Orthodontics and Orthodontists

Somebody has rightly said that “Life is short. Smile while you still have teeth”. But not all of us are blessed to smile confidently. I have seen people covering up their mouth when they smile. There could be numerous reasons, and some of the most common issues are a gummy smile, crowded teeth, spacing, etc. Everyone wants to have a perfect smile. This requires proper knowledge and awareness about dental treatments and appliances.

The good news is that nowadays various treatments are available in Orthodontics and you may consult Orthodontists to get a perfect smile. There is a wide range of orthodontic appliances that help to provide the desired results. Furthermore, these appliances offer long-term harmony between the teeth and the gums.

Orthodontic evaluation often requires thorough oral examinations and radiographic study. These diagnostic tools help to identify the type of malocclusion and the correct treatment plan. While you may be enjoying the benefits of orthodontic treatment., it is essential to maintain proper oral hygiene. Today’s article will highlight some of the essential aspects of orthodontics.

What is Orthodontics and Who are Orthodontists?

Orthodontics is a branch of dentistry that corrects teeth and jaws which are not in the right position. Crowded teeth and the teeth which do not align properly are harder to clean and hence difficult to maintain oral hygiene. Therefore, Orthodontics is a specialty field which focuses on providing a healthier mouth and teeth.

Orthodontics also focuses on improving your oral health and smile. The dental personnel who specializes in the branch of Orthodontics are known as Orthodontists. (1) Orthodontists are registered dental specialists who complete an additional three years of full-time training in the varied fields such as Orthodontic treatment, facial growths, and dental development of children, teens, and adults.

When do you need an Orthodontist?

Your Dentist and Orthodontist can only suggest if you have to go through Orthodontic treatment. The various diagnostic procedures which can be implied before treatment are –

  • Single tooth x-rays (IOPA),
  • Full mouth x-rays (OPG),
  • Fabricated stone and plaster models of the teeth
  • Previous dental and medical history

In the following cases, you may require an Orthodontic treatment –

Crowding

Crowding occurs when there is a lack of space for all the teeth to fit normally within the jaws.

Spacing

Spacing happens when there is an excess of space for your teeth, which results in gaps between your teeth.

Openbite

It is a condition where the upper and lower front teeth do not come together when the mouth is in a closed position. (2)

Crossbite

Crossbite is the condition of teeth when the upper teeth fall inside your lower teeth.

Overbite

Where the upper front teeth lie too far forward over the lower teeth; sometimes also called “buck teeth.”

Underbite

Where the lower teeth are too far forward or the upper teeth too far back, giving a bulldog appearance.

Misplaced midline

Misplaced midline happens when the center of your upper front teeth does not line-up with the center of your lower teeth.

Parafunctional habits

Parafunctional habits are abnormal behavior or functioning of the oral structures and associated muscles. Typical examples are nail-biting, lip biting, bruxism, mouth breathing, and tongue thrust.

Speech, chewing & biting problems

All these problems result from improper occlusion and jaw alignment.

Self-image

An attractive smile can boost a person’s self-image and confidence. (3)

Finger or thumb sucking

Finger or thumb sucking is the most common habits found in children. But these habits can cause protrusion of the upper incisor teeth and constriction of the upper jaw.

Teeth which erupt out of position

This type of eruption can happen with growing age. However, it can be easily aligned if treated at an early age.

What are the benefits of orthodontic treatment?

Orthodontic treatments are widely categorized as cosmetic dental treatments. This unique dental treatment has many short terms as well as long term benefits that help to provide a healthy oral environment. Some of the benefits of orthodontic treatment include –

  • Improving the aesthetics of the smile – orthodontic treatments are a permanent solution to your crooked smile. Additionally, teeth spacings and rotations can also be fixed by orthodontic treatment. This allows proper alignment of the teeth, which enhances the appearance of the patient’s smile. (4)
  • As mentioned above, orthodontic treatments permanently resolve the malocclusions in the mouth. This helps to maintain a positive harmony between the teeth and the gums. Moreover, it has long term health benefits on the teeth and the gums.
  • Orthodontic treatments are also considered as a preparatory adjunct to align the teeth before performing a skeletal modification of the bone. Jaw repositioning surgeries often require correction of the bite and dental discrepancies which are corrected by orthodontic treatments.
  • Another long-term effect of orthodontic treatment includes relief from future dental ailments. For example, problems of jaw pain and disorders, muscle spasms, and improper bone functioning that usually occur as a consequence of malocclusions and misalignment of the teeth.
  • Correction of the smile appearance and alignment of the teeth in a perfect position instantly boosts up the confidence of the patient. Moreover, it allows the patient to regain back their lost self-esteem.

Age limit for orthodontic treatment

Orthodontic treatment can usually start when a child’s permanent teeth start erupting, which is generally at about 12 years of age. The whole treatment also depends on the growth of the face and jaws. For adults, the orthodontic treatment can begin at any age, but Orthodontists have limited treatment options to choose. Also, Orthodontic treatment won’t begin unless one maintains good oral hygiene since the treatment may increase the risk of tooth decay.

