Orthodontics

BRACES

Orthodontic Treatment (Braces)

The benefits of orthodontic treatment often go beyond the obvious physical changes of an improved bite and straighter teeth; it’s also a great way to improve a person’s overall self-image. While having beautiful straight teeth is important, even more important is the need to alleviate any potential health problems associated with the teeth or jaw. Crooked teeth or jaw problems may contribute to improper cleaning of teeth, leading to tooth decay and, possibly, gum disease or total tooth loss. Orthodontic problems that go untreated can lead to chewing and digestion difficulties, speech impairments, and abnormal wear of tooth surfaces. Over time, excessive strain on gum tissue and the bone that supports the teeth can affect the jaw joints leading to problems such as headaches or face and neck pain.

The Canadian Association of Orthodontics recommends that children get an orthodontic evaluation no later than age 7. Though orthodontic treatment can be done at any age, timely treatment ensures maximum dental health.

With all of the recent advancements in orthodontics, wearing braces has never been easier. State-of-the-art appliances and treatments are now available, from traditional metal braces, to clear and tooth colored brackets, to NASA type wires that are heat activated and require fewer adjustments! Some patients may even be candidates for treatment with Invisalign, a revolutionary way to straighten teeth using clear, retainer type aligners that require no braces or wires!

If treatment is necessary, we will thoroughly discuss which treatment option is best suited for you!

Reasons for orthodontic treatment (braces) adults & children:

• Breathing or swallowing problems– Mouth breathing can lead to snoring and sleep apnea.
• Crossbite– One or more upper teeth bite inside the lower teeth (towards the tongue).
• Crowding– Involving extra teeth or malpositioned teeth.
• Deep Overbite– The lower front teeth bite into the upper tissue of the upper teeth.
• Disfiguring of the face & mouth– Affects the development of the jaw and position of the teeth.
• Jaw & jaw joint pain
• Missing or extra teeth– Due to tooth decay, injuries, or inherited problems.
• Overjet (protruding upper teeth)– Upper teeth that protrude beyond normal and are usually associated with a short lower jaw.
• Self-image– An attractive smile can boost a person’s self-image and confidence.
• Spacing between teeth– Teeth are missing or may be too small or too large.
• Speech, chewing or biting problems
• Underbite (lower jaw protrusion)– Lower jaw is longer than the upper jaw.

Specific to children:

• Finger or thumb sucking– These habits can cause protrusion of the upper incisor teeth, and mouth breathing.
• Teeth erupting out of position– Can be guided to proper alignment.

What does orthodontic treatment involve?

Orthodontic treatment involves three phases:

1. Planning Phase– Your first couple of visits may include the following:

• A medical and dental history evaluation.
• Castings or “molds” of your teeth.
• Computer generated photograph of the head and neck that will aid in planning.
• Photographs of your face and mouth.
• X-rays of the teeth and jaws.

After careful planning, your orthodontist will design and apply braces or fabricate custom-made appliances for you.

2. Active Phase– Active treatment involves visiting your orthodontist on a regular basis for adjustments and following specific treatment requirements to ensure successful treatment.
3. Retention Phase– When treatment is completed, the braces and/or appliances are removed and a new appliance is made. Usually these retainers are removable and will maintain the changes made to your teeth if worn continuously until the teeth and bone are stabilized in their new positions.

Treatment and retention times vary depending on each individual case. Your orthodontist will ensure you have a successful treatment for a beautiful smile that can last a lifetime.

Orthodontics can not only help straighten your teeth, giving you an appealing smile, but can greatly contribute to the health of your jaw, teeth and sometimes your overall health.

What Causes misalignment of teeth?

Poorly aligned teeth often cause problems speaking, biting and chewing. Most irregularities are genetic or occur as a result of developmental issues. Conversely, some irregularities are acquired or greatly exacerbated by certain habits and behaviors such as:

• Mouth breathing
• Thumb or finger sucking
• Prolonged pacifier use
• Poor oral hygiene
• Poor nutrition

What’s involved when a child gets braces?

