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HEATHWOOD
DENTAL PRACTICE
- Orthodontics -
TOOTH STRAIGHTENING
Orthodontics is the teeth straightening speciality. Although teeth are held stationary in the bone, they can be moved with small constant forces; this is how braces work. However, it is not only braces that can move teeth. Any constant force can do this, with the most common causes that we see being use of a dummy or thumb sucking in children. This for example causes a narrower palate to develop, resulting in a more crowded and narrow upper arch, with the teeth becoming overlapped, and failing to meet properly. Thus, there are many reasons for pursuing orthodontic treatment:
Orthodontic treatment is commonly initiated in children once all the adult teeth have erupted, and we can arrange referral to an orthodontic specialist at the appropriate time. In children, the timing is important as often the facial growth can be harnessed to adjust the facial contours, and correct issues such as a narrow palate. In addition, their bone is softer, meaning that teeth usually move faster, resulting in shorter treatment times.
Orthodontics is not limited to children, and an increasing number of adults are taking advantage of modern dentistry to improve their smiles.
It is critical to understand that the long term success of all orthodontics, whether in children or adults, is linked to the use of retainers; these are issued at the end of orthodontic treatment, and need to be worn, typically at night long term, to prevent the teeth from drifting out of place. They are usually clear, and look like the retainer in the Invisalign picture below.
TYPES OF ORTHODONTICS
Orthodontics is carried out using a few different types of appliances:
Removable appliances - as the name suggests, these can be taken out of the mouth, so good compliance is required from the patient! They are used typically to tilt teeth, although there are also appliances used to modify the growth of the jawbones. Occasionally at the end of treatment, the retainers may be made in this format.
Fixed braces - “train tracks”. These are the most commonly used orthodontic appliances, and are very effective, as they can be used to move a whole tooth through the bone, rather than just tip it as with removable appliances. There are many different systems, and your specialist will select the appropriate one for each case. Some rapid fixed appliance systems also exist, which aim to reduce the total treatment time, and are aimed more commonly at adults (for example ‘Six Month Smiles’). Classically, the brackets and wires are made of metal, although modern clear and porcelain brackets, together with white coated wires are now available to reduce the visibility in the mouth. Fixed braces can sometimes be applied to the tongue side of the teeth to reduce their visibility, and your orthodontist can advise as to the suitability of ‘lingual orthodontics’ for you.
Clear Aligners - Invisalign is the most established clear aligner system. It involves a series of clear sheaths that fit over the teeth, and are virtually invisible. Multiple iterations of aligners are made, each one coaxing a small amount of movement from the teeth, until the next is required.
In this way orthodontics can be carried out virtually invisibly to correct overcrowded teeth, widely spaced teeth and other problems. There are no metal brackets or wires, and each aligner is used for approximately 2 weeks.
Retainers - These are issued at the end of treatment, and are critical to long term success of orthodontics. Teeth have a tendency to drift back towards their previous position, with certain movements such as rotations particularly prone to relapse. Retainers are usually clear sheaths, much like the clear aligner shown in the photo above, which are worn at night for the long term, and stabilise the position of the teeth to prevent any regression. Your orthodontist may also bond some wire to the inside of the front teeth to act as an adjunctive non removable retainer.
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