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Orthodontic
treatment can improve your dental health and change your facial appearance
for the better, and it can boost your self-esteem. It can provide you with
the chance to participate in improving the way you look. Patients often feel
more self-confident even before treatment is completed.
Facts About
Orthodontics
What
is orthodontics?
Orthodontics is the branch of dentistry that specializes in the diagnosis,
prevention and treatment of dental and facial irregularities. The technical
term for these problems is "malocclusion," which means "bad bite." The
practice of orthodontics requires professional skill in the design,
application and control of corrective appliances, such as braces, to bring
teeth, lips and jaws into proper alignment and to achieve facial balance.
Is it
ever too late for a person to get braces?
No. Because healthy teeth can be moved at any age, an orthodontist can
improve the smile of practically anyone-in fact, orthodontists regularly
treat patients in their 50s, 60s and older!
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At what age can people have orthodontic
treatment?
Children and adults can both benefit from orthodontics, because
healthy teeth can be moved at almost any age. Because monitoring growth
and development is crucial to managing some orthodontic problems well, it
is recommended that all children have an orthodontic screening no later
than age 7. Some orthodontic problems may be easier to correct if treated
early. Waiting until all the permanent teeth have come in, or until facial
growth is nearly complete, may make correction of some problems more
difficult.
An orthodontic evaluation at any age is advisable if a parent, family
dentist or the patient’s physician has noted a problem.
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What causes orthodontic problems
(malocclusions)
Most malocclusions are inherited, but some are acquired. Inherited
problems include crowding of teeth, too much space between teeth, extra or
missing teeth, and a wide variety of other irregularities of the jaws,
teeth and face.
Acquired malocclusions can be caused by trauma (accidents), thumb, finger
or dummy (pacifier) sucking, airway obstruction by tonsils and adenoids,
dental disease or premature loss of primary (baby) or permanent teeth.
Whether inherited or acquired, many of these problems affect not only
alignment of the teeth but also facial development and appearance as well.
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What are the most commonly treated
orthodontic problems?
Crowding: Teeth may be aligned poorly because the dental arch is small
and/or the teeth are large. The bone and gums over the roots of extremely
crowded teeth may become thin and recede as a result of severe crowding.
Impacted teeth (teeth that should have come in, but have not), poor biting
relationships and undesirable appearance may all result from crowding.
Overjet or protruding upper teeth: Upper front teeth that protrude
beyond normal contact with the lower front teeth are prone to injury,
often indicate a poor bite of the back teeth (molars), and may indicate an
unevenness in jaw growth. Commonly, protruded upper teeth are associated
with a lower jaw that is short in proportion to the upper jaw. Thumb and
finger sucking habits can also cause a protrusion of the upper incisor
teeth.
Deep overbite: A deep overbite or deep bite occurs when the lower
incisor (front) teeth bite too close or into the gum tissue behind the
upper teeth. When the lower front teeth bite into the palate or gum tissue
behind the upper front teeth, significant bone damage and discomfort can
occur. A deep bite can also contribute to excessive wear of the incisor
teeth.
Open bite: An open bite results when the upper and lower incisor
teeth do not touch when biting down. This open space between the upper and
lower front teeth causes all the chewing pressure to be placed on the back
teeth. This excessive biting pressure and rubbing together of the back
teeth makes chewing less efficient and may contribute to significant tooth
wear.
Spacing: If teeth are missing or small, or the dental arch is very
wide, space between the teeth can occur. The most common complaint from
those with excessive space is poor appearance.
Crossbite: The most common type of a crossbite is when the upper
teeth bite inside the lower teeth (toward the tongue). Crossbites of both
back teeth and front teeth are commonly corrected early due to biting and
chewing difficulties.
Underbite or lower jaw protrusion: About 3 to 5 percent of the
population has a lower jaw that is to some degree longer than the upper
jaw. This can cause the lower front teeth to protrude ahead of the upper
front teeth creating a crossbite. Careful monitoring of jaw growth and
tooth development is indicated for these patients.
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Why is orthodontic treatment important?
Crooked and crowded teeth are hard to clean and maintain. This may
contribute to conditions that cause not only tooth decay but also eventual
gum disease and tooth loss. Other orthodontic problems can contribute to
abnormal wear of tooth surfaces, inefficient chewing function, excessive
stress on gum tissue and the bone that supports the teeth, or misalignment
of the jaw joints, which can result in chronic headaches or pain in the
face or neck.
When left untreated, many orthodontic problems become worse. Treatment by
a specialist to correct the original problem is often less costly than the
additional dental care required to treat more serious problems that can
develop in later years.
The value of an attractive smile should not be underestimated. A pleasing
appearance is a vital asset to one’s self-confidence. A person's
self-esteem often improves as treatment brings teeth, lips and face into
proportion. In this way, orthodontic treatment can benefit social and
career success, as well as improve one’s general attitude toward life.
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How long will orthodontic treatment
take?
In general, active treatment time with orthodontic appliances (braces)
ranges from one to three years. Interceptive, or early treatment
procedures, may take only a few months. The actual time depends on the
growth of the patient’s mouth and face, the cooperation of the patient and
the severity of the problem. Mild problems usually require less time, and
some individuals respond faster to treatment than others. Use of rubber
bands and/or headgear, if prescribed by the orthodontist, contributes to
completing treatment as scheduled.