The orthodontist initially conducts a visual examination of the child’s teeth. This will be accompanied by panoramic x-rays, study models (bite impressions) and computer generated images of the head and neck. These preliminary assessments are sometimes known as the “planning phase” because they aid the orthodontist in making a diagnosis and planning the most effective treatment.

In many cases, the orthodontist will recommend “fixed” orthodontic braces for a child. Fixed braces cannot be lost, forgotten or removed at will, which means that treatment is completed more quickly. Removable appliances may also be utilized, which are less intrusive, and are generally used to treat various types of defects.

Here is a brief overview of some of the main types of orthodontic appliances used for children:

• Fixed braces– Braces comprised of brackets which are affixed to each individual tooth, and an archwire which connect the brackets. The brackets are usually made of metal, ceramic, or a clear synthetic material which is less noticeable to the naked eye. After braces have been applied, the child will have regular appointments to have the braces adjusted by the orthodontist. Orthodontic elastic bands are often added to the braces to aid in the movement of specific teeth.
• Headgear– This type of appliance is most useful to treat developmental irregularities. A headgear is a custom-made appliance attached to wire that is worn to aid in tooth movement. A headgear is intended to be worn for 12-20 hours r each day and must be worn as recommended to achieve good results.
• Retainers– Retainers are typically utilized in the third phase (retention phase). When the original malocclusion has been treated with braces, it is essential that the teeth do not regress back to the original misalignment. Wearing a retainer ensures the teeth maintain their proper alignment, and gives the jawbone around the teeth a chance to stabilize.

If you have questions about braces for children, please contact our office.

BRACES FOR ADULTS

Orthodontic braces were historically associated with teenagers. Today, an increasing number of adults are choosing to wear braces to straighten their teeth and correct malocclusions (bad bites). In fact, it is now estimated that almost one third of all current orthodontic patients are adults.

Orthodontic braces are predictable, versatile and incredibly successful at realigning the teeth. Braces work in the same way regardless of the age of the patient, but the treatment time is greatly reduced in patients who are still experiencing jaw growth and have not been affected by gum disease. In short, an adult can experience the same beautiful end results as a teenager, but treatment often takes longer.

Can adults benefit from orthodontic braces?

Absolutely! Crooked or misaligned teeth look unsightly, which in many cases leads to poor self esteem and a lack of self confidence. Aside from poor aesthetics, improperly aligned teeth can also cause difficulties biting, chewing and articulating clearly. Generally speaking, orthodontists agree that straight teeth tend to be healthier teeth.

Straight teeth offer a multitude of health and dental benefits including:

• Reduction in general tooth decay
• Decreased likelihood of developing periodontal disease
• Decreased likelihood of tooth injury
• Reduction in digestive disorders

Fortunately, orthodontic braces have been adapted and modified to make them more convenient for adults. There are now a wide range of fixed and removable orthodontic devices available, depending on the precise classification of the malocclusion.

The most common types of malocclusion are underbite (lower teeth protrude further than upper teeth), overbite (upper teeth protrude further than lower teeth) and overcrowding, where there is insufficient space on the arches to accommodate the full complement of adult teeth.

Prior to recommending specific orthodontic treatment, the orthodontist will recommend treatment of any pre-existing dental conditions such as gum disease, excess plaque and tooth decay. Orthodontic braces can greatly exacerbate any or all of these conditions.

What are the main types of orthodontic braces?

The following are some of the most popular orthodontic braces:

• Traditional braces– These braces are strong and tend not to stain the teeth. They are comprised of individual brackets which are cemented to each tooth and accompanied by an archwire which constantly asserts gentle pressure on the teeth. Traditional braces are generally metal but are also available in a clear synthetic material and “tooth colored” ceramic. The ceramic brackets are generally more comfortable than the metal alternative, but can become discolored by coffee, wine, smoking and certain foods.
• Invisalign^®– Invisalign aligners are favored by many adults because they are both removable and invisible to onlookers. Invisalign^®aligners are clear trays, and should be worn for the recommended amount of time each day for the quickest results. Invisalign^®aligners are more comfortable and less obtrusive than traditional braces, but also tend to be more costly. Not all patients are candidates for Invisalign^®.
• Lingual braces– These appliances are usually metal and fixed on the tongue side of the teeth, therefore not seen when a patient smiles. Lingual braces tend to be moderately expensive and in some cases, can interfere with normal speech.