Types of Orthodontic treatment

Braces are the most widely and commonly used Orthodontic device which can correct the misaligned or crowded teeth. Your treatment and its duration depend on the nature of the problem.

An Orthodontist may use a range of dental devices such as headgears, plates, braces, brackets, crib appliance, bite guards, etc. The duration of the treatment will depend on the complexity of the dental problem. Typically, the duration is between 18 to 24 months. Orthodontic treatment involves three stages –

1. Planning stage

Your first couple of visits may include the following –

  • Evaluation of your medical and dental history.
  • Preparation of positive replica of your teeth impression in the form of castings or molds.
  • Photographs of your face and mouth.
  • X –rays of teeth and jaws.

Subsequently, your Orthodontist designs and applies braces or fabricate custom made dental appliances for you.

2. Active stage

This stage involves your visit to the Orthodontist on a regular basis for the adjustments of your dental devices or appliances. Also, you may undergo specific dental treatment as and when required.

3. Retention stage

After the completion of the procedure, the braces/appliances will be taken off. Subsequently, a new removable device in the form of retainers will help to maintain the changes made to your teeth if worn as instructed. The treatment and retention times may vary depending on case to case. Retention is a lifetime process.

What are the types of orthodontic appliances?

There are several types of orthodontic appliances that are used to correct all types of malocclusions. All these devices are selected depending on the type of misalignment and the choice of material. Let’s take a brief look at all the different types of orthodontic appliances –

Correction devices

Typically, the corrective orthodontic appliances can be categorized into two types –

Fixed appliances

Fixed appliances are usually bonded to the tooth surface. Once attached, these devices cannot be removed by the patient. Fixed orthodontic appliances work on the principle of applying intermittent light pressure on the tooth surface. Some of the standard fixed orthodontic appliances include –

Metallic and ceramic braces

Braces are one of the most well known orthodontic devices. Typically, metal braces are considered better than ceramic as they have more strength and require less treatment time. These orthodontic appliances are suitable for young adults.

Ceramic braces are a variation of the traditional metal braces. These appliances were designed to overcome the unpleasing metallic appearance of the braces. Many adults who are conscious of their appearance choose ceramic braces. (5) Some facts about orthodontic braces are listed below –

  • Typically, it takes minimum 1-2 years to correct the misalignment and malocclusions using metallic braces. This time may exceed in case of ceramic braces. This is because ceramic braces are made from plastic material which has less strength as compared to metal. As a result, it exerts less pressure on the teeth an takes a longer time in moving the teeth.
  • Ceramic braces usually match the tooth color; therefore, they are an excellent option for people who want to undergo braces treatment without hampering the appearance of their smile.
Palatal expanders for children

As the name suggests, palatal expanders are specially designed appliances with a prime goal of broadening the upper jaw. This device is usually made from stainless steel. It consists of supporting bars that attach to the teeth on either side and to a screw at the center of the palate.

The dentist uses a key or instructs the patient to use the key precisely in order to move the screw and increase the expansion. Palatal expanders are typically used in children between the age of 8-13 years. This is because of continuous bone formation that helps to replace the space created in the palate. Some of the dental malocclusions treated by palatal expander include –

  • Crossbite
  • Overcrowding of the upper teeth
  • Expansion of a narrow upper jaw
  • Corrective therapy for mouth breathing

Rapid palatal expansion takes around 3-6 months to treat dental malocclusion adequately.

Removable appliances

Removable orthodontic appliances are typically used to treat skeletal and dental modification of growing children. As the name suggests, these appliances can be easily worn and removed by the patient. Some of the common removable orthodontic appliances are listed below –

Orthodontic headgear and face mask

Orthodontic headgears are one of the oldest types of removable orthodontic devices. However, they are still used for individual cases of skeletal modifications in children. Typically, these devices help to restrict the downward and forward growth of the maxilla.

Face masks, on the other hand, perform a different function as compared to the orthodontic headgear. These devices help to allow the upper jaw to grow forward and improve the facial profile of the patient. Generally, both of these devices consist of extra-oral and intra-oral components such as –

  • Braces, coil springs and elastic bands that are placed inside the mouth to move the teeth
  • Power chains that help to align the teeth in the jaws further (6)
  • Elastic straps that attaches the extra-oral head support with the braces

Headgears and face masks apply a pressure of 350 – 450 grams per side. Some of the common types of orthodontic headgears and facemask include –

  • Cervical pull headgear which is used to correct the overjet and overbite
  • Reverse pull facemask – these devices are primarily used to pull the lower jaw forward. Such movements help to align the lower jaw with the upper jaw properly. (7)
Myofunctional orthodontic appliances

As the name suggests, myofunctional devices enhance the growth of the jaw muscles and bone in order to correct dental and skeletal misalignments.

