| What
is Orthodontics?
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
and to correct problems with the bite and positions
of teeth. The technical term for these problems is "malocclusion",
which means "bad bite".
The
terms 'facial orthopaedics' and 'functional orthodontics'
are sometimes used to describe treatment to alter or
enhance the development of either the upper or lower
jaw bones, or both. These concepts may be useful to
explain the effects of treatment on the skeletal facial
structures (orthopaedics) as distinct from the effects
on the teeth (orthodontics). However, in reality, the
distinction is far from clear and all are part of the
specialty of orthodontics. More information can be found
in the orthopaedics page.
It
is often thought orthodontic treatment can only be carried
out in young people but treatment can, in most cases,
also be undertaken very successfully for adults (a third
of our patients are adults).
Why
Do Problems Arise?
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,
jaw muscle characteristics and some jaw growth problems.
Acquired
or environmental factors modify the way in which the
jaws and dentition develop. Examples include thumb or
finger sucking, mouth breathing, some types of tongue
posture and behaviour, and the previous loss of teeth
because of decay or accidents. However, some of these
may also be subject to genetic control such as tongue
size and posture.
Why Orthodontics?
Most patients seek orthodontic treatment to improve
appearance. This is not vanity but recognition that
an attractive smile is an essential component of self
esteem. But, as shown by psycho-social research, it's
more than just self esteem as appearance also affects
the way people are treated by others. Orthodontic treatment
can also undo the effects of thumb and digit sucking
habits.
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Although
an incorrect bite is not always harmful, there
are some abnormalities of the bite that are damaging
to the gums or the teeth themselves. No clear
relationship between the bite and jaw joint problems
has been shown by properly conducted research,
but a link may be present in some individual cases.
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| Some
types of bite can be damaging. |
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.
Statistically, one boy in five breaks or damages a tooth
in an accident by the age of 15. The risks increase
when the front teeth protrude and orthodontic treatment
is used to reduce the risk of damage.
When
Orthodontics?
The American Association of Orthodontists recommends
that every child first visit an orthodontist by age
7. We don't disagree with this view although 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 treatment of that particular
condition.
Who Does Orthodontics?
Depending on the complexity of the problem, orthodontic
treatment can be carried out by general dentists but,
in the UK, the majority of treatment is carried out
by orthodontic 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 between
100 and 150 cases under very close guidance and supervision.
The training programmes, which are inspected by the
Royal College of Surgeons, also include detailed study
of facial growth, orthodontic science and previous research.
The trainees also have to pass a testing series of exams
if they are to be awarded an MOrthRCS qualification
and registered as specialists with the General Dental
Council. (It is important to distinguish this process
from weekend courses where participants are not assessed
for competence but are nevertheless awarded certificates.)
It
may be of interest that Dr Kirschen has been appointed
by the Royal College of Surgeons as an examiner for
the MOrthRCS qualification undertaken by specialist
trainees at the end of their three year course.
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