Braces & Aligners

When patients think about orthodontics, braces are the first thing that come to their mind. However, orthodontics is more than just braces. Orthodontists are concerned with the position of the teeth and jaws, what has caused them to arrive at their current position, and what future movement may be needed so that a patient’s bite is optimally functional, aesthetic and stable.

An orthodontist can carry out work that aims to achieve the following:

• Closing wide gaps between the teeth.
• Straightening crooked teeth.
• Modify growth of jaws as required.
• Influence the position of the lips to some extent.
• Improving speech or chewing ability.
• Boosting the long-term health of gums and teeth.
• Preventing long-term excessive wear or trauma of the teeth.
• Treating an improper bite.

Since the teeth are borne by the jaws, any discrepancy in the position of the jaws can lead to improperly placed teeth, thereby affecting the smile.

Jaw discrepancy can result due to an excessive or reduced growth of one or both the jaws. These conditions can be corrected by growth modification appliances. There are different kinds of these appliances like removable, fixed, intra-oral (to be worn in the mouth only) or extra-oral (to be worn in the mouth taking support from the neck or the head).

The growth modification treatment gives best results when commenced before the pubertal growth spurt of the child.

Optimum treatment time for growth modification:

• For girls around the age of 10 to 12 years.
• For boys around the age of 11 to 13 years.

The first check up of a child by an orthodontist must be at the age of 6 years followed by regular check ups every 6 months. This helps in prevention and early correction of a developing problem. It is not advisable to wait till all the milk teeth fall off because major growth increments may be over by then.

Growth modification treatment cannot be done in adults. If a person requires correction of severely disproportionate or displaced jaws after the growth is over, then orthodontic treatment alone would give a compromised result. Only surgical correction of one or both the jaws combined with orthodontic treatment would give the best possible result in such cases.

Any irregularity of the teeth can be treated orthodontically even at the age of 40 to 45 years. It is not the age of the patient but the condition of the tooth-supporting bone that determines the feasibility of orthodontic treatment.

Removable or fixed orthodontic appliances, commonly known as braces, are used to align and relocate teeth. Fixed braces have much better control over the tooth movements and hence give much better results. Various options for fixed braces are available today. Routinely used are metal braces and tooth coloured braces.

Metal Braces

Usually being made out of metal, they will be noticeable on the front of your teeth. You’ll be able to eat normally while wearing a fixed appliance. However, you should avoid certain foods stuffs that are hard, sticky, crispy and crunchy, as they can damage the braces and your teeth.

Tooth Coloured Braces

Ceramic brackets are the most popular. Ceramic brackets with metal inserts are more advantageous to use because the teeth get corrected faster with these. Ceramic brackets are strong, not very visible, inert and stable in the oral conditions.

Clear Orthodontic Aligners

The aligners consist of a sequence of clear, removable trays that fit over the teeth to straighten them. Each tray must be worn by the patient for a specified amount of time—usually around 20 to 22 hours a day for approximately two weeks–before the patient can progress to the next tray. In most situations, the aligners can straighten teeth in anywhere from 6 to 18 months.

The patient is supposed to wear the trays as instructed and check ups are done every 6-8 weeks by the orthodontist to monitor the progress.

Clear orthodontic aligners are suitable for patients with mild or moderate crowding, or minor spacing issues. They may not be appropriate for patients with severe crowding or spacing. While the aligners can correct a mild malocclusion, patients with severe underbites, overbites or crossbites may require more advanced orthodontic treatment.

Unlike traditional braces, the trays can be removed for brushing, flossing, and eating. Because the trays are clear, patients can undergo this type of orthodontic treatment without the usual discomfort associated with regular braces.

Patient cooperation is of utmost importance.

Patients may experience speech problems for a few days.

Although treatment prices for aligners are normally set by the individual dentist or orthodontist, they can be more expensive than braces. If a patient fails to wear the trays properly, or loses them, additional costs may be incurred if new trays or impressions of a patient’s teeth are needed.

They are not visible so adult patients not wanting to wear braces can get their teeth corrected with aligners.

Retainers

They hold straightened teeth in place while the surrounding gum and bone adjusts to their new position. Retainers can be removable or fixed. There could be some tooth movement if you stop wearing your retainer. Changes in the position of your teeth can continue throughout life and are part of the normal ageing process. The only way to have permanently straight teeth is to wear a retainer on a part-time basis for life.