Not many of us are blessed with well arranged teeth or so called ideal occlusion. We very often come across many children and adults having teeth that are protruded teeth or crowded teeth or spaced teeth etc. These irregularities of teeth are called malocclusions and are an important factor in robbing one of a good smile. Orthodontics is the specialization of dentistry, which deals with correcting the bite and arrangement of teeth, therefore improves the smile and function of
Who is an orthodontist?
An orthodontist is the dental specialist who corrects your bite and
improves your smile by using various types of braces. In other words
an orthodontist is a dentist who treats crooked teeth to improve your
smile.
What are braces?
Braces are appliances that the orthodontist uses to correct your bite.
These braces are either fixed on to the teeth or rest against your teeth
and bring about the desired movement of your teeth.
Why do we need braces?
Improves your smile- A good smile adds up to the personality
of an individual. A fabulous smile makes you attractive and also improves
one's confidence levels. Braces improve your smile and therefore improve
your appearance.
Improves chewing -Teeth are an important part of the digestive
system. Chewing of food by the teeth is the beginning of the digestive
process before the food is passed on to the tummy. So having a good
bite improves the function of the teeth.
Prevents other dental problems- Crooked teeth prevent maintenance
of good oral hygiene. This can lead to other dental problems such as
dental decay and gum diseases.
Psychological benefits- Not having a good smile can adversely
affect the appearance and therefore the mental well being of an individual.
It tends to make one an introvert and highly self-conscious.
Risk of trauma- Teeth that are protruding out increase the risk
of trauma to them. This is more so in children during play or due to
an accidental fall.
What is malocclusion?
Malocclusion can be said to be a deviation from the normal or abnormal
arrangement of teeth.
Why do people have malocclusion?
Numerous are the causes of malocclusion. The following are some of the
more common causes.
Heredity- The genes are probably the most important factors.
Many disorders in the arrangement of the teeth are inherited.
Thumb sucking and other habits- Children at times tend to develop
habits such as sucking of the thumb or fingers, lip sucking, lip biting
etc. Presence of thumb sucking or finger sucking till 2-3 years age
does not usually produce any ill effects on the teeth and the jaw bones.
Continued sucking of the thumb beyond 4 years of age very often causes
protrusion of the teeth and other abnormalities in the bite.
Use of pacifiers- Children who have used pacifiers for too long
tend to develop some problems of the bite
Injuries- Injuries to the teeth or the bone during childhood may cause
abnormalities of the bite.
Dental decay and diseases of the gums- They may sometimes cause
drifting of the teeth and therefore problems of the bite.
Things that alert you to go to an
Orthodontist
Parents are often worried about their children's teeth. It is a good
idea to consult your orthodontist if you have any doubts about your
child's bite. The presence of certain features should alert you to seek
professional advice from an orthodontist.
1. In case of delay in emergence of the teeth. Most children
start getting their baby teeth by 5-7 months of age. In case of delay
beyond 1 year of age in the emergence of the teeth it is advisable to
seek opinion of your dentist.
If the milk teeth is shed off and the permanent teeth do not replace
it.
Teeth that are erupting too close to one another or are crowded together
2. Teeth that are too far apart or spaced teeth.
If the front teeth are too far forward and the lip does not cover the
teeth.
3. Continued presence of habits such as finger sucking beyond
4 years of age often requires professional assistance to discontinue
the habit and to rectify the damage done to the bite.
4. Cross Bite :Normally the upper teeth are ahead of the lower
teeth. In case the lower teeth are ahead of the upper it is called cross
bite and should alert you to immediately seek professional advice.
5. Open bite: If a space exists between the upper and the lower
teeth when the teeth are brought together. This is called open bite
and signifies improper bite that requires orthodontic care
6. Midline diastema.: Presence of a space in the middle between
the 2 incisors. This is called midline diastema.
7. Difficulty in chewing or biting
8. Difficulty in pronunciation of certain words or lisping.
9. Children who breathe through the mouth due to some nasal problem
or as a habit.
10. In case one or both the parents have had orthodontic problems in
the past.
11. In case your child is habituated to the use of pacifiers for too
long.
At what age should orthodontic treatment
begin?
Although orthodontic treatment can be done at any age they are best
carried out in young children of 8-15 years age. During this age it
is possible for the orthodontist to foresee any dental problems that
are likely to occur and can take preventive measures. This is called
preventive orthodontics. It is also possible to intercept disorders
of the bite at an early stage so that it does not mature to a big dental
problem. This is called interceptive orthodontics. The jaws are actively
growing by 8-10 years of age and therefore are the ideal time to mould
the jaws. The permanent teeth start erupting by 6-7 years of age and
complete erupting by 12-14 years (all except the wisdom teeth). This
would therefore be the ideal time to start treatment.
What happens if the treatment is
delayed?
At an early age the braces are less painful and the treatment duration
is shorter. Advancing age makes the jaws harder and therefore makes
it difficult to mold the jaws and to move the teeth. As mentioned in
the earlier section, in younger individuals it is possible to prevent
and intercept the developing problems. But orthodontic treatment can
be carried out at any age.
How long does orthodontic treatment
take?
The duration of treatment depends from person to person and from one
orthodontist to other. Most jaw molding and jaw corrections carried
out during the growing age takes 1-11/2 years. Orthodontic treatment
with braces often takes 2 - 2 1/2 years. The orthodontist would advice
you on how long the treatment is going to take after studying the case.
