orthodontic treatment faq's

Orthodontic treatment is the way by which an orthodontist straightens or moves teeth from its original position to a desired position. The orthodontic treatment is undertaken to improve the alignment of the teeth for cosmetic purposes as well as to improve the way teeth work against each other in both the jaws. The well-executed orthodontic treatment helps to look after the long-term health of the teeth, gums and jaw joints, by distributing the biting pressure over all your teeth.

Can my general dentist perform the orthodontic treatment?

General dentists are not qualified to undertake the orthodontic treatment. An orthodontist; a dentist who has specialized in the study of Orthodontics and maxilla-facial orthopedics is your guy when you seek orthodontic treatment. 

People who have crowded or crooked teeth should get orthodontic treatment. Orthodontic treatment aligns the teeth, and moves them into a better position. Thus orthodontic treatment can improve the appearance as well as the function when the upper teeth bite on the lower teeth. It also makes them easier to clean.

Some people have front teeth that stick out and look unsightly. These 'prominent' teeth are more prone to accidental fractures or damages caused by faulty bite. But orthodontic treatment can bring them back into line. Sometimes, the way the upper and lower jaws meet is improper leading to unsightly looking smile and can cause an incorrect bite. Orthodontic treatment does address all these problems.

A faulty bite puts strain on the muscles of the jaw, thus leading to jaw and joint problems and sometimes headaches. Orthodontic treatment thus makes the biting comfortable reducing the strain on jaw muscles and joints. Orthodontic treatment is an investment that pays well when you need the teeth, the most, well down to the old age.

The orthodontic consultation should begin when the teeth are changing over from milk teeth to permanent dentition, roughly around the age of seven. The interceptive orthodontic procedures are undertaken at this stage if needed. It helps in development of both the jaws better and braces can be suggested at an appropriate time by the consulting orthodontist. 

On a general note, the best time to get orthodontic treatment is generally during childhood and adolescence, but nowadays adults can have orthodontic treatment too. Age matters less if one still has the healthy teeth and gums and if they are motivated enough to undergo the time consuming orthodontic treatment to improve their smile 

Sometimes, orthodontic treatment is given before restoring the teeth with crowns, bridges and implants. It is called Pre-prosthetic orthodontic treatment.

The first thing is to get a reference for a qualified orthodontist in your vicinity. The major outcome of the orthodontic treatment depends upon the expertise and skill of the consulting orthodontist and not the type of braces used. 

The orthodontist would make you undergo examination complete with visual checking, radiographic examination with two sets of full mouth and head x-rays, taking extra-oral and intra-oral pictures and making plaster models of your teeth and gums.

It is only then the orthodontist will discuss what treatment is possible in your case. The orthodontic treatment modality is designed keeping in mind your specific needs, a customized treatment plan.

Teeth (mostly Premolars) are only pulled out if there is not enough room/ space in your jaw to accommodate all the teeth. After all, that’s the reason they are either crowded or are sticking out. In some cases, especially where spacing is there between teeth, the extraction might not be needed. Also, in cases of jaw discrepancies, teeth might not be pulled. 

Besides, the extraction of teeth in the course of orthodontic treatment is an accepted modality and the final decision should be of the orthodontist as he/she is a better judge as to what is better for the long term stability of your bite/ smile.

The most common and accepted routine of orthodontic treatment is through ‘braces’. After the treatment planning, your orthodontist will inform you how best to go about it. In certain cases, some orthopedic appliances are given first for the correction/ expansion of the jawbones. Your orthodontic treatment is tailor-made for you. So your orthodontist is the best person to answer that question for you.

How long will be the orthodontic treatment time?

The length of the orthodontic treatment depends upon the severity of the problem. It could take a few months to over two years.

Braces are clips or brackets that are stuck on teeth at specific positions to bring about controlled movement of teeth within the arch, the jawbones. A flexible wire is then inserted between the slots on the brackets and the teeth are glided into the desired positions using accessories like springs, elastics etc. from time to time. An orthodontist needs to change the wires as required but the position of braces normally remains same through out the period of orthodontic treatment.

Like the word says, removable plates are appliances, which are given in some cases where the bony movements, jaw corrections are needed before or during the course of orthodontic treatment with braces. The use of removable plates for complete orthodontic corrections is limited and should be used with caution.

Children are usually recommended metal braces/ brackets. It could be standard ligating brackets or self-ligating depending upon the type of mal-occlusion. Metal brackets are sturdier and easily cleansable.

Other than that there are clear/ coloured brackets for those who want less of metal show. These types of braces are normally recommended for adults.

This is a new-age treatment technique carried out using ‘aligners’. It straightens the teeth with the help of several sets of specially moulded plastic aligners. A pair of aligners is worn for a period of two weeks before going to the next. These are removable appliances, so the control lies with the patient’s compliance, a lot.

Headgear is an external support mechanism, which is used to bring about or restrict certain jaw growth patterns during the orthodontic treatment. It is normally worn in the evening or at night when the growth rate is high. Headgears are normally recommended during the growing period in children. They sometimes are helpful in avoiding surgical corrections of faulty jawbones, if worn judiciously.

Like the saying goes, ‘no pain, no gain’! A new appliance in the mouth is sure to feel foreign for a while till our mouth accepts it. There is no taking away from the fact that there will be discomfort initially when the braces start pulling the teeth. I call it good pain, which tells us that our treatment has begun and teeth have started moving towards their destined positions. It gets better in a few days time. Ask your orthodontist for remedies to relieve the discomfort.

Retainers are passive appliances, which are given after the active orthodontic treatment is over and the teeth are in their desired position. After the completion of the orthodontic treatment, teeth need to be held in their new position for a while so that the soft tissues around them (gums, tongue and muscles) adapt to them. 

The retainers can be removable or fixed, depending on the original problem.

Success of the orthodontic treatment depends on both the skills of the orthodontist, and the enthusiasm and co-operation of the patient (and parents, if the patient is a child). It is advisable to follow the instructions given by the orthodontist and keep up with the follow up appointments.

If the orthodontist is confident and the patient is committed, there is every reason for the orthodontic treatment to be successful. 

The only reason to worry during orthodontic treatment for teeth damage is poor hygiene. The braces and wires can trap food particles and thus cause cavities. The use of specially designed orthodontic brushes and fluoride mouthwashes are a must as is the nighttime brushing. 

The missing of follow up appointments can drag the treatment time thus a longer breeding ground for bacteria for cavities.

Repeated breakages make the treatment go back and forth unnecessarily thus causing undue movement of teeth when not needed. Little caution can avoid a lot of damages. 

Growth is a continuous process, so minor changes can occur in the position of teeth as we grow. Most of the time, they are negligible to seek retreatment.

But if retainers are not worn properly or for the required period of orthodontic retention, chances of a relapse increase.

HAPPY SMILING

Start by spending more time in cleaning your teeth.

· Clean your teeth every time you eat something. If you are somewhere outside and can’t brush, make sure to rinse them vigorously after eating.

· There are special brushes designed to clean the teeth with braces. The surface brushes only do half the work. The thin interdental brushes go between the brackets under the wire to clean them properly. Learn to clean each tooth, each brace and each surface effectively and delicately so as not to cause breakages.

· Bring down the frequency of eating. Eat in small morsels. Cut down on sugary, fizzy and refined foods that stick to the teeth. Also, avoid eating or biting on hard foods.

· Brushing at night is as important as breathing during the course of orthodontic treatment. Saliva is thick at night so the food stuck on your teeth at night is sure to cause cavities. Morning and afternoon brushing could be less rigorous. Use a fluoride mouthwash regularly and you are good to go.