ORTHODONTI

CS

Definition

Orthodontics is a specialty of
dentistry that is concerned with the
study and treatment of malocclusions
(improper bites), which may be a result
of tooth irregularity, disproportionate
jaw improved bite (occlusion).

Diagnosis and treatment

planning

In diagnosis and treatment planning, the

orthodontist must:
recognize the various characteristics of
malocclusion and dentofacial deformity;
define the nature of the problem, including
the etiology if possible;
design a treatment strategy based on the
specific needs and desires of the individual;
present the treatment strategy to the
patient in such a way that the patient fully
understands the ramifications of his/her
decision.

Therapy
Therapy can be:
Functional: indicated to reduce and
eliminate any possible problems,
using muscular exercises and/or
passive orthodontic devices, which
guide mastication forces;
Mechanical: when extra/intraoral
devices are used, to correct the
present anomalies
Surgical: indicated especially in
adults and/or when orthodontic
methods cant fix the problems

2. Why is it important to have orthodontic treatment?

Orthodontic problems can disfigure the face and mouth.
Orthodontics can improve the appearance of the teeth and face.
Normal speech and chewing can be made possible by orthodontic
treatment.
A bad bite can make biting or chewing difficult or even impossible,
and can cause the teeth to wear down.
Crooked teeth are very hard to brush properly.
If teeth are not kept clean, this can result in tooth decay, and loss of
teeth.
Orthodontic problems can damage the gums and underlying bone
structure.
If the jaws are not properly positioned, pain in the jaw joints can
result.
Orthodontic problems can get worse if they are neglected. They will
not just "go away".
If not treated in time, a problem can become more difficult and more
expensive to treat later on.

 4. Why should orthodontic treatment start when the

child is young?
There are many good reasons for early orthodontic treatment:
When the jaws and teeth are still growing it is much easier to
move teeth and influence the position and size of the jaw.
Early treatment will shorten the treatment time.
Treatment of thumb-sucking and abnormal swallowing patterns is
more successful in a young child.
Protruding front teeth are easily damaged, so the sooner they are
corrected the better.
The space left by the early loss of a baby tooth must be kept
open.
If left untreated, this space will close, as adjacent teeth will drift
into it. The permanent tooth may then not have enough space to
grow into and may become impacted. Early treatment can keep
the space open and allow the permanent tooth to erupt normally.
Insufficient space for permanent teeth often results in crowding.

Crowded and irregular teeth

treatment
before

treatment

after

 Is orthodontic treatment painful?

When braces or other orthodontic
appliances are first placed in the mouth,
some discomfort or pain is experienced,
but this soon passes.
Adjustments to appliances may cause
temporary pain or discomfort.
The appliances may initially irritate the lips,
teeth or tongue, but the orthodontist will
adjust them to minimise any discomfort.

 How long will the orthodontic

treatment take to complete?
Treatment takes from a few months to about
3 years. The average is about 2 years.
The length of treatment depends on how difficult
and complicated the problem is.
Some people respond to treatment more quickly
than others.
Co-operation by the patient, or lack of it, can
affect the length of treatment.
Your orthodontist will be able to give you an idea
of how long it will take.

 What is the plan of action for the

entire treatment period?
The treatment plan is divided into
three parts.
The planning phase
The active phase
The retention phase

 10. What happens in the planning

phase?
A pre-treatment record is made, which
includes:
A medical and dental history.
The making of casts for the upper and lower teeth
and jaws.
Photographs of the face and teeth for before and
after treatment comparisons.
A complete set of x-rays of the jaws and teeth.
A computer-generated photograph of the
anticipated result.
Formulation of the treatment plan.

What happens during the active phase?

Extraction of teeth
Space maintenance
Orthodontic appliances

Orthodontic appliances are used in conjunction with braces to

influence the growth patterns of the jaws.
They can be either removable or fixed.

A. Removable appliances

Removable appliances are used to move one or a few teeth.

The appliances are made of plastic and may have wires that
exert a slow gentle pressure on the teeth to be moved.
Removable appliances must be worn continuously or as your
orthodontist instructs.
A removable brace may for example be used to correct teeth that
have been forced forward and outward by a thumb sucking habit.
It can also be used to hold or retain teeth in their corrected
positions.
Removable and fixed appliances can be used to increase the
width of the upper jaw.
This influences the rate of upper jaw growth and tooth eruption.
B. Fixed appliances
Fixed appliances are attached to the teeth and remain in the
mouth for the duration of the active phase.

The placement of fixed braces

Little metal, ceramic or clear acrylic brackets are bonded or

cemented onto the teeth.
Specially bent wires are then attached to the brackets.
Tightening of the wires causes the controlled movement of the
teeth.
Fixed or removable braces are used in conjunction with rubber
bands.
Braces are designed to exert a constant gentle pressure on teeth
in order to move them into their correct positions.
New, high-tech materials and modern methods of bonding
brackets to teeth, make braces less obtrusive and easy to fit.

What happens during the

retention phase?
When active treatment is completed,
the braces and other appliances are
removed.
To maintain the changes that have
been made, a special removable
retainer is made for the patient.
It is designed to keep the teeth and
jaws in their new positions, and to
prevent a relapse.
The retainer must be worn continuously
until the teeth and bone have stabilised
in their new positions.
This may be a temporary or a longterm measure.

Once the corrections have "set" in their

new positions, the improvements
should last a lifetime.

 1. Is it unusual for adults to have

orthodontic treatment?
More and more adults are having orthodontic
treatment to correct crooked or crowded
teeth.
Orthodontics can make the teeth more
attractive and more functional, by improving
jaw alignment, and correcting "the bite".
Improved techniques have been devised for
treating adults.
Modern orthodontic braces are less obtrusive
and adults are more willing to wear them.

 2. Is adult orthodontic treatment

successful?
Adult orthodontics is particularly
successful for correcting crowding and
jaw problems.
Healthy teeth can be moved with
braces at any age.
Very similar treatments and appliances
are used for children and adults.

5. What problems could make orthodontic treatment for

adults more difficult?
Periodontal Disease
Adults may suffer from periodontal disease, which is a deterioration of the
gums and underlying bone.
Periodontal treatment will be necessary before the orthodontic treatment can
start.

Tooth decay
All dental decay should be treated before orthodontic treatment starts.
It is less comfortable to have dental treatment after braces have been fitted.

Abnormal jaw relationships

The growth of the jaws has been completed in adults, and so this treatment is
not always possible.
In children, the ongoing growth of the jaw can be directed to correct the
abnormalities that are present.

Worn down or broken teeth

These must be built up or restored before orthodontic treatment can start.

Lack of commitment
Adult patients may find it hard to commit to long term treatment, especially to
wearing braces for long periods.