Posts for tag: orthodontic treatment
In any given year, 4 million tweens and teens are in the process of having their teeth straightened with braces or clear aligners. It's so common we tend to consider orthodontic treatment for young people as a rite of passage into adulthood.
But it doesn't necessarily have to be that way—it might be possible to stop or at least minimize a poor bite before it fully develops. That's the goal of interceptive orthodontics—treatments that head off or “intercept” a bite problem early.
The goal isn't necessarily to reposition misaligned teeth, but to correct a problem that can lead to misalignment. Here are some examples.
A narrow jaw. A narrowly developing jaw can crowd incoming teeth out of their normal positions. For the upper jaw, though, we can take advantage of a temporary separation in the bones in the roof of the mouth (palate) with a device called a palatal expander. Placed against the palate, the expander exerts outward pressure on the teeth and jaw to widen this separation. The body fills in the gap with bone to gradually widen the jaw.
Abnormal jaw alignment. It's possible for a jaw to develop abnormally during childhood so that it extends too far beyond the other. Using a hinged device called a Herbst appliance, it's possible to interrupt this abnormal growth pattern and influence the bones and muscles of the jaw to grow in a different way.
Missing primary teeth. An important role for a primary (baby) tooth is to hold a place for the future permanent tooth. But if the primary tooth is lost too soon, other teeth can drift into the space and crowd out the intended permanent tooth. To prevent this, we can insert a space maintainer: This simple looped metal device prevents teeth from drifting and preserves the space for the permanent tooth.
Although these and other interceptive treatments are effective, some like the palatal expander do their best work within a limited age frame. To take advantage of interceptive orthodontics in a timely manner, parents should seek a bite evaluation for their child from an orthodontist around age 6. The earlier we detect a growing bite problem, the greater your chances for successful intervention.
If you would like more information on treating emerging bite problems early, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Interceptive Orthodontics.”
If you're into social media, you might have run across the idea that there's nothing to straightening your teeth. According to some SM influencers, you can even do it yourself with a few rubber bands. But the truth is, the mechanics of moving teeth are much more complex—and taking orthodontics into your own hands can cause extensive dental damage.
In reality, all bite problems (malocclusions) require the advanced knowledge and expertise of an orthodontist to correct them safely and effectively. Some, in fact, may require other devices along with braces or clear aligners to achieve the desired outcome for a particular malocclusion.
Here are a few of those additional tools an orthodontist may use and why they may be needed.
Headgear. Some malocclusions result not just from misaligned teeth, but problems with jaw or facial structure development. To accommodate additional factors like this, an orthodontist may include headgear during treatment, usually a strap running around the back of a patient's head or neck and attached in the front to brackets bonded to the teeth (usually the molars). Wearing this headgear for several hours a day can improve jaw and facial development.
Elastics. Unlike basic rubber bands DIYers might use to move their teeth (often with damaging results), elastics are specialized bands designed for targeted tooth movement. They're needed for bite problems that require moving some teeth and not moving others. As such, elastics can be applied in conjunction with braces to perform either intended task—move or prevent movement for specific teeth.
Anchorage. One of the tools often used with elastics for targeted tooth movement are temporary anchorage devices (TADs). These are typically tiny screws imbedded into the jawbone a short distance from fixed braces. An elastic band connected to the braces at a specific point is then attached to the TAD, which serves as an anchor point for the elastic.
These and other devices can help orthodontists achieve a successful correction for certain individual bite problems. And unlike the DIY methods touted on the Internet, these additional tools help them do it safely.
If you would like more information on straightening teeth through orthodontics, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Orthodontic Headgear & Other Anchorage Appliances.”
If your child has seen the dentist regularly, and brushed and flossed daily, there's a good chance they've avoided advanced tooth decay. But another problem might already be growing right under your nose—a poor dental bite (malocclusion).
A dental bite refers to the way the upper and lower teeth fit together. In a normal bite the teeth are in straight alignment, and the upper teeth slightly extend in front of and over the lower when the jaws are shut. But permanent teeth erupting out of position or a jaw developing abnormally can set the stage for a malocclusion.
Although the full effects of a malocclusion may not manifest until later, there may be signs of its development as early as age 6. If so, it may be possible to identify a budding bite problem and “intercept” it before it goes too far, correcting it or reducing its severity.
Here are 6 signs your school-age child could be developing a malocclusion.
Excessive spacing. If the spacing between teeth seems too wide, it could mean the size of your child's teeth are out of proportion with their jaw.
Underbite. Rather than the normal upper front teeth covering the lower, the lower teeth extend out and over the upper teeth.
Open bite. There's a space or gap between the upper and lower teeth even when the jaws are shut.
Crowding. Due to a lack of space on the jaw, incoming teeth don't have enough room to erupt and may come in misaligned or “crooked.”
Crossbites. Some of the lower teeth, either in front or back of the jaw, overlap the upper teeth, while the rest of the upper teeth overlap normally.
Protrusion or retrusion. This occurs if the upper front teeth or jaw appear too far forward (protrusion) or the lower teeth or jaw are positioned too far back (retrusion).
Besides watching out for the preceding signs yourself, it's also a good idea to have your child undergo a comprehensive bite evaluation with an orthodontist around age 6. If that does reveal something amiss with their bite, intervention now could correct or lessen the problem and future treatment efforts later.
While retainers are often viewed as a nuisance, they’re crucial to protect the gains made with bite correction. Without them, all of the progress achieved through braces or clear aligners could be lost.
Here’s why: The same elastic gum tissue called the periodontal ligament that holds teeth in place also allows them to move incrementally in response to changes in the mouth. That’s why we