Orthodontic Care

If you have crooked teeth or a misaligned bite, there are a variety of orthodontic treatments that can help improve the appearance and function of your teeth and jaw, such as braces and retainers.

According to the UK’s National Health Service , teeth that are straighter and better aligned are often easier to clean, and can reduce strain on the muscles and joints of the jaw. Not to mention, your smile will look even better.

These are some of the most common reasons that people seek orthodontic treatment:

• Protruding upper front teeth: This is one of the most common dental problems, particularly because protruding teeth are more prone to damage during falls or contact sports
• Crowding: If you have a narrow jaw, it may mean there is not enough room for your teeth, resulting in crowding
• Asymmetry: In some people, the centre of their upper and lower teeth do not match, giving their teeth an asymmetrical or crooked appearance
• Impacted teeth: This is when the adult teeth come through and  grow in the wrong position
• Deep overbite: When your upper teeth cover the lower teeth too much
• Reverse bite: When your upper teeth bite inside the lower teeth
• Open bite: When your front teeth remain apart when your back teeth meet; the tongue is often still visible between the upper and lower front teeth
• Crossbite: Here, the upper teeth rest significantly inside or outside the lower teeth, which can make it difficult to bite or chew and may also cause the jaw to shift to one side as it grows

There are a variety of causes for abnormalities of the teeth and jaw. Sometimes problems that affect normal development of the teeth are genetic, while other times teeth can be damaged in an accident, such as a sports injury. However, in many cases, there is no known cause for abnormalities with a person's teeth and jaw. 

Orthodontic treatment options vary depending on your individual needs, however most treatments occur in two phases:

• Active phase: This involves applying slight pressure to your teeth over a long period of time to move them into proper alignment and correct the bite. Braces are commonly used during this phase.
• Retention phase: Once braces have moved your teeth into the desired positions, a retainer is used to maintain or hold the teeth in their new positions while your bite stabilises.

Braces

Braces are metal devices used in orthodontics that align and straighten teeth. In their entirety, braces work by applying continuous pressure over a period of time to slowly move teeth in a specific direction.

The time required for braces varies from person to person depending on the severity of the problem, the distance the teeth must travel, and the health of the teeth, gums, and supporting bone. On average, however, braces are worn for one to three years.

When applying braces, the orthodontist will attach small brackets to your teeth with special dental bonding agents. You can choose brackets made of metal, ceramic or plastic. In most cases though, stainless steel brackets are used.

Your orthodontist will then place wires called arch wires through the brackets. They act as tracks to create the "path of movement" that guides the teeth to their correct positions. As treatment progresses, your teeth will change position and your orthodontist will need to adjust the braces accordingly.

You will usually experience some minor discomfort within the first few weeks of getting braces. Your teeth may be sore and the wires, brackets and bands may also irritate your tongue, cheeks or lips.  Your orthodontist will usually recommend topical and other medications to help ease any discomfort.

Retainer

After your braces are removed, you will need a retainer to hold your teeth in their new positions. Retainers are individually designed to prevent teeth from reverting to their original positions. They can take the form of a removable appliance or a fixed wire bonded at the back of your front teeth.

If you’ve always been bothered by crooked teeth but dread the thought of wearing braces for several years – accelerated orthodontics is a viable option. Accelerated orthodontics is a new concept in orthodontic treatment that can accomplish the same results as traditional orthodontics, but in much less time.

With traditional orthodontics, patients typically need to wear braces for 18-36 months. However, teeth can be moved around four times faster with accelerated orthodontics, reducing treatment time just three to eight months.

Traditionally, orthodontic treatment takes such a long time because of insufficient size, shape and responsiveness of the bone that surrounds the teeth. Accelerated orthodontics solves this dilemma with a minor surgical procedure, usually performed by a periodontist (gum specialist) about a week after the braces are applied. Done under local anesthesia, the in-office surgical procedure alters the gums and bones that hold the teeth in place, which allows the teeth to move into their proper places more quickly. The surgery is only minor, and generally causes the same amount of discomfort as a dental cleaning.

Accelerated orthodontics is effective in most cases where traditional orthodontics is the recommended treatment. The cost is also similar to traditional orthodontic treatment, even though the length of treatment is shorter. Because accelerated orthodontics is fairly new though, there are no long-term studies on how well it works. 

All forms of dental treatment have potential risks and limitations. Fortunately, there are few risks involved in orthodontic treatment. And if they do occur, they are usually of minor consequence.

It is a great idea to be aware of the potential risks and limitations which apply to your treatment and to discuss any questions or concerns you have with your orthodontist. He or she may be able to offer alternative treatment options that you are more comfortable with.

The main risks and limitations of orthodontic care are:

• Increased risk of gum and tooth problems: If the teeth are not cleaned properly, problems such as gum disease, tooth decay, and decalcification (white or coloured marks on the teeth) can result. Orthodontic appliances themselves do not cause these problems and, in general, orthodontic treatment lessens the possibility of tooth loss or gum infection due to misalignment of the teeth or jaws. However, it takes more effort to maintain adequate oral hygiene if you are wearing braces or retainers, so the risk of any of these problems occurring is greater during orthodontic treatment.
• Possiblity of relapse: Teeth may have a tendency to change their positions after treatment, with the most vulnerable teeth being those at the front. The Australian Society of Orthodontists emphasise that the long term, faithful wearing of retainers will reduce this tendency.
• Root shortening: In some patients the length of the roots of the teeth may be shortened during orthodontic treatment. It is nearly impossible to predict who this might affect. Root shortening is usually insignificant, but on very rare occasions it may become a threat to the longevity of the teeth involved.
• Unusual jaw growth: Insufficient, excessive, or asymmetrical changes in the growth of the jaws may limit the orthodontist’s ability to achieve the desired result. Unusual growth may also increase the treatment time.
• Prolonged treatment time: The total time required to complete treatment may be longer than the estimate. However, this is usually the result of not following the orthodontist’s instructions in wearing the braces and retainer.