What, Why, When, Who
If you don't find the Question & Answer you are looking for, there is lots more information to be found in the About Orthodontics section.
Orthodontics is the branch of dentistry concerned with the growth and development of the teeth, jaws and face. Orthodontic treatment aims to enhance facial appearance, straighten irregular teeth, correct problems with the bite and of course create a great smile.
It is often thought orthodontic treatment can only be carried out in young people but treatment can also be undertaken very successfully for adults.
Most patients seek orthodontic treatment to obtain a great smile. This is not vanity but recognition that an attractive smile is an essential component of positive self esteem. But, as shown by psycho-social research, it's more than just self esteem as appearance also affects the way people are seen and treated by others.
|Before and after. Now a smile to be proud of.|
Incorrect bites are not always harmful, but some abnormalities are damaging to the gums or the teeth.
It is not strictly necessary to have straight teeth to keep them clean and free of decay but it is a lot easier. It is also probably true that people who are happy with their teeth are better motivated at looking after them.
One boy in five breaks or damages a tooth in an accident by the age of 15 and the risks increase when the front teeth protrude. Orthodontic treatment is used to reduce the risk of damage.
|Some types of bite can be damaging.|
The American Association of Orthodontists recommends that every child first visit an orthodontist by age 7. However, we prefer to advise an initial visit be arranged when either the child, parent or dentist first become concerned about the development of the face, bite or dentition.
If a problem is identified but the timing is not right for treatment, arrangements are made to see the child again at the optimum age for that particular condition.
Short courses of treatment at age 8 are desirable for certain problems such as crossbites. For some patients, functional appliances are used at age 10 to improve growth of the jaw and the facial profile. However, the majority of treatments begin when most of the permanent teeth have come through, at age 11 to 13.
So long as the teeth and gums are sufficiently healthy, there is no upper age limit. More information is available in the 'Adult Orthodontics' page in the About Orthodontics section.
The large majority of orthodontic treatment can be carried out without the extraction of any teeth. However, when the teeth are severely crowded, the process of alignment causes the front teeth to come too far forward and look unattractive. Additionally, teeth in this position are vulnerable to recession of the gums and will tend to relapse towards their original positions.
Extractions are therefore only undertaken when failure to extract would result in a poor appearance or could be damaging or unstable. When crowding is just moderate, other techniques are available to create space without extractions. For more information, go to crowding in About Orthodontics.
The mouth and dentition develop under the combined influence of both genetic inheritance and acquired environmental factors. Genetics undoubtedly has a role. How else do people look like their parents? The influence can be remarkably detailed; for example, identical twins often have the exact same tooth that is twisted, in the same direction, and by a similar amount. Inherited factors control the size of the teeth, extra or missing teeth and some aspects of jaw growth.
Acquired or environmental factors modify the way in which the jaws and dentition develop. Examples include thumb or finger sucking, mouth breathing and some types of tongue posture and behaviour.
The majority of treatment in the UK is carried out by specialists. In order to become a specialist in orthodontics, it is necessary for a dentist to undergo a further three years full time training during which he or she treats over 100 patients with severe orthodontic problems under very close guidance and supervision. The training programmes also include detailed study of facial growth, orthodontic science and published research. The trainees have to pass postgraduate exams if they are to be awarded an MOrthRCS qualification and registered as specialists with the General Dental Council.
It may be of interest that for six years Dr Kirschen was a Royal College of Surgeons examiner for the MOrthRCS qualification.
We have specialised in the use of ceramic cosmetic braces over many years and these are used routinely for adults and selectively for children. The alternatives are high quality mini metal or low friction braces.
We also offer invisible lingual braces (bonded to the inside surfaces of the teeth) for the treatment of irregular front teeth in suitable cases. We don't offer lingual braces for the treatment of more complex problems as we are not totally satisfied with the quality of results achieved for this group of patients. For patients with bite problems or more severe crowding, ceramic labial braces offer more predictable and better quality results.
More information on braces can be found in About Orthodontics.
There are few risks in orthodontics. If the teeth are not kept properly clean or if the diet includes frequent intakes of sweetened foods and drinks, white spots can occur on the teeth. Permanent marking of the teeth is rare as we provide dental hygiene advice and toothbrushes throughout treatment and, when needed, fluoride mouthwash.
As the teeth move, the roots shorten slightly at their tips. This is very common and is usually of no significance. A few people are at greater risk of rare but more severe root shortening. However, we mitigate against this by checking the radiographs for risk factors (though some people are susceptible without visible risk factors), by using gentle forces and by keeping the fixed brace part of treatment as short as possible.
Finally, a rare complication in adults is ankylosis. This is when part of the surface of the root of a tooth is fused to the bone of the jaw. The effect is that such a tooth is literally unable to move orthodontically. Ankylosed teeth can often but not always be identified before the start of treatment.