We provide diagnostic and treatment for tooth misalignment and irregularity in the jaw area.
Orthodontics is one of many dental specialties. Orthodontics is specifically concerned with diagnosing and treating tooth misalignment and irregularity in the jaw area. Initially, orthodontic treatments were geared toward the treatment of teens and pre-teens, but these days around 30 percent of orthodontic patients are adults.
There are many advantages to well-aligned teeth, including easier cleaning, better oral hygiene, clearer speech and a more pleasant smile. Though orthodontic treatment can be effective at any age, the American Dental Association suggests that an orthodontic assessment should be performed around the age of seven. The earlier orthodontic treatment begins, the more quickly the problem can be successfully resolved.
What problems can be treated with orthodontics?
Orthodontics is a versatile branch of dentistry that can be used alone, or in combination with maxillofacial or cosmetic dentistry.
Here are some of the common conditions treated with orthodontics:
- Anteroposterior deviations - The discrepancy between a pair of closed jaws is known as an anteroposterior discrepancy or deviation. An example of such a discrepancy would be an overbite (where the upper teeth are further forward than the lower teeth), or an underbite (where the lower teeth are further forward then the upper teeth).
- Overcrowding - Overcrowding is a common orthodontic problem. It occurs when there is an insufficient space for the normal growth and development of adult teeth.
- Aesthetic problems - A beautiful straight smile may be marred by a single misaligned tooth. This tooth can be realigned with ease and accuracy by the orthodontist. Alternatively, orthodontists can also work to reshape and restructure the lips, jaw or the face.
Orthodontics is a technologically advanced field which offers many sophisticated solutions to malocclusions and other cosmetic problems. The orthodontist will generally perform a visual examination, panoramic X-rays, and study models (bite impressions) in order to assess the exact nature of the discrepancy.
When a diagnosis has been made, there are a variety of orthodontic treatment options available.
Here is an overview of some of the most common treatments:
Fixed orthodontic braces : A metal or ceramic dental base is affixed to each tooth, and a dental wire is inserted through each base. The orthodontist is able to gradually train the teeth into proper alignment by regularly adjusting the wire. When the desired results are achieved, the fixed dental braces are completely removed.
Removable appliances : There are a wide range of removable appliances commonly used in orthodontics, including headgear that correct overbites, Hawley retainers that improve the position of the teeth even as the jawbone reforms, and facemasks which are used to correct an underbite.
- Invisalign® : This is a newer, removable type of dental aligner that is completely transparent. Invisalign® does not interfere with eating because of its removable nature, and mechanically works in the same way as the traditional metal dental braces. Not all patients are candidates for Invisalign®.
In much the same way as doctors choose to specialize in areas such as cardiology and neurology, dentists can also choose to specialize. Orthodontics is a dental specialty which aims to prevent, diagnose and treat facial and dental irregularities, such as malocclusions (bad bites). Many orthodontic practices are limited to dentofacial orthopedics and general orthodontics but can successfully treat patients of any age.
Orthodontists are fully qualified dentists who embark on a further three years of university-based study and gain extensive clinical experience in an orthodontic residency program. The American Association of Orthodontists (AAO) is the regulating body for this branch of dentistry. Selecting an orthodontist who is a member of this organization adds the assurance that treatment is being administered by an individual with specialty education in oral biology and biomechanics. The AAO recommends that children should first be examined by the orthodontist around the age of seven, to ensure that jaw and tooth irregularities are not beginning to form.
What does an orthodontist do?
Orthodontists are experts in correcting misalignments of the teeth and jaw. There are many debilitating problems associated with misalignment, for example, speech defects, difficulties chewing and difficulty maintaining adequate oral hygiene.
Here is a brief overview of some of the most common issues an orthodontist can successfully treat:
Anteroposterior deviations - Common examples of anteroposterior deviations include underbite (the lower teeth are positioned further forward than upper teeth) and overbite (the upper teeth are positioned further forward than the lower teeth). Both of these deviations can cause difficulty articulating and chewing.
Overcrowding - Overcrowding is one of the most common problems orthodontists treat. On occasion, lack of jawbone space means adult teeth cannot erupt in alignment with existing teeth. The orthodontist is able to realign the teeth using a number of unobtrusive devices and treatments.
- Aesthetic issues - In some cases, the shape of the whole face is negatively impacted by malocclusions or a bad bite. The orthodontist can restructure and realign the jaw, lips and teeth to create a beautiful, even smile.
