- straightens teeth that are rotated, tilted, or otherwise improperly aligned
- corrects crowded or unevenly spaced teeth
- corrects bite problems
- aligns the upper and lower jaws
Although orthodontic treatment can be performed at any age, children are easier, faster, and less expensive to treat than adults. Most often orthodontic treatment is used on older children and adolescents whose teeth are still developing. However some types of problems are corrected more readily before all of the permanent teeth have erupted and facial growth is complete. If a child’s permanent lower incisors erupt behind each other, braces may be required at a young age. Crossbites are usually treated early because they can interfere with biting and chewing. Early treatment also is used when thumb- or finger-sucking has affected teeth positioning.
Minor misalignment or crowding may not require treatment. However untreated malocclusions can cause the following:
- teeth that are partially impacted or fail to erupt
- lips, tongue, or cheeks that contact biting surfaces due to poor tooth alignment
- inefficient or uncomfortable biting, chewing, and digestion
- speech impairments
- teeth that are hard to clean, leading to cavities and gum disease
- abnormal wear of tooth surfaces
- chipped teeth
- loosening or fracturing of a misaligned tooth that is overstrained
- injury to a protruding upper incisor
The orthodontist compiles pretreatment records that are used for diagnosis, determining the course of treatment, and measuring the progress of treatment. These records may include:
- a complete medical and dental history
- a clinical examination
- x rays revealing the positions of erupted and unerupted teeth, development of unerupted teeth, any missing or impacted teeth, shortened or damaged tooth roots, and the amount of bone supporting the teeth
- a facial-profile x ray or cephalometric film revealing the sizes, positions, and relationships of the teeth and jaw, as well as facial form, growth pattern, and the inclinations of tipped or tilted incisors
- plastic impressions of the bite and plaster models made from the impressions
- photographs and other measurements of the teeth and face
Based on the diagnosis the orthodontist develops a custom treatment plan and designs the appropriate corrective appliances that will gradually straighten or move the teeth. Severe overcrowding may necessitate the extraction of permanent teeth, usually the premolars, to create space prior to using braces to move teeth.
By applying constant gentle pressure in a specific direction, braces can slowly move teeth through the supporting bone to a new position. Springs and wires put pressure on teeth in order to straighten them. The pressure causes bone in the jaw to dissolve in front of the moving tooth as new bone grows behind the tooth. Braces and other appliances may be removable or fixed and are made of clear or colored metal, ceramic, or plastic. Removable appliances are often plastic plates that fit into the roof of the mouth and clip onto a tooth.
Fixed braces exert more pressure than removable braces and can achieve more complex movements. They consist of wires and springs that are held in place by small brackets glued to the outside surfaces of the incisors and sometimes the premolars. Lingual braces have brackets bonded to the back of the teeth. Bands encircling the molars also can be used for attachments. The wires, springs, and other devices attached to the brackets or bands put pressure on the teeth, gradually shifting them into new positions. The nickel-titanium wires are very light, and some are heat-activated. These are very flexible at room temperature and actively begin to move the teeth as they warm to body temperature. Elastic bands sometimes connect the upper and lower teeth to create tension.
Orthodontic treatment usually continues until the desired outcome is reached. Active orthodontic treatment lasts an average of two years, with a range of one to three years. Some children respond to treatment faster than others and interceptive or early treatments may continue for only a few months. Appliances are adjusted periodically during treatment. Factors affecting the duration of treatment include:
- the growth of the mouth and face
- the severity of the problem
- the health of the teeth, gums, and supporting bones
- the child’s level of cooperation
Our priority is to provide our patients with a full dental care service at the highest level.