Orthodontics is the branch of dentistry that corrects misaligned teeth and jaws. Crooked teeth and teeth that do not fit together properly are more difficult to clean, are at risk of early loss due to tooth decay and periodontal disease, and cause additional stress on the chewing muscles that can lead to headaches, TMJ syndrome, and neck, shoulder and back pain. Crooked or misplaced teeth can also affect a person's appearance.
The benefits of orthodontic treatment include a healthier mouth, a more pleasing appearance and teeth that are more likely to last a lifetime.
A specialist in this field is called an orthodontist. Orthodontists receive at least two years of study in addition to their four years of dental school in an ADA-approved orthodontic training program.
How do I know if I need orthodontics?
Only your dentist or orthodontist can determine if you are eligible for orthodontics. Based on diagnostic tools that include a complete medical and dental history, a clinical examination, plaster models of your teeth, x-rays and special photographs, an orthodontist or dentist can decide if orthodontics is recommended and develop a treatment plan that is right for you.
If you have any of the following characteristics, you may be a candidate for orthodontic treatment:
- Over-articulated, sometimes called "rabbit teeth" - where the upper front teeth are too far forward (protruding) on the lower teeth.
- Overbite - a "bulldog" appearance where the lower teeth are too far forward or the upper teeth are too far back.
- Crossbite - where the upper teeth do not move slightly forward of the lower teeth during normal bite.
- Open bite - the space between the biting surfaces of the front and/or side teeth when the back teeth bite together.
- Displaced midline - when the centre of your upper front teeth do not align with the centre of your lower front teeth.
- Spacing - spaces, or gaps, between teeth due to the absence of teeth or teeth that do not "fill" the mouth.
- Crowding - when there are too many teeth for the dental ridge to accommodate.
How does orthodontic treatment work?
Many types of appliances, both fixed and removable, are used to help move teeth, re-educate muscles and affect jaw growth. These appliances work by exerting light pressure on the teeth and jaws. The severity of your problem will determine the orthodontic approach that is likely to be most effective.
Fixed appliances include :
• Braces - the most common fixed appliances, braces consist of bands, wires and/or brackets. The bands are attached around the teeth or tooth and serve as an anchor for the appliance, while brackets are most often attached to the front of the tooth. The archwires are passed through the supports and attached to the bands. Tightening the archwire tightens the teeth and gradually brings them into their correct position. Braces are usually adjusted monthly to achieve the desired results, which can be achieved in a few months or years. Today's braces are smaller, lighter and have much less metal than in the past. They come in bright colours for children as well as clear styles preferred by many adults.
• Special fixed braces - used to control thumb sucking or tongue thrusting, these braces are attached to the teeth with bands. Because they are very uncomfortable during meals, they should only be used as a last resort.
• Fixed space maintainers - if a baby tooth is lost prematurely, a space maintainer is used to keep the space open until the permanent tooth erupts. A band is attached to the tooth next to the gap, and a wire is extended to the tooth on the other side of the gap.
Removable devices include :
Aligners - an alternative to traditional adult braces, serial aligners are used by an increasing number of orthodontists to move teeth in the same way as fixed braces, but only without wires and brackets. The aligners are virtually invisible and are removed for eating, brushing and flossing.
Removable space maintainers - these devices perform the same function as fixed space maintainers. They are made of an acrylic base that fits over the jaw and have plastic or wire prongs between specific teeth to keep the space between them open.
Jaw repositioning appliances - also known as splints, these appliances are worn on the upper or lower jaw and help train the jaw to close in a more favourable position. They can be used for disorders of the temporomandibular joint (TMJ).
Lip and cheek bumpers - these are designed to move the lips or cheeks away from the teeth. The muscles of the lips and cheeks can put pressure on the teeth, and these bumpers help relieve this pressure.
Palatal expander - a device used to widen the arch of the upper jaw. It is a plastic plate that fits over the roof of the mouth. Outward pressure applied to the plate by screws forces the joints in the palatal bones to open lengthwise, widening the palatal area.