Orthodontic treatment
is a way of straightening or moving teeth, to improve the appearance
of the teeth and how they work. It can also help to look after
the long-term health of the teeth, gums and jaw joints, by spreading
the biting pressure over all the teeth.
Many people have crowded
or crooked teeth. Orthodontic treatment will straighten the
teeth or move them into a better position. This can not only
improve their appearance but also the way the teeth bite together,
while also making them easier to clean.
In some patients the
upper front teeth can stick out and look unsightly. These ‘prominent’
teeth are more likely to be damaged, but orthodontic treatment
can move them back into line. In others, the way the upper and
lower jaws meet can cause teeth to look unsightly and lead to
an incorrect bite. Orthodontic treatment may be able to correct
both.
When the teeth don’t
meet correctly, this can put strain on the muscles of the jaw,
causing jaw and joint problems and in some cases headaches.
Orthodontic treatment can help you to bite more evenly and reduce
the strain.
Orthodontic treatment
is generally best carried out in children, but adults can have
orthodontic treatment too – and more and more are doing. Age
is less important than having the proper number of teeth. In
children it may be necessary to wait for enough teeth to come
through before starting treatment.
Any dentist may carry
out orthodontic treatment. Or the dentist may send the person
to a specialist who has extra qualifications. The specialist
may be in a practice or in a hospital department, and is called
an orthodontist.
The most important thing
is to have a full examination. This will usually involve looking
at your teeth, taking x-rays and making plaster models of your
teeth.
Your dentist or orthodontist
will then discuss what treatment is possible. Once you are sure
you want to go ahead, the treatment can begin as soon as you
have enough permanent teeth.
You may not have enough
room for all your permanent teeth and so it may be necessary
to take out some permanent teeth to make space. Your dentist
will tell you whether this is the case. Sometimes space can
be created using other forms of treatment.
Simple treatment may be carried out with a removable appliance
(a plate that can be taken out to be cleaned). It has delicate
wires and springs attached, which move the teeth using gentle
pressure.
It is sometimes possible
to change the way the jaws grow, using orthodontic appliances.
These functional appliances use the power of your jaw muscles
and can help with certain types of problem.
Often, teeth need to
be guided more accurately than they can be using a removable
plate. So fixed appliances are used. These have brackets and
bands temporarily stuck to the teeth. A flexible wire joins
all the brackets and allows the teeth to be moved. It is not
possible for the patient to take the appliance out and so it
is called a fixed appliance.
As well as an appliance
it is sometimes necessary to wear headgear. You usually only
need to wear it in the evening or at night. Your orthodontist
will discuss whether it is necessary. It is very important to
wear it in the way the orthodontist tells you otherwise treatment
may not progress correctly.
They are tough, clear
plastic ‘aligners’ (moulds) that are used to straighten teeth.
Several sets of specially moulded, slightly different aligners
are made for each patient. Each set is worn for two weeks before
being replaced with the next one. They are made from clear plastic,
so they are nearly invisible. This means that no one need know
you are straightening your teeth.
The aligners should be
worn for 22 to 23 hours a day for the best results. They can
be easily removed for eating, drinking, brushing and flossing.
You need to have all your adult teeth before you can have this
treatment
The length of treatment
depends on how severe the problem is, and may take anything
from a few months to two and a half years. Most people can be
treated in one to two years.
What happens when the teeth are in the
right position?
When treatment is finished
the teeth need to be held in position for a time. This period
is called retention, and the appliances that hold the teeth
in place are called retainers.
The retainers hold newly
straightened teeth in position while the surrounding gum and
bone settles. The retainers can be removable or fixed depending
on the original problem.
A retainer holds newly straightened teeth in place
All appliances may feel
strange to begin with and can cause discomfort. If the problem
doesn’t go away the orthodontist may be able to carry out adjustments
to help. Teeth are usually uncomfortable immediately after adjustment
but this will settle.
Success depends on a
partnership between the skills of the orthodontist, and the
enthusiasm and help of patient and parents. It is important
to attend regularly and carry out any instructions given by
the orthodontist.
The success of the treatment
also depends on the commitment of the patient. For children’s
orthodontic treatment it is very important that the patient
is as keen as the parent.
Your teeth can be damaged
if they are not properly looked after during treatment. Appliances
will not in themselves cause damage, but poor cleaning and too
many sugary drinks and snacks can cause permanent damage. Brackets,
wires and braces can trap food and cause more plaque than usual
to build up. So the teeth and appliance need to be cleaned very
thoroughly.
Even after retention,
it is normal for minor tooth movements to happen throughout
life, so no permanent guarantee can be given. However, it is
unusual for teeth to alter enough to need further treatment.
The first thing to do
is to go along to your own dentist and get his or her advice.
Your dentist will know whether you need treatment and make the
necessary arrangements.
You can have orthodontic
treatment under the National Health Service or as a private
patient. National Health treatment is free for children up to
the age of 18 and students up to the age of 19 based as long
as there is a clinical need. Other people entitled to free treatment
are patients on a low income, pregnant women and nursing mothers.
Everyone else has to pay the NHS charges. There is no charge
for treatment in hospital departments.
You will only be entitled
to treatment under the NHS if your condition is serious. Minor
problems may be classed as cosmetic and would therefore be charged
privately.
If you decide to have
treatment privately, the orthodontist will be able to estimate
the cost of your treatment and give you details. It is always
a good idea to discuss the cost fully before treatment and,
if necessary, have the cost confirmed in writing to avoid any
confusion.
It is important to continue to have your teeth checked by your
dentist while having orthodontic treatment. You also need to
take extra care of your teeth and mouth:
1. Clean your teeth carefully
every day, including between your teeth where you can. Appliances
are delicate and you need to make sure you clean them carefully
so that they do not break. Your dentist or hygienist will be
able to show you the special techniques to use depending on
the appliance you are wearing.
2. Cut down on how often
you have sugary foods and drinks. Avoid ‘snacking’ on foods
or drinks containing sugars, and on fizzy drinks. Also, sticky
and hard foods may damage the delicate orthodontic appliances.
3. Brush your teeth twice
a day with fluoride toothpaste and, if necessary, use a mouthwash.
Your dentist or hygienist may recommend a fluoride toothpaste
or application for you to use. Look for a product carrying the
British Dental Health Foundation’s accreditation logo. This
shows that the product has been checked by a panel of experts
and does what it says on the packet.
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