How does orthodontic treatment work?
The jaws in a growing child can be molded by application of some pressure
on them. They can be made to become bigger, longer, shorter, wider etc.
by using appropriate type of braces.
The teeth that are embedded in the jaws can be moved around until they
are in the right place by applying a force on them by using braces.
Do braces hurt and cause sores in
the mouth
Initially for a few days after the braces are fixed, the mouth tends
to be sore and some pain can be expected. Much depends on the pain perception
of the individual and his pain tolerance. However pain is expected for
a few days after braces are fixed and every time your orthodontist tightens
them. Sores may develop on the cheeks or lips or the tongue after the
braces are fixed. These often heal in a few days. You can use orthodontic
wax to screen an area of the braces that are sharp and hurting.
In addition warm salt water rinsing of the mouth help heal the sores. If the braces are damaged and therefore hurting the cheeks or lips you should immediately seek orthodontic consultation.
Should sports activities be avoided?
Well having the braces should not prevent you from carrying on normal
daily activities. However care should be taken during sports activities
as you may fall and injure the mouth and teeth. Tell your orthodontist
about your sports activities so that he prepares a mouth guard for you.
The mouth guard should protect you from inadvertent injuries during
sports. It is advisable to avoid contact sports such as boxing, wrestling,
karate, judo etc where injury to the jaws and mouth can occur.
Will I experience any difficulty
in talking?
Most orthodontic braces do not interfere with talking. However the orthodontist
may at times give you a removable plate to wear. This could cause difficulties
in speaking for a few days. However you get used to it very soon and
start talking normally.
Are there any restrictions in eating
when the braces are on?
Initially once the braces are fixed the mouth tends to be sore for a
few days. During this period it is better to have soft food. You should
be careful in avoiding hard, crunchy and sticky food such as toffee,
nuts, chocolates and gums as they may break the braces that are fixed
to your teeth. When you are eating fruits like apple make sure you cut
them into pieces before you eat them. It is better to avoid meat with
bones.
Sometimes a part of the braces comes off. This may occur when you bite on a piece of hard food. The orthodontist will then have to fix it for you. It is advisable to immediately seek an appointment if a part of the braces falls off. It is better to take care of the braces by following the do's and don'ts so that they do not break frequently as this delays the treatment.
What happens if you swallow a loose
piece of braces?
Accidental swallowing of a small piece of the braces that becomes loose
usually does not cause any harm. They are likely to pass down the digestive
tract and make their exit. However accidental inhalation is a more serious
problem and may require medical attention to remove them. However such
incidences are rare.
What are the different kinds of braces?
Braces have evolved over the years. The modern day braces are smaller
and have contours that are more comfortable for the tissues Some braces
move teeth while certain other appliances are used to mold the jaws
during the growing period
Steps in treatment
It takes several appointments before the orthodontist places the braces.
In the very first appointment the orthodontist gets familiar with you
and asks a few questions to assess what your problem is. This is done
by interactive questioning or by giving you a history form that you
have to fill up. The history goes a long way in the final diagnosis.
Once the history is taken the orthodontist examines you and tries to
find out whether you require braces. He looks at your face and also
into your mouth to diagnose your problem and arrive at a tentative plan
of action called the tentative treatment plan.
The next appointment is often a few days later when a number of records are made. It includes
Impressions -Impressions of the mouth are taken with a paste
to make a model of your teeth. This helps the dentist to visualize your
bite from all angles. The impression is made of both your upper and
the lower teeth.
Panaromic X rays -They are special X rays that are used to see
the inside of your jaws, teeth and the jaw joints. This is taken in
a machine where you stand still and an X ray machine goes around you.
These X rays are highly informative for your dentist and help him in
the overall treatment planning.
Cephalometric X ray -In simple words this is an X ray that tells
your dentist about how your jaws are growing.
Photographs- Most orthodontists take pictures of yourself and
your bite before starting treatment. These pictures are taken from different
angles and serve the dentist in keeping track of how the effects of
the treatment are unfolding.
Once the records are made the orthodontist arrives at a final diagnosis
and treatment plan. He would discuss the plan with you and advice you
regarding his fees. You would then be scheduled for fixing of the braces.
How much do braces cost?
Well braces are expensive. But then the gains are highly rewarding.
The price of the braces differs from one country to another. You should
therefore consult your dentist. In the US on an average it costs 2000
to 10,000$.
Does the orthodontist remove teeth
as part of the treatment?
In case the teeth are too crowded or they are too far in front the orthodontist
would advice you to remove some teeth. This depends from case to case
and is decided after the final diagnosis once all the records are made.
It is not uncommon for the orthodontist to advice you to remove 2 or
even 4 teeth. The teeth most often removed are the premolars that are
present at the sides of the mouth.
What are the parts of the braces?
The braces or the orthodontic appliance as it is called has a number
of components. 1. Bands They are stainless steel tubes that are made
to fit on the last tooth called the molar. They have tubes fitted on
them called molar tubes. 2. Brackets The rest of the teeth have small
brackets that help in holding the wire. 3. Wire The wire fits into the
bracket and brings about the desired tooth movement. The wires are available
in different sizes and shape and are often changed a number of times
during the treatment. 4. Ligating rings They are small plastic rings
that encircle the bracket and hold the wire against the brackets. These
rings come in a number of colors. You can tell your orthodontist the
color you would like to have. In case you don't want to get noticed
then he would put transparent or white rings for you
