Orthodontics, the branch of dentistry concerned with the growth of the teeth, jaws and face, is in high demand. Orthodontic treatment is about making the best of your teeth; it’s about improving the harmony of your mouth and jaws. Once you can bite together correctly, you can eat more comfortably and care for your teeth and gums more easily. And your smile will benefit immensely.
The Starting Point
Most courses of orthodontic treatment begin with a referral from a general dentist to a specialist. Depending on what treatment is needed, most patients are seen by a specialist in a local practice or by a consultant in hospital. Some patients are treated by dentists with extra training and experience to treat the milder cases.
These are some of the most common reasons for a referral:
- Protruding upper front teeth – one of the most common dental problems
- Crowding – a narrow jaw may mean there is not enough room for your teeth, resulting in crowding. Conversely, some patients have significant gaps between their teeth.
- Asymmetry – particularly when the centre lines of the upper and lower front teeth do not match, perhaps because the teeth have drifted or the position of the jaw has shifted.
- A deep bite – when your upper teeth cover the lower teeth too much
- A reverse bite – when your upper teeth bite inside the lower teeth
- An open bite – when your front teeth remain apart when your back teeth meet; the tongue is often still visible between the upper and lower front teeth.
- Impacted teeth – in some patients, secondary teeth come through in the wrong position or do not erupt at all. Orthodontic treatment can help bring these teeth into the correct position.
Every patient needs tailor-made treatment, planned by the orthodontist and agreed with you, the patient. In order to decide what treatment is required for you, your orthodontist will need to carry out a full assessment of your teeth which is likely to include x-rays, impressions (moulds of the teeth) and photographs. Treatment can take more than two years so it is important you are happy from the outset with what is recommended. Braces are almost always needed. Those which are used most often are:
A fixed brace – this is the most common type of brace today, often known as “train tracks”. Brackets are glued onto the teeth and linked by wires. Small elastic hoops are often used to hold the wire in position. The wires exert gentle pressure to move the teeth into a new position. The brackets can be metal, ceramic or even gold and the elastic hoops come in many colours.
A removable brace – this is sometimes used for correcting a simple problem, such as moving a single tooth or expanding the dental arch. It has a plastic baseplate with wires and springs attached. Removable braces need to be worn all the time except for cleaning or sport.
Functional appliances – these are used to harness the growth of the jaws and improve way the upper and lower teeth meet. There are several designs all of which fit on to both the upper and lower teeth and hold the lower jaw forward. They are mostly removable but should be worn as near to full-time as possible.
Retainers – at the end of treatment, all patients should wear retainers to hold their teeth in the new position. These can be removable or fixed and are an important part of treatment.
Ceramic (Invisible Braces )
Traditionally, braces have consisted of metal brackets and wires. However, some people have feared the idea of a “metal mouth” so much that they refuse to wear braces altogether, missing out on the possibility of a beautiful smile. For this reason, orthodontic research began to focus on less visible options.
Those wanting “invisible” braces can choose from four options:
Ceramic, sapphire and lingual braces all function the same way as metal braces. Brackets are glued to the front of your teeth. A wire is shaped into the ideal position of your teeth, then threaded through the brackets. As the wire struggles to get back to its original shape, it gradually pressures your teeth into that shape as well. Your orthodontist (a dentist trained in tooth movement and dentofacial orthopedics) will tighten the wires every four to six weeks. You should see a nice, straight smile within two or two and a half years (though this time period can be shorter or longer, depending on the severity of your problem). Once your braces come off, you will likely wear a retainer for six months to a year, to keep your teeth from shifting and make sure your new smile stays in place.
The difference, though, is that these three types of braces don’t look like traditional braces. Ceramic brackets are transparent and blend in with the teeth. Sapphire brackets are also very transparent, but tend to look best against very white teeth (otherwise, they can stand out). Both of these types of braces are placed on the front of the teeth and are barely visible from over a metre away, or in photographs. Lingual brackets and wires, meanwhile, are glued onto the back of the teeth, making them completely invisible when you smile.