when eating and drinking. It is important to remove the trays when consuming food or drink because food can become trapped between the tray and the teeth, causing tooth decay.
Usually, new trays are necessary every two weeks and progress between appointments can be seen with the naked eye. There is no doubt that Invisalign® aligning trays have revolutionized orthodontics. Invisalign® is renowned for being both comfortable and effective.
If you have questions about Invisalign®, please ask your dentist.