How does an orthodontist realign jaws and teeth?
Initially, the orthodontist conducts a thorough examination of the jaw and teeth. Panoramic X-rays and study models (bite impressions) will be taken prior to the orthodontist making treatment recommendations. The orthodontist will recommend the best treatment plan for the patient's particular condition.
Here is a brief overview of some of the treatments orthodontists may use:
Dental braces - The combination of brackets (which are affixed to each individual tooth), and an archwire (which connects each bracket) are commonly placed to gently train the teeth into proper alignment. Dental braces can be made of metal, ceramics or clear (?invisible?) materials.
Headgear and facemasks - These devices are generally used to correct a developmental problem, such as an overbite or an underbite. In addition to the dental braces, the orthodontist will design the headgear and/or facemask which fit around the head and attaches to the braces. This structure will further encourage the teeth and jawbone into alignment.
- Retainers - After the orthodontist has realigned the teeth using dental braces, removable devices or a headgear, a retainer may then be provided to ensure that the teeth do not begin to move back toward their original positions. Retainers are generally worn until the underlying bone has reformed into the correct position.
Orthodontics is a specialized branch of dentistry that is concerned with diagnosing, treating and preventing malocclusions (bad bites) and other irregularities in the jaw region and face. Orthodontists are specially trained to correct these problems and to restore health, functionality and a beautiful aesthetic appearance to the smile. Though orthodontics was originally aimed at treating children and teenagers, almost one third of orthodontic patients are now adults. A person of any age can be successfully treated by an orthodontist.
A malocclusion (improper bite) can affect anyone at any age, and can significantly impact the individual's clarity of speech, chewing ability and facial symmetry. In addition, a severe malocclusion can also contribute to several serious dental and physical conditions such as digestive difficulties, TMJ, periodontal disease and severe tooth decay. It is important to seek orthodontic treatment early to avoid expensive restorative procedures in the future.
What problems can orthodontics treat?
Orthodontics can treat a wide range of dental problems and in most cases, completely realign the teeth. Orthodontists may work alone, or in combination with a maxillofacial surgeon.
The typical irregularities requiring orthodontic treatment are as follows:
Overcrowding - An overcrowded mouth means there is insufficient space within the jaw for all of the adult teeth to fit naturally. Overcrowding may lead to displaced, rotated or completely misaligned teeth.
Overbite - An overbite refers to the protrusion of the maxilla (upper jaw) relative to the mandible (lower jaw). An overbite gives the smile a ?toothy? appearance and the chin looks like it has receded.
- Underbite - An underbite, also known as a negative underjet, refers to the protrusion of the mandible (lower jaw) in relation to the maxilla (upper jaw). An underbite makes the chin look overly prominent. Developmental delays and genetic factors generally cause underbites and overbites.
How can orthodontics help?
Orthodontic dentistry offers techniques which will realign the teeth and revitalize the smile. There are several treatments the orthodontist may use, depending on the results of panoramic X-rays, study models (bite impressions), and a thorough visual examination.
Fixed dental braces can be used to expediently correct even the most severe case of misalignment. These braces consist of metal or ceramic brackets which are affixed to each tooth and an archwire which is used to gradually move the teeth through the duration of the treatment.
Removable appliances include headgear (which consists of a metal wire device attached to customized braces), retainers, Invisalign® aligners (which are almost invisible to the naked eye), palate expanders and tooth movers. Faceguards are generally used to correct developmental delays in both the upper and lower jaw, and palate expanders are used to combat overcrowding.
Whatever the dental irregularity or the age of the individual, orthodontic appliances can properly realign the teeth and create a beautiful smile.
One of the most commonly asked questions about dental braces is whether placing them causes any pain or discomfort. The honest answer is that braces do not hurt at all when they are applied to the teeth, so there is no reason to be anxious. In most cases, there is mild soreness or discomfort after the orthodontic wire is engaged into the brackets, which may last for a few days.
There are two common types of fixed dental braces used to realign the teeth: ceramic fixed braces and metal fixed braces. Both types of fixed appliances include brackets which are affixed to each individual tooth and an archwire the orthodontist fits into the bracket slot to gently move the teeth into proper alignment. Elastic or wire ties will be applied to hold the wire in place. Some orthodontists may use self-ligating brackets which do not require a rubber or wire tie to secure the wire.
