Braces Treatment and Orthodontics

Children and adults with poorly aligned teeth tend to have much more tooth decay, gum disease and jaw joint problems. Facial esthetics can also be affected by irregular teeth.

Age is not a factor. However, a timely screening will lead to better treatment results. Patients require healthy supporting structures to have orthodontic therapy.

Major advances in technology and materials have taken place leading to the following –

Transparent invisible fibre braces are available, which are aesthetically appealing. With the advances that have been made in this area of specialisation, orthodontic treatment is possible even in patients as old as 45 - 50 years provided the gum condition is good.

Depending on the compliance of the patient and treatment needs, the orthodontist selects either fixed or removable appliances.

Fixed appliances are worn all the time and are indicated for treating moderate to severe mal-alignment. Brackets, bands and wires constitute fixed braces. Brackets can be made of metal, ceramic or plastic or combinations of these materials.

Removable appliances are indicated for mild deformities. This appliance can be removed by the patients.

Ceramic brackets are typically clear or tooth-colored. They are used for adult patients who want to minimize the visibility of their braces.

Dentofacial (jaw) growth discrepancies are often corrected using functional appliances.

CLASS II: When the lower jaw growth does not keep up with upper jaw growth, cervical pull or high pull headgear helps in reducing the problem.

CLASS III: Reverse pull headgear, facemasks and chin cups help when upper jaw growth does not keep up with lower jaw growth.

Children who have crowded teeth and narrow arches require palatal expanders. The palatal expander is a device that is either permanently or temporarily placed into the upper arch and will gradually widen it enough to make room for the teeth.

A palatal expander is used for expanding narrow upper arch and normally used for six to eight months. After the device is inserted, either the parent or the orthodontist will expand the palate once or twice a day.

Palatal expanders broaden the upper arch and create a soft rounded "U" shape arch. This helps to make the smile attractive.

Lingual braces are placed behind the teeth in contrast to metal or ceramic braces which are applied to the front of your teeth. They are highly cosmetic alternative to those patients who otherwise would not consider treatment. Initially, the tongue becomes sore but the discomfort reduces as the treatment progresses.

Orthognathic Surgery treats improper bite and incorrectly positioned jaws. Jaw growth is a slow and gradual process. This can affect chewing function, speech, long-term oral health, and appearance. Injury to the jaw and birth defects can also affect jaw alignment.

While orthodontics alone can correct many "bite" problems if only the teeth are involved, Orthognathic Surgery may be required if jaws are involved or are not related properly.

Pre-surgical orthodontics will move your teeth into a new position, so they will fit together properly when the jaws are surgically repositioned. During this pre-surgical orthodontic phase of treatment, which usually lasts 6-18 months, you will be wearing braces and will visit your orthodontist regularly for necessary adjustments to your braces and ongoing evaluation.

After surgery, final orthodontic tooth movement is usually necessary to "fine-tune" your bite.

Orthodontic treatment usually takes 18 - 24 months. Some patients may finish treatment earlier and others may take longer to complete. The total treatment time depends on the severity of the malocclusion, the type of treatment carried out, and the co-operation of the patient.

After the completion of the active part of orthodontic treatment, the braces are removed and retainers (retaining appliances) are fitted to hold the teeth steady in their new position. These appliances may be removable plates or wires fitted behind the teeth.

Retainers play an important role in the treatment. If they are not worn according to instructions, the teeth may move back towards their original position.

The retaining appliances are usually worn:

The orthodontist observes the corrected teeth periodically for about five years after the retainers have been phased out.