While orthodontic treatment requires a time commitment, patients are
rewarded with healthy teeth, proper jaw alignment and a beautiful smile
that lasts a lifetime. Teeth and jaws in proper alignment look better,
work better, contribute to general physical health and can improve
self-confidence.
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What are orthodontic study records?
Diagnostic records are made to document the patient's orthodontic
problem and to help determine the best course of treatment. As orthodontic
treatment will create many changes, these records are also helpful in
determining progress of treatment. Complete diagnostic records typically
include a medical/dental history, clinical examination, plaster study
models of the teeth, photos of the patient's face and teeth, a panoramic
or other X-rays of all the teeth, a facial profile X-ray, and other
appropriate X-rays. This information is used to plan the best course of
treatment, help explain the problem, and propose treatment to the patient
and/or parents.
The profile X-ray, or cephalometric film, shows the facial form, growth
pattern, and inclination of the front teeth (if teeth are tipped or
tilted), which are essential in planning comprehensive treatment.
Panoramic or other dental X-rays are used to locate impacted teeth,
missing teeth, and shortened or damaged tooth roots, to determine the
amount of bone supporting teeth, and to evaluate position and development
of permanent teeth that have not yet come in, among other things. From the
necessary records, a custom treatment plan is created for each patient.
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How is treatment accomplished?
Custom-made appliances, or braces, are prescribed and designed by the
orthodontist according to the problem being treated. They may be removable
or fixed (cemented and/or bonded to the teeth). They may be made of metal,
ceramic or plastic. By placing a constant, gentle force in a carefully
controlled direction, braces can slowly move teeth through their
supporting bone to a new desirable position.
Orthopedic appliances, such as headgear, bionator, Herbst and maxillary
expansion appliances, use carefully directed forces to guide the growth
and development of jaws in children and/or teenagers. For example, an
upper jaw expansion appliance can dramatically widen a narrow upper jaw in
a matter of months. Over the course of orthodontic treatment, a headgear
or Herbst appliance can dramatically reduce the protrusion of upper
incisor teeth (the top four front teeth) or retrusion of the lower jaw (a
lower jaw that is too far behind the upper jaw), while making upper and
lower jaw lengths more compatible.
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Are there less noticeable braces?
Today’s braces are generally less noticeable than those of the past
when a metal band with a bracket (the part of the braces that hold the
wire) was placed around each tooth. Now the front teeth typically have
only the bracket bonded directly to the tooth, minimizing the "tin grin."
Brackets can be metal, clear or colored, depending on the patient’s
preference. In some cases, brackets may be bonded behind the teeth
(lingual braces). Modern wires are also less noticeable than earlier ones.
Some of today’s wires are made of "space age" materials that exert a
steady, gentle pressure on the teeth, so that the tooth-moving process may
be faster and more comfortable for patients. A type of clear orthodontic
wire is currently in an experimental stage.
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How have new "high tech" wires changed
orthodontics?
In recent years, many advances in orthodontic materials have taken
place. Braces are smaller and more efficient. The wires now being used are
no longer just stainless steel. They are made of alloys of nickel,
titanium, copper and cobalt, and some of the wires are heat-activated.
These new kinds of wires cause the teeth to continue to move during
certain phases of treatment, which may reduce the number of appointments
needed to make adjustments to the wires.
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How do braces feel?
Most people have some discomfort after their braces are first put on
or when adjusted during treatment. After the braces are on, teeth may
become sore and may be tender to biting pressures for three to five days.
Patients can usually manage this discomfort well with whatever pain
medication they might commonly take for a headache. The orthodontist will
advise patients and/or their parents what, if any, pain relievers to take.
The lips, cheeks and tongue may also become irritated for one to two weeks
as they toughen and become accustomed to the surface of the braces.
Overall, orthodontic discomfort is short-lived and easily managed.
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Do teeth with braces need special care?
Patients with braces must be careful to avoid hard and sticky foods.
They must not chew on pens, pencils or fingernails because chewing on hard
things can damage the braces. Damaged braces will almost always cause
treatment to take longer, and will require extra trips to the
orthodontist’s office.
Keeping the teeth and braces clean requires more precision and time, and
must be done every day if the teeth and gums are to be healthy during and
after orthodontic treatment. Patients who do not keep their teeth clean
may require more frequent visits to the dentist for a professional
cleaning.
The orthodontist and staff will teach patients how to best care for their
teeth, gums and braces during treatment. The orthodontist will tell
patients (and/or their parents) how often to brush, how often to floss,
and, if necessary, suggest other cleaning aids that might help the patient
maintain good dental health.
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How important is patient cooperation during orthodontic treatment?
Successful orthodontic treatment is a "two-way street" that requires a
consistent, cooperative effort by both the orthodontist and patient. To
successfully complete the treatment plan, the patient must carefully clean
his or her teeth, wear rubber bands, headgear or other appliances as
prescribed by the orthodontist, and keep appointments as scheduled. Damaged
appliances can lengthen the treatment time and may undesirably affect the
outcome of treatment. The teeth and jaws can only move toward their
desired positions if the patient consistently wears the forces to the
teeth, such as rubber bands, as prescribed. Patients who do their part
consistently make themselves look good and their orthodontist look smart.
To keep teeth and gums healthy, regular visits to the family dentist must
continue during orthodontic treatment. Adults who have a history of or
concerns about periodontal (gum) disease might also see a periodontist
(specialist in treating diseases of the gums and bone) on a regular basis
throughout orthodontic treatment.
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