Orthodontics

Orthodontic treatment is often recommended to correct abnormalities in jaw and tooth position, crowding or other bite problems, such as an overbite or protruding teeth. An overbite is when the top teeth bite over the bottom teeth more than normal. In extreme cases, the edges of the front teeth can damage and strip away the gum and loosen the lower teeth or the edges of the lower teeth can cut into the roof of the mouth.

Protruding, or 'buck' teeth is when the front teeth are positioned further forward than normal. A person with protruding teeth is more susceptible to tooth loss from accidents and may suffer from speech or eating problems. Many people also choose to correct protruding teeth for cosmetic reasons.

It is usually provided by an orthodontist - a dentist with special training in this particular field. Most orthodontic therapy is done around 10-12 years, however, more treatment is being done when adult teeth first appear (age 6-7 years) and even earlier for some bite problems in the baby dentition (crossbite).

Orthodontic treatment is not only for children or adolescents, however. More and more adults are get orthodontic treatment done, in order to position their teeth correctly.

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Often times cosmetic procedures such as veneers are not always the best solution to treat a cosmetic dentistry case, especially, when the bite is not well balanced. In such cases, orthodontic treatment can be the better option. Click on the image to the left to illustrate this.

Child and adolescent treatment

During the childhood and teen years, the orthodontist will time the treatments to match with your child's natural growth spurts to move permanent teeth into place.

Treatment for crowding, the most common malocclusion problem, may mean removing (extracting) some permanent teeth, but orthodontists avoid removing permanent teeth when they can.

The malocclusion treatments for children and adolescents are:

Growth modification. This involves wearing fixed or functional appliances during the day and night to move the jaw into a better position.
Extraction (serial removal). Removing some baby teeth may ease severe crowding.
Fixed appliances (braces). For children and teens, this treatment phase usually lasts about 24 months; for adults, about 28 months.
Retainers. Retainers hold the teeth in place after orthodontic treatment. Some orthodontists recommend that retainers be worn for many years, because teeth have a natural tendency to drift out of place.
Space maintainers, made of metal or plastic. Spacers keep the surrounding teeth from moving (drifting) into open spaces created when teeth are pulled or lost in an accident.

Adult treatment

Most adults have little or no jaw growth. This means that surgery is the only way to correct jaw-related bite problems. Some adults may benefit from simply camouflaging, or hiding, a jaw-related problem. Using braces, the orthodontist can move the teeth so that they fit together, despite the jaw discrepancy. However, surgery is the best way to treat more severe jaw problems.

Orthodontic treatment for malocclusion is a popular option for adults, due in part to better technology. In the past, wide silver bands held braces in place. Today they are less obvious. Instead of the wide bands, a small metal or ceramic fastener is bonded to each tooth, and a narrow wire passes through the fasteners.

New options include:

Clear plastic instead of silver braces.
Lingual braces. These braces attach to the back of the front teeth.
Removable clear plastic aligners (Invisalign). These are molded specifically for you.

Lingual braces and aligners don't work for everyone. They aren't options for children. Your orthodontist can tell you the best choices for your situation.

Orthodontic treatment for adults may also involve:

Removal (extraction) of teeth to create more space.
Orthognathic surgery of the jaw.
A retainer, after braces are removed.
Adjustments, such as grinding of high tips of teeth, to prevent continued or increased malocclusion for adults.

Below are some images that illustrate some of the above mentioned treatment options.

Removable retainers are made of (often colored) acrylic that goes behind the teeth with a wire which runs along the fronts of the teeth. There are many different fun colors to choose from and since they are removable, there are no special hygiene requirements and no restrictions on eating. Retainers are most often used after orthodontic treatment is complete.

Clear (ceramic) brackets are made of composite materials. They are very strong and generally do not stain. Adults like to choose ceramic because they "blend in" with the teeth and are less noticeable than metal.

Lingual braces are ideal for those who want the effects of braces, but are apprehensive about showing a mouthful of orthodontic work to the world. Unlike standard brackets, which are mass-produced, lingual braces require a custom-made bracket for each tooth.

While not braces at all, Invisalign is a small tray custom designed to the contours of your mouth that attempts to straighten your teeth much like braces would, but remain invisible and easy to remove.

Whichever orthodontic treatment modality is chosen, there is definitely a solution available for almost every patient. With constant advances in the fields of orthodontics and esthetic dentistry, we can often combine the two disciplines to turn a simple case of some mal-aligned teeth into a very nice and esthetic arch form, as can be seen above, if you click on the image (remember to activate the Active-X mode).