Orthodontics is the branch of dentistry concerned with the growth of the teeth, jaws and face and moving teeth with “braces” to give the best cosmetic and functional bite. General Dentists are trained in Orthodontics but increasingly treatment is provided by specialists either in a Practice or Hospital environment to get the best result possible.
Treatment is usually provided in the early teenage years as problems become apparent and once all adult teeth are present but more and more adults are also deciding to have treatment later in life. This is usually still possible but often more complicated to perform.
Common reasons for referral to an Orthodontist include protruding or crooked front teeth, crowding, asymmetry, deep bite, reverse bite, open bite (sometimes due to thumb sucking) and impacted or missing teeth.
Every patient needs tailor-made treatment, planned by the Orthodontist and agreed with the patient and parent / guardian. In order to decide what treatment is required, the Orthodontist will need to carry out a full assessment of the teeth which is likely to include x-rays, impressions (moulds of the teeth) and photographs. Treatment can take more than two years so it is important to be happy from the outset with what is recommended. Where braces are needed, those which are used most often are:
A fixed brace – this is the most common type of brace today, often known as “train tracks”. Brackets are temporarily “bonded” onto the teeth and linked by wires. Small elastic hoops are often used to hold the wire in position. The wires exert gentle pressure to move the teeth into a new position. The brackets can be metal, ceramic or even gold and the elastic hoops come in many colours.
A removable brace – this is sometimes used for correcting a simple problem, such as moving a single tooth or expanding the dental arch. It has a plastic base with wires and springs attached. Removable braces need to be worn all the time except for cleaning or playing sport.
Functional appliances – these are used to harness the growth of the jaws and improve the way the upper and lower jaws relate rather than moving teeth. They are often used as a precursor to fixed brace treatment. There are several designs all of which fit on to both the upper and lower teeth simultaneously and hold the lower jaw forward. They are usually removable but should be worn as near to full-time as possible for maximum benefit.
Retainers – are used at the end of treatment to hold the teeth in their new position and limit further unwanted movement as the new bite becomes established. They can be fixed but are usually removable thin clear plastic covers. A typical regime would be six months full time and six months night time only wear once “active” treatment has been completed. There is also good evidence to suggest a more stable final result if worn 2-3 nights a week into mid twenties age.