Orthodontics

     Orthodontics is the discipline of dentistry that is involved in the movement of teeth. When teeth are out of position, rotated, crooked, tipped, crowded, open spaced and or impacted they need to be moved into their proper position with orthodontics. Orthodontics can re-establish not only the aesthetic (cosmetic) aspect of a patient’s smile, but even more importantly it can re-establish the patient’s occlusion or the functional component of a patient’s bite so the patient’s teeth are guided into place and intercuspate (fit together) properly when the patient is fully closed. Orthodontics is also used to reposition teeth when other teeth are lost, often times a third molar or wisdom tooth can be brought forward to replace a missing second molar thus avoiding the need for an implant or bridge, and orthodontics can be used to straighten teeth in a more upright position so that they can be restored more effectively, especially for a crown or when being used as part of a bridge. Orthodontics can be used to increase the size of a patient’s jaw usually by employing a rapid palatal expander. This is useful when there is a large size discrepancy between the maxillary (upper) and mandibular (lower) jaws of the patient. When the upper jaw is smaller and narrower than the lower jaw it causes a cross bite in the patient where the upper teeth are inside the lower teeth instead of the upper teeth being on the outside of the lower teeth.  By using orthodontics to properly position a patient’s teeth the benefits to the patient are numerous. Not only will the patient’s appearance be drastically improved but their ability to chew their food properly is enhanced which aids in their digestion and achieving proper nutrition, orthodontics can also inhibit improper bone growth and promote proper bone growth. Properly aligned teeth through orthodontics also promotes proper cleaning of the teeth and gingiva (gum) which helps reduce tooth decay and periodontitis (gum disease) and the loss of teeth form both of the these disease processes. The patient’s ability to speak properly and even the patient’s comfort are enhanced once orthodontics is used to properly reposition their teeth.

     There are several different treatment options in orthodontics today. Many patients’ malocclusions can be dealt with at an early age with removable appliances that can be taken in and out of the patient’s mouth. With this orthodontic treatment the patient avoids the use of brackets or bands but must follow their home care instructions on how, when and for how long they need to wear their removable appliance. Often times for children this becomes impractical and therefore their orthodontic treatment is accomplished with fixed brackets or bands that stay on the patient’s teeth until their orthodontic treatment is over and need less compliance from the patent for them to be effective. Today there are many ways in which the brackets or bands can be less obvious and unsightly. The brackets used today are much smaller in size then they used to be, they can be tooth colored or clear in color to make them less noticeable. In some cases the brackets can be placed on the inside of the patient’s teeth, combine this with tooth colored brackets or clear brackets and the orthodontic appliance is practically undetectable. Today there is also Invisalign that are a series of clear, nearly invisible, removable orthodontic appliances that are used to reposition a patient’s teeth in a series of steps. Again these appliances are very patient compliant dependant as with the other removable appliances.

     Orthodontic treatment is not only for children, adults that need to have restorative treatment such as crowns, bridges and implants can greatly enhance their restorative treatment by having their teeth realigned into their proper position before having their restorative treatment. Most adults that are replacing missing teeth have other teeth in their mouths that are out of ideal position because they have been missing teeth for a long time and the adjacent teeth have drifted and tipped into the open space and their opposing teeth have over erupted into the open space. Today there are two ways to achieve this type of orthodontic treatment. The patient can have the traditional brackets placed on all or most of their teeth that are used as anchors so that the teeth that are out of position can be moved back into position and rotated back into an upright position or the patient can have a mini implant placed that can be used as the anchor for repositioning their teeth that need to be moved and have the brackets only on those teeth that need to be repositioned. This reduced the number of teeth that need to have brackets on to achieve the orthodontic treatment the patient needs and thus reduces the visibility of the treatment. In fact for most posterior (back) teeth the orthodontic treatment is practically undetectable.

     Some of the restrictions of orthodontic treatment are that patient’s need to avoid foods that can damage the brackets or bands such as chewing gum, nuts, popcorn, hard candies, caramel, gummy bears and so forth. Having orthodontic brackets and bands also means that oral hygiene is more difficult and therefore needs more attention to detail and needs to be preformed more often and for a longer period of time than usual. Orthodontics can be an integral aspect of a patient’s treatment no matter what their age and can make a world of difference in the outcome of treatment, making it more aesthetic and imparting additional longevity to it thus giving the patient additional value to whatever restorative treatment they have.