Orthodontics

Orthodontics is the area of dentistry that focuses on the re-alignment of teeth which are improperly positioned in an individual’s mouth. It is an important area of dentistry, in that teeth which do not fit correctly together can lead to a range of other dental health concerns. For some individuals, it can also lead to self-consciousness about their appearance, which can be exacerbated given that we live in the age of social media where dozens of selfies are taken daily and everyone is after those 'Instagram worthy' flawless smiles.

For the majority of us, however, we do not have perfectly aligned straight teeth. Some of us have crooked teeth, some have large gaps in between teeth, whilst some of us have teeth protruding out of our natural jaw structure. This is where orthodontic treatments, such as braces and clear aligners, can help be the catalyst to obtaining not only a healthy smile, however, a natural smile with beautifully straight teeth.

How do I know if I require orthodontic treatment?

Whilst in some dental cases, the requirement of orthodontic treatment can be obvious, particularly if the direction in which your teeth are growing is visibly crooked, this is not always the case.

As mentioned above, orthodontic treatment may be considered in a range of situations. These can include:

• In cases of an overbite or 'buck teeth', where the upper front teeth are further forward and stick over compared to the lower teeth.
• An underbite, where the lower front teeth are further forward and stick out compared to the upper teeth.
• A crossbite, where the teeth line up when closed and the upper teeth do not come down slightly in front.
• An open bite, where when the back teeth are together the front and possibly side teeth are apart.
• A misplaced midline, where the centre of the upper teeth is of centred to the centre of the lower front teeth.
• Spacing between the teeth, either in the upper or lower jaw, is not even with gaps or spaces between some teeth.
• Overcrowding, where there are too many teeth for the area to accommodate.
• Crooked teeth, either due to another issue above or not.
• Realignment of the existing teeth is required prior to dental crowns, dental implants, veneers or dentures being placed.

With any of the above, our team can pick up on these issues during your routine dental examinations with us. For example, we may be able to pick up certain alignment or spacing issues from an x-ray or more simply a visual inspection. Without routine dental examinations, it can be harder to spot some of these issues, particularly if you are not aware there may be an issue. For example, you may never notice a small gap between your teeth or may not think much of it. By coming in for the routine dental examinations we can help find these issues and address them earlier, where by it can result in a shorter treatment and generally better oral health.

What happens if I leave my teeth as they are?

When we recommend that orthodontic treatment may be required, some people ask us what will happen if they don't undertake the treatment. For example, they may be accustomed to a gap between certain teeth or a slightly crooked tooth. Whatever the reason for that orthodontic treatment may be required, in almost all cases doing nothing can lead to a hindrance in maintaining good oral health care. This can lead to other dental issues such as gum disease and tooth decay, possibly even requiring root canal treatment or the removal of a dead tooth. Further adverse effects of misaligned teeth can also include headaches due to excessive pressure on the chewing muscles. In other words, the positive effects of orthodontic treatments reach far beyond simply straighter teeth for a beautiful smile.

Who can have orthodontic treatments?

There is some misconception sometimes that only children or teenagers are suitable for orthodontic treatments. This usually stems from the fact that dental issues that may require orthodontic treatment can be detected at the age of 7-9. After this, a lot of orthodontic work is started when most permanent teeth have come through, around the age of 11-13. Despite this, adults can benefit from such treatments as well and therefore, age is not an issue for orthodontic treatment.

What orthodontic treatments are available?

Whilst the field of orthodontic treatment has progressed significantly from only really having the one size fits all approach of metal braces, the treatments available will depend on the patient's individual requirements. We must remember that orthodontic treatment is about using both fixed and sometimes removable appliances to gently place pressure on the teeth and jaw to treatment the issue. The severity of the individual issue will therefore affect the options available. The most common options are ceramic braces, lingual braces, clean aligners and the tried and tested metal braces.

To begin with the last first, metal braces are still a very effective form of treatment for all ages and are still the most common treatment option for teenagers. The process involves gluing very small metal brackets to each of the teeth and then connecting these with a thin strand of wire. The size of these has significantly reduced over the years with advances in the technologies available. The actual pressure is applied to the teeth via a systematic tightening of the wire where required. This is readjusted at regular intervals to ease the teeth into place. Whilst more discrete elastic modules can be used in those places where it is required, children often select brighter colours to make them more colourful. Whilst it will come down to a case by case basis, as a general rule of thumb, this option is usually the most cost effective compared to those that follow.

Ceramic braces are usually the next option that is discussed as these are very similar to metal braces, however, are often favoured by adults as they are less noticeable. This more discrete look is achieved by using clear or possibly even tooth colour brackets instead of metal brackets glued to the teeth. The wire used can also be coloured to further reduce the visibility. If a child is self-conscious about having metal braces, then this maybe a good alternative as by enlarge they are just as effective, however less noticeable. Naturally, the cost of ceramic braces is slightly higher than traditional metal braces given the extra cost in manufacturing and work to achieve the best 'fit' in terms of looks.

Lingual braces are for those who really want a truly invisible option. Whilst they work in a similar fashion to metal braces, in that brackets are glued to the tooth and tighten with wire, this is done on the inside surface of the tooth. This application on back side of the teeth means that they will not be seen when you smile. Whilst all orthodontic options take some time to get used to wearing, lingual braces may take longer. Despite being custom made to follow the contour of your teeth, due to their position near the tongue, they may temporarily affect speech and eating, until you are more used to wearing them. Given the cost and other medical considerations, lingual braces are generally only worn by adults who truly require an invisible option.

The next option can be categorised under the heading of 'clear aligners', of which some of the better known brands are 'Invisalign' and 'Clear Correct'. These can somewhat resemble thin, clear mouthguards rather than what you would normally think of when hearing the word 'orthodontics'. For less severe orthodontic issues, this sequence of clear plastic aligners can provide an effective alternative to fixed braces. Naturally, the advantage of this options is that the aligners can be removed, however, even when worn are virtually invisible. Unfortunately, given their design and way in which they move teeth, this option is usually more applicable to adults then children or teenagers. Additionally, as they can be removed, they are sometimes prone to not being worn responsibility and taken out more than is advised. This can lead to the treatment taking longer or being ineffective.

Finally, the less common treatments in the orthodontic field can include fixed space maintainers for babies, specially fixed appliances for infants, removable space maintainers, jaw repositioning appliances and palatal expanders.

Whilst you may have a preference from reading the above, please remember that depending on the dental issue that is being treated, some options are more suited than others. The best course of action is to come in and discuss your unique situation with one of our team.

Are there any risks with orthodontic treatments?

Every medical procedure carries with it some inherent risks, however, in the case of orthodontic treatment these are usually very small and are far outweighed by the benefits of the treatment, such as improved general oral health. Some of the issues that may arise are:

• Minor toothaches or discomfort, usually more so at the being of the treatment.
• Scratches and ulcers from the braces.
• Gum infections, possibly due to ineffective brushing technique give the presence of the braces.
• Enamel demineralisation, sometimes in parts only on a tooth where it cannot be effectively cleaned or re-mineralised.
• Root shortening.

As stated above, these risks are small and given that you will be required to maintain your regular visits and routine dental examination appointments, these can usually be quickly and effectively treated and therefore should not be a cause for concern.