The prime purpose of using a myofunctional appliance is to correct skeletal discrepancies in the jaw. Additionally, these unique orthodontic devices are used to correct proclination of the upper front teeth and crowding of the teeth. Some of the common myofunctional dental appliances include –

  • Vestibular screen – it consists of an acrylic curved shield that is positioned between the dental arches and the lips. This device allows the growth of the muscles that surround the mouth. Additionally, vestibular screens are an excellent choice of the appliance to correct thumb sucking, tongue thrusting, and lip biting.
  • Lip bumper – this is a fixed myofunctional device which forms a barrier between the lower dental arch and the lower lip. It is mainly used to correct the habit of lip biting. Moreover, the lip bumper helps to correct a hypertonic lower lip.
Habit break appliances

There is a wide range of habit break appliances which hare specifically designed to stop parafunctional or pernicious habits of the children. Some of the oral habits include thumb sucking, tongue thrusting, lip biting, and nail-biting. All of these oral habits have a severe impact on the health of the teeth and gums. Some of the common habit break appliances include –

  • Bluegrass appliance – It is a reliable device which consists of a Teflon roller that helps to distract the tongue during tongue thrusting. Moreover, bluegrass appliance also interferes with thumb sucking. (8)
  • Palatal crib appliance – these appliances are similar to the bluegrass appliances except that it consists of a metallic loop that restrict the movement of the tongue towards the upper front teeth. Moreover, they help to reposition the tongue in the mouth.

Retainers

Orthodontic retainers are individual dental appliances that are typically used after the completion of orthodontic treatment.  As the name suggests, these devices used to retain the teeth in their new position. There generally are two types of retainers used in dentistry –

  • Fixed retainers – these devices are bonded on the back of the upper and lower front teeth. Fixed retainers are long-lasting and allow ideal retention to the newly moved teeth.
  • Removable retainers – removable retainers are appliances that take support from the teeth and the gums. These devices are worn for a specific period of time during the day. The patient can remove the appliance while eating, brushing, or going out in a social gathering. (9)

Typically, retainers are worn for a period of six months to one or two years. However, it is best to use the retainers for as long as possible. Other types of orthodontic appliances consist of a mouth guard or night guards, sleep disorder devices, and space maintainers.

A note on orthodontic care during and after the treatment

Oral health care during the treatment

Keeping the mouth clean during orthodontic treatment may seem like a challenging task. However, there are many easy tips to maintain proper hygiene throughout the process of braces –

  • Choose the best type of toothbrush that fits in the spaces between the wire and teeth-for example, an orthodontic brush. This brush has a small head and well-aligned bristles which can easily remove the food debris and bacteria from the tooth surface.

Most of the orthodontic toothbrush has a cylindrical, small proxy brush attached to the other end. This helps to clean the interdental areas between the teeth.

  • Flossing may seem like a tedious task with braces on. Switch to super flosser or a water flosser that allows immediate cleaning of the interdental area without struggling to out the threader through space.
  • Always use fluoridated toothpaste to strengthen the enamel during orthodontic treatment. These toothpaste work well with hidden white spots of tooth decay. Moreover, they help to improve gum health as well.
  • Always rinse your mouth with water after every meal to flush out the food lodged between the teeth and wire.
  • Regular dental check-ups are incredibly crucial to maintain proper health of the mouth. Additionally, the dentist can advise on any modification required in your daily oral health practice. Tooth decay and gum disease can also be addressed during this time.

Oral health care post orthodontic treatment

The last day of the orthodontic treatment is a moment of joy for every patient. However, it is essential to pay attention to your oral hygiene even after removal of the braces. (10) This helps to maintain the appearance of the smile. Some of the post-treatment health tips include –

  • Get professional tooth cleaning immediately after you get your braces removed. This allows removing the plaque and tartar that must have accumulated around the tooth surface where brackets were fixed.
  • Continue your oral health practice regularly even after the braces have been removed. Switch to a normal manual or electric toothbrush to properly clean all the surfaces of the teeth. Use a fluoridated toothpaste to strengthen the enamel.
  • It is advised to start a soft diet like boiled vegetables, fruits, milk, cheese, and yogurt. Gradually incorporate other varieties of food items in your diet. Avoid acidic drinks and food rich in sugar or carbohydrate.
  • Always wear your retainer to prevent the relapse of your orthodontic treatment.

Over to you

So far, you must have understood the significance of Orthodontics and Orthodontist. Orthodontists are the smile makers and smile changers. Orthodontics can contribute to the health of your teeth, jaw, and your overall health and personality.

Some of the common dental malocclusions corrected by orthodontic treatments include overbite, crossbite, overjet, crooked smile, teeth spacing, parafunctional habits, skeletal discrepancies, and tooth retention. Several orthodontic appliances can benefit every type of malocclusion. Some of the appliances may range from fixed to removable devices. It is essential to maintain proper hygiene, especially during orthodontic treatment.