CLEARLINE – clear aligners that move teeth provided by Protec Laboratories

If you have any questions about orthodontic braces, please contact our office.

RETAINERS

Care Following Orthodontics – Retainers

When braces are finally removed, the “retention” phase begins for most individuals. The objective of this phase is to ensure the teeth do not regress back to their previous position. A retainer will be used to maintain the improved position of the teeth. A retainer is a fixed or removable dental appliance which has been custom-made by the orthodontist to fit the teeth. Retainers are generally made from transparent plastic and thin wires to optimize the comfort of the patient.

Retainers are worn for varying amounts of time, depending on the type of orthodontic treatment and the age of the patient. Perseverance and commitment are required to make this final stage of treatment successful. If the retainer is not worn as directed by the orthodontist, treatment can fail or take much longer than anticipated.

What types of retainer are available?

There are a variety of retainers available; each one geared towards treating a different kind of dental problem. The orthodontist will make a retainer recommendation depending on the nature of the original diagnosis and the orthodontic treatment plan.

The following are some of the most common types of retainers:

• Hawley retainer– The Hawley retainer consists of a metal wire on an acrylic arch. The metal wire may be periodically adjusted by the orthodontist to ensure the teeth stay in the desired position. The acrylic arch is designed to fit comfortably on the lingual walls or palate of the mouth.
• Essix– The Essix retainer is the most commonly used vacuum formed retainer (VFR). A mold is initially made of the teeth in their new alignment, and then clear PVC trays are created to fit over the arch in its entirety. VFR’s are much cheaper than many other types of retainers and also do not affect the aesthetic appearance of the smile in the same way as the Hawley retainer. The disadvantage of VFR’s is that they break and scratch more easily than other types of retainers.
• Fixed retainers– A fixed retainer is somewhat similar to a lingual brace in that it is affixed to the tongue side of a few teeth. Usually, a fixed retainer is used in cases where there has been either rapid or substantial movement of the teeth. It usually consists of a single wire. The inclination of the teeth to move rapidly means they are also more likely to regress back to their previous position if a fixed retainer is not placed.

What do I need to consider when using a retainer?

There are a few basic things to consider for proper use and maintenance of your retainer.

Don’t lose the appliance – Removable retainers are very easy to lose. It is advisable to place your retainer in the case it came in while eating, drinking and brushing. Leaving a retainer folded in a napkin at a restaurant or in a public restroom can be very costly if lost because a replacement must be created. A brightly colored case serves as a great reminder.

Don’t drink while wearing a retainer – It is tempting to drink while wearing a retainer because of the unobtrusive nature of the device. However, excess liquid trapped under the trays can vastly intensify acid exposure to teeth, increasing the probability of tooth decay.

Don’t eat while wearing a retainer – It can be difficult and awkward to eat while wearing a removable retainer and it can also damage the device. Food can get trapped around a Hawley retainer wire or underneath the palate, causing bad breath. When worn on the upper and lower arches simultaneously, VFR retainers do not allow the teeth to meet. This means that chewing is almost impossible.

Clean the retainer properly – Removable retainers can become breeding grounds for calculus and bacteria. It is essential to clean the inside and outside thoroughly as often as possible. Hawley retainers can be cleaned with a toothbrush. Because harsh bristles can damage the PVC surface of a VFR, denture cleaner or a specialized retainer cleaner is recommended for this type of device.

Wear the retainer as directed – This phase of treatment is critical. The hard work has been done, the braces are off and now it is tempting not to wear the retainer as often as the orthodontist recommends. Retainers are needed to give the muscles, tissues and bones time to stabilize the teeth in their new alignment. Failure to wear the retainer as directed can have regrettable consequences, such as teeth returning to their original position, added expense and lost time.

If you have any questions or concerns about retainers, please contact our office.