Fixed dental braces are used to treat a wide variety of malocclusions, including overbite, underbite, crossbite, and overcrowding. If the orthodontist has determined that the malocclusion has been caused by overcrowding, it is possible that teeth may need to be extracted to increase the amount of available space to properly align the teeth.
What to expect when getting braces
Here is an overview of what you can expect when getting braces:
- Placement day - The placement of braces will not be painful in the slightest. It may take longer to eat meals, but this is largely because it takes some time to adjust to wearing the braces. In some cases, the teeth may feel more sensitive than usual. Hard, difficult to chew foods should be avoided in favor of a softer, more liquid-based diet for the first few days after placement of braces.
- Two days after placement - The first several days after placement of braces can be slightly uncomfortable. This is because the teeth are beginning the realignment process and are not used to the pressure of the archwire and orthodontic elastic bands. The orthodontist will provide relief wax to apply over the braces as necessary. Wax helps provide a smooth surface and alleviates irritation on the inner cheeks and lips. Additionally, over-the-counter pain medication (e.g., Motrin® and Advil®) may be taken as directed to relieve mild soreness.
- Five days after placement - After five days, any initial discomfort associated with the braces should be completely gone. The teeth will have gradually acclimated to the braces, and eating should be much easier. Certain hard foods may still pose a challenge to the wearer, but normal eating may be resumed at this point.
- Orthodontic appointments - Regular orthodontic appointments are necessary to allow the orthodontist to change the archwire, change the rubber or metal ties, and make adjustments to the braces. Fixed braces work by gradually moving the teeth into a new and proper alignment, so gentle pressure needs to be applied constantly. The first several days after an orthodontic adjustment may be slightly uncomfortable, but remember that this discomfort will quickly fade.
- Dealing with discomfort - Over-the-counter pain medication and orthodontic relief wax will help alleviate any mild soreness and discomfort following placement of braces and orthodontic adjustments. Another effective remedy is to chew sugar-free gum, as this increases blood flow which helps reduces discomfort and can also encourage the teeth to align quicker.
If you have any questions or concerns about orthodontic treatment, please contact our office.
Straighter teeth perform chewing, biting and speaking functions more effectively than crooked teeth. In addition, a straight smile boosts confidence, is aesthetically pleasing to look at, and can help stave off a wide variety of dental ailments.
There are several types of malocclusion including overbite, underbite, crossbite, and overcrowding. Each of these alignment problems negatively impacts the functionality and cosmetic appearance of the teeth.
Here is a brief overview of some of the main disorders associated with crooked teeth:
Periodontitis - Periodontitis or gum disease begins with a bacterial infection. The bacterial infection is caused by inadequate oral hygiene. Crooked teeth are hard to clean effectively, which means that debris, plaque and bacteria can build up in hard-to-reach areas. Straight teeth are much easier to clean and are at less risk of contracting gum disease.
Temporomandibular Joint Disorder (TMJ) - Crooked teeth can lead to improper jaw alignment, which in turn causes a painful condition known as TMJ. Severe headaches, jaw pain, lockjaw and the grinding of teeth characterize this debilitating disorder.
Tooth injury - Straight teeth creates a strong wall, which means injuries are less likely to occur. Crooked teeth are weaker and often protrude, making them far more vulnerable to external injury.
Uneven wear - Crooked teeth cause some of the teeth to work harder than others when biting and chewing. Straight teeth share the workload evenly, meaning less risk of injury and better aesthetics.
Teeth can be straightened using either orthodontic braces or customized aligning trays. Orthodontic braces are usually affixed to the teeth for a set duration. The brackets and archwires are tightened regularly by the orthodontist and removed when treatment is complete. Fixed braces can be placed on the front side or back side of the teeth and are effective for most types of malocclusion.
Aligning trays are fully removable and are used where the malocclusion is less severe, and the teeth need to move a shorter distance. These trays are replaced every few weeks for the duration of the treatment, and have proven to be equally effective for straightening teeth.
If you have questions about orthodontics and straightening teeth, feel free to book a consultation with our orthodontist: Dr. Ahmed Rizk
Many children are ambivalent about getting braces. On one hand, they like the idea of perfect teeth, but on the other hand, they are nervous about whether the braces will cause pain and discomfort. The good news is that the placement of orthodontic braces is not at all painful, and the end result will be a beautiful straight smile.
