Orthodontics
Braces
Dental braces (also known as orthodontic braces) is a device used in orthodontics to align teeth and their position with regard to a person's bite. They are often used to correct malocclusions (A malocclusion is a misalignment of teeth and/or incorrect relation between the teeth of the two dental arches) such as underbites, overbites, cross bite and open bites, deep bites, or crooked teeth and various other flaws of teeth and jaws, whether cosmetic or structural. Orthodontic braces are often used in conjunction with other orthodontic appliances to widen the palate or jaws or otherwise shape the teeth and jaws.
The type of braces you want depends on a number of factors:
· The extent of your treatment, such as:
o The severity of your bite or tooth crookedness problems
o If extractions are necessary
o If jaw surgery is necessary
o If headgear or other special appliances are necessary
o The amount of time you will need to wear braces
· How much you are willing to pay
· How long you will be in braces to correct your problems
· What you, yourself desire.
· Metal braces - (Multiple sittings)
· Metal brackets can be silver or golden. The golden brackets look a bit more "jewelry-like" and are often a popular choice with young women.
· Metal brackets are very strong and can withstand most types of treatment. At first they may irritate your gums, but after a few weeks, when your cheeks get "toughened up" they are not a problem anymore. Most traditional metal braces require an elastic o-shaped rubber band, called a ligature to hold the arch wire onto the bracket. Sometimes orthodontists use metal tie wires (little wires which are twisted around the bracket) in place of elastic ligatures.
Pros
· Metal brackets tend to be the least expensive of all the types of braces.
· They tend to take the least amount of time among all the types of braces.
· You can choose a darker ligature, which will not show curry, smoking, or black coffee stains.
· Self-ligating brackets do not contain rubber ligatures, so staining will never be a problem.
· They are strong and rarely break.
· The golden brackets are different, novel, and generally look nice.
· Viazis Brackets and self-ligating brackets can complete treatment in a shorter time with less pain; however orthodontists need special training in these systems, and they not available everywhere.
Cons
· They are more visible than ceramic and Invisalign (the traditional "metal mouth.")
· They tend to be a bit less comfortable at first, (but that feeling wears off after a couple of weeks).
· When you have a canker sore, they tend to irritate your gums more than ceramic brackets.
· Invisible orthodontics
o Invisalign - (Multiple sittings)
Invisalign braces are great for people who do not have severe problems. The "braces" consist of strong plastic trays that are fabricated especially for you. They are indeed invisible. If your bite is not severely off and your teeth are not severely crooked, then Invisalign would be a good choice. You would be able to get your teeth straightened without anyone seeing that you are wearing "braces"! This appeals to many adults, especially people who wore traditional braces as children and then need more treatment later in life. However, if your bite is very bad, if you need extractions or require headgear or other appliances, then Invisalign will not work for you; you will need to wear traditional braces.
Pros
· They are virtually invisible, and nobody knows you're wearing them but you.
· They are easier to clean than traditional braces.
· They don't irritate your gums as much as traditional braces, so there is little (if any) need for dental wax.
· They do not stain at all.
· The aligners are numbered and worn for two weeks each, so your time in treatment is well established.
· You'll get a computer simulation showing how your teeth will move during treatment, and see the projected final outcome.
Cons
· They cost as much as traditional braces, and sometimes even more.
· Treatment can take as long as traditional braces.
· In some cases, you may still need traditional braces for a few months after your Invisalign treatment, to correct certain problems.
· You will still have tooth pain, because your teeth will be moved by the Invisalign trays. Invisalign is not a pain-free treatment.
· The plastic trays are computer-fabricated by Align Technologies. Your orthodontist only has some control over your treatment.
· It takes 6 weeks for the aligners to arrive from the factory -- a long time to wait. You may need more aligners (i.e., enhancements) after the original set of aligners.
· If you have severe problems, your orthodontist will tell you that you are not a candidate for Invisalign.
o Ceramic Braces - (Multiple sittings)
Ceramic brackets are made of composite materials. They are very strong and generally do not stain. Adults like to choose ceramic because they "blend in" with the teeth and are less noticeable than metal. The ligatures (tiny rubber bands) that hold the arch wire on to the ceramic brackets are often white or clear. The ligatures can stain if you eat a lot of curry, smoke, or drink a lot of black coffee. The ligatures are changed each time you get an adjustment - usually, monthly. It's only the ligatures that stain, not the brackets themselves.
Pros
· They blend in with most teeth, particularly if they are not perfectly white. They are not very noticeable at a distance or in photos.
· Some people feel that they are more comfortable than metal and irritate your gums less.
· Contrary to what you may have heard, ceramic brackets do not usually break or come off your teeth. They are very strong, and if bound with a plasma light, stay on as well as metal brackets.
Cons
· The clear or white ligatures (little elastics that hold the arch wire to the brackets) can stain, which defeats esthetics of the ceramic braces. But those are changed at your monthly adjustment.
· Ceramic brackets are are usually more expensive than traditional metal brackets.
· Treatment can take a few months longer in ceramic braces.
· From a purely esthetic point of view, they are a bit larger than metal brackets.
· If you have severe problems, your orthodontist will not use ceramic brackets in many cases, because they may not be strong enough to withstand the forces of some types of treatment.
o Lingual Orthodontic treatment - (Multiple sittings)
Lingual braces are placed behind your teeth, and are therefore virtually invisible to other people. Usually, lingual brackets are made of metal.
Pros
· Other people can't see the brackets unless they look inside your mouth.
Cons
· They tend to hurt your tongue and make it difficult to speak at first.
· They tend to be more expensive than traditional metal, because treatment is specialized.
· Treatment can take a few months longer than traditional braces.
· If you have severe problems, or need certain types of appliances, lingual treatment may not be applicable.
· Surgical Orthodontics - (Multiple sittings)
Surgical Orthodontics is also called Orthognathic Surgery. An orthodontist cannot move teeth anywhere the bone will not follow. In instances of extreme deformity, where an adult's lower jaw is hopelessly inadequate (Class II) to correct with orthodontics alone, or in many cases of lower jaw prognathism (Class III), and frequently in cases of anterior open bite (where only the upper and lower back teeth make contact), it becomes necessary to combine the orthodontist's skills with that of an oral surgeon to affect a cure. One of the largest advantages of surgery combined with orthodontic treatment is the marked improvement most patients have in their facial appearance after treatment. Patients have quick relief from long standing functional disabilities as well. Those who could not chew their food can now eat without difficulty. Patients who could not close their lips around their front teeth now can.
· Adult Orthodontics - (Multiple sittings)
Most people have a misconception that orthodontics is only for growing children. The following are some of the reasons why most adults today opt for orthodontic treatment
· Straight teeth are healthy teeth. Teeth that aren't overly crowded are easier to keep clean. This means that adult gums will be healthier and this will diminish the chances of decay and early tooth loss.
· Teeth that do not line up properly can cause abnormal wear of tooth surfaces as well as cause excess stress on supporting bone and gum tissue. This can lead to gum disease and the eventual need for denture.
· Many adults suffer from temporomandibular disorders or TMD for short. These disorders can cause jaw clicking, headaches, facial pain and a vast array of symptoms. Proper tooth and jaw position can eliminate these problems.
However following are the cons of this procedure
· The bones of an adult, unlike those of a child, are no longer growing. Because of this, treatment can be slower and take longer to accomplish. The end results, however, are usually well worth the wait.
· The bony support for an adult's teeth is firmer than that of a growing child and is naturally more resistant to tooth movement. Though this is a hindrance, it isn't a deterrent. As long as the teeth, the gums, and the underlying bone are healthy, teeth can be straightened at any age.
In most cases, treatment for adults is nearly identical as for children
· Growth Modification and Growth Enhancement in children - (Multiple sittings)
Growth modification (early treatment) is part of the first phase of two-stage orthodontic treatment of children with malocclusion (poor bite). Growth modification is only possible when bones are still growing. It is most effective during children's growth spurts. Orthodontists use growth modification devices (appliances) to change the position, shape, length, or width of the jawbone(s). Some common devices are:
- Headgear, an appliance that uses pressure to guide teeth and jaw growth.
- Herbst, an appliance attached to the upper and lower molars that corrects overbites caused by a small lower jaw.
- Bionator, a removable appliance that guides teeth and jaw growth.
- Palatal expansion, an appliance that corrects crossbite by widening the upper jaw.
Ideal timing of treatment varies depending on the condition, when adult teeth come in, and the amount of growth necessary to correct the malocclusion. Many children who begin growth modification in second or third grade are finished with orthodontic treatment before they begin high school.
Children are often more cooperative than teenagers when it comes to wearing their appliances for a certain number of hours a day. And they don't seem to mind closer parental supervision as much as teens do. Because the jaw continues to grow during childhood and adolescence, growth modification doesn't always last. Some teens and adults keep their new jaw structure and size, while others have short-lived improvement. However, relapse can also occur after treatment with braces alone.
· Habit breaking appliances
These are appliances that is made by a dentist to combat habits in children like thumb sucking, finger biting, nail biting, lip biting, mouth breathing, tongue thrusting etc. They can be either a fixed or removable type. If these habits are continued for a prolonged period of time that can result in gum disease, change in position of teeth and change in shape of the jaws.
