Orthodontics is a specialty of dentistry that deals with the diagnosis, prevention and correction of malpositioned teeth and jaws. It can also focus on modifying facial growth, known as dentofacial orthopedics.
Abnormal alignment of the teeth and jaws is common. Nearly 50% of the population, according to the American Association of Orthodontics, has malocclusions severe enough to benefit from orthodontic treatment. although this figure decreases to less than 10% according to the same AAO statement when referring to medically necessary orthodontics. Treatment can take several months to a few years, it involves the use of dental braces and other appliances to slowly move the teeth and jaws around. If the malocclusion is very severe, jaw surgery may be used. Treatment is usually started before a person reaches adulthood since bones can more easily be moved around in children.
Orthodontic therapy can include the use of fixed or removable appliances. The majority of orthodontic therapy is delivered using appliances that are fixed in place, for example with braces that are bonded to the teeth with adhesives. Fixed appliances can have a greater mechanical control of the teeth and the treatment outcome is greater with the use of fixed appliances.
BracesBraces are usually placed on the front side of the teeth, but may also be placed on the side facing the tongue (called lingual braces). Brackets made out of stainless steel or porcelain are bonded to the center of the teeth using an adhesive. Wires are placed in a slot in the brackets which allows for controlled movement in all three dimensions.
HeadgearOrthodontic headgear, sometimes referred to as an “extra-oral appliance” is a treatment approach that requires the patient to have a device strapped onto his or her head to help correct malocclusion — typically used when the teeth do not align properly. Headgear is most often used along with braces or other orthodontic appliances: While braces correct the position of teeth, orthodontic headgear — which as the name suggests is worn on or is strapped onto the patient’s head — is most often added to orthodontic treatment to help alter the alignment of the jaw, although there are some situations in which such an appliance can help move teeth, particularly molars.
Palatal expansionPalatal expansion can be achieved using either fixed or removable appliances.
Jaw surgeryJaw surgery may be required to fix severe malocclusions. The bone is broken during surgery and is stabilised with titanium (or bioresorbable) plates and screws to allow for healing to take place. After surgery, regular orthodontic treatment is used to move the teeth into their final position.
Post treatmentAfter orthodontic treatment has completed, there is a tendency for teeth to return, or relapse, back to their pre-treatment positions. Over 50% of patients have some reversion to pre-treatment positions within 10 years following treatment. To prevent relapse, the majority of patients will be offered a retainer once treatment has completed, and will benefit from wearing their retainers. Retainers can be either fixed or removable.
Removable retainers are made from a clear plastic, and they are custom-fitted for your mouth. It has a tight fit and holds all of your teeth in position. There are many types of brands for clear retainers including, Zendura Retainer, Essix Retainer and Vivera Retainer. Hawley retainer is also a removable orthodontic appliance made from a combination of plastic and metal that is molded custom to fit your mouth. Removable retainers will be worn for different periods of time depending on patient need to stabilise the dentition.
Fixed retainers are a simple wire fixed to the tongue-facing part of the incisors using dental adhesive and can be specifically useful to prevent rotation in incisors. Other types of fixed retainers can include labial or lingual braces, with brackets fixed to the teeth.