Although patients of any age can benefit from orthodontic braces, they tend to work much quicker on pre-teens and teenagers since they are still experiencing jaw growth. The American Association of Orthodontists (AAO) recommends that children should first see an orthodontist around the age of seven years-old. An orthodontic examination may be beneficial before age seven if facial or oral irregularities are noted.
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 on children:
Fixed braces - Braces are comprised of brackets that are affixed to each individual tooth and an archwire that connects 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 aids in tooth movement. A headgear is intended to be worn for 12-20 hours each day and must be worn as recommended to achieve the intended result.
- 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 that 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.
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 can cause a low 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 usually more comfortable than the metal alternative, but can become discolored by coffee, wine, smoking, and certain foods.
- Invisalign® - Invisalign® aligners are clear trays and should be worn for the recommended amount of time each day for the quickest results. 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 cannot be seen when a patient smiles. Lingual braces tend to be moderately expensive and can interfere with normal speech.
If you have any questions about orthodontic braces, please contact our office.
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, 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.
One of the primary concerns people often have about dental braces is the aesthetic impact of the metalwork on their smile. Especially for adults, the prospect of wearing unattractive metal braces for long periods of time can be very discouraging. Invisalign® offers an almost invisible aligning system that straightens teeth fast and contains no metal.
Invisalign® treatment consists of a series of custom-made aligning trays. The dentist changes the trays every several weeks to fit the new tooth configuration. In addition to the reduced visual impact, Invisalign® aligning trays can be temporarily removed for important occasions - meaning that treatment duration is patient-controlled. A great number of people report complete satisfaction with both the Invisalign® treatment and the stunning results.
What kind of bite problems can Invisalign® correct?
Invisalign® corrects the same dental problems as traditional metal braces; the only difference is that Invisalign® trays are almost invisible to the naked eye, and can be removed at will.
Here are some problems that are commonly corrected with Invisalign®:
- Overcrowding - This occurs when there is too little space for the teeth to align normally in the mouth. Overcrowding can cause tooth decay and increase the likelihood of gum disease.
- Large gaps between teeth - This can sometimes occur because teeth are missing or because the jaw continues to grow abnormally.
- Crossbite - This common dental problem occurs when one or multiple upper teeth bite inside the lower teeth. As a consequence, uneven wear can lead to bone erosion and gum disease.
- Overbite - This problem occurs when the upper teeth project further than, or completely cover, the lower teeth. Eventually, jaw pain and TMJ may occur.
- Underbite - This is the inverse of the overbite; the lower teeth project further than, or completely cover, the upper teeth. Eventually, jaw pain and TMJ can occur.
Traditional dental braces, Invisalign® aligning trays, and dental veneers are three different ways to perfect the alignment of the teeth. There are many different considerations to make when deciding which treatment will be best, and each of these options works better in certain situations.
Invisalign® differs from traditional braces in that the aligning trays are fully removable. This means that more discipline and commitment is required from the patient. This is not usually a problem since the trays are comfortable and nearly invisible. Almost identical results can be obtained by using either treatment.
Invisalign® is preferable to veneers in many cases because unlike veneers, Invisalign® actually straightens the teeth. Veneers are thin covers that the dentist permanently affixes to the teeth. Teeth must be etched beforehand, meaning that to remove dental veneers, an alternative covering must be constructed. In addition to being somewhat expensive, veneers can break and often last for less than 20 years.
What does Invisalign® treatment involve?
First, the dentist needs to devise an initial treatment plan before creating the special aligning trays. Three-dimensional digital images are taken of the entire jaw. These images allow the dentist to move specific teeth on the screen, view the jaw from different angles, and also foresee what the face might look like in years to come. In essence, this technology can show how Invisalign® trays will change the facial aesthetics.
Once planning is complete, a unique set of aligners is made. The total amount of aligners required varies with each individual case, but 20-29 sets per arch is typical.
What are some considerations when wearing Invisalign® trays?
Life with Invisalign® aligning trays may take several weeks to get used to. The trays should be worn constantly, except when eating and drinking. It is important to remove the trays when consuming food or drink because food can become trapped between the tray and the teeth, causing tooth decay.
Usually, new trays are necessary every two weeks, and progress between appointments can be seen with the naked eye. There is no doubt that Invisalign® aligning trays have revolutionized orthodontics. Invisalign® is renowned for being both comfortable and effective.
If you have questions about Invisalign®, please contact our office.