What Are Orthodontics?
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 30% of the population has malocclusions severe enough to benefit from orthodontic treatment. 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.
How Does Orthodontic Treatment Work?
In their entirety, braces work by applying continuous pressure over a period of time to slowly move teeth in a specific direction. As the teeth move, the bone changes shape as pressure is applied.
Braces are made up of the following components:
- Brackets are the small squares that are bonded directly to the front of each tooth with a special dental bonding agent or are attached to orthodontic bands. Brackets act like handles, holding the archwires that move the teeth. There are several types of brackets, including stainless steel and tooth-colored ceramic or plastic, which are often selected because they’re less obvious. Occasionally, brackets are cemented to the back of teeth, in order to hide them from view.
- Orthodontic bands are stainless steel, clear, or tooth-colored materials that are cemented to the teeth with dental bonding agents. They wrap around each tooth to provide an anchor for the brackets. The clear or tooth-colored bands are more cosmetically appealing options but are more expensive than stainless steel. They are not used in all patients. Some people have only brackets and no bands.
- Spacers are separators that fit between teeth to create a small space prior to the placement of orthodontic bands.
- Arch wires attach to the brackets and act as tracks to guide the movement of the teeth. Archwires can be made of metal or be clear or tooth-colored.
- Ties are small rubber rings or fine wires that fasten the archwire to the brackets. They can be clear, metal, or colored.
- A buccal tube on the band of the last tooth holds the end of the archwire securely in place.
- Tiny elastic rubber bands, called ligatures, hold the archwires to the brackets.
- Springs may be placed on the archwires between brackets to push, pull, open, or close the spaces between teeth.
- Two bands on the upper teeth may have headgear tubes on them to hold the facebow of the headgear in place. (A headgear is another tool used by orthodontists to aid in correcting irregularities of the teeth; see below)
- Elastics or rubber bands attach to hooks on brackets and are worn between the upper and lower teeth in various ways. They apply pressure to move the upper teeth against the lower teeth to achieve a perfect fit for individual teeth.
- Facebow headgear is the wire gadget that is used to move the upper molars back in the mouth to correct bite discrepancies and also to create room for crowded teeth. The facebow consists of an inner metal part shaped like a horseshoe that goes in the mouth, attaching to buccal tubes, and an outer part that goes around the outside of the face and is connected to a headgear strap.
Newer “mini-braces,” which are much smaller than traditional braces, may be an option for some. There is another method of straightening teeth that uses removable plastic retainers that may also work when crowding of the teeth is not too severe. Your orthodontist will discuss the various types of braces with you and determine which might be the best option for your situation.
How Often Will I Need to See the Orthodontist During Treatment?
Your orthodontist will want to see you about every month or so in order to make sure the braces are exerting steady pressure on the teeth. To create more tension and pressure on your teeth, the orthodontist will make adjustments in the wires, springs, or rubber bands of the braces. In some cases, braces alone aren’t enough to straighten the teeth or shift the jaw. In these situations, an external appliance, such as headgear, may need to be worn at home in the evening or through the night.
How Long Will I Have to Wear Braces?
The time required for braces varies from person to person, depending on the severity of the problem; the amount of room available; the distance the teeth must travel; the health of the teeth, gums, and supporting bone; and how closely the patient follows instructions. On average, however, once the braces are put on, they usually remain in place for one to three years. After braces are removed, most patients will need to wear a retainer all the time for the first six months, then only during sleep for many years.
Will Braces Be Painful?
Some of the adjustments your orthodontist may make to your braces may make your mouth feel sore or uncomfortable. When needed, over-the-counter pain relievers like Motrin or Tylenol can help relieve the pain. If you always experience a lot of pain after your braces are adjusted, talk to your orthodontist about it; he or she may be able to make the adjustments a bit differently.
Does the Age Affect the Success of Braces?
The mechanical process used to move teeth with braces is the same at any age. So the benefits of orthodontic treatments are available to both children and adults who wish to improve their appearance and bite. The main differences between treatments in adults and children is that certain corrections in adults may require more than braces alone and the treatments may take longer because adult bones are no longer growing.
Can I Continue to Play Sports While Wearing Braces?
If you have braces, you can continue to participate in any sport you choose. When playing sports where there is a possibility of getting hit in the mouth, a specially designed mouthguard will need to be worn. The mouthguard, made of durable plastic, is designed to fit comfortably over your braces and will protect the soft tissues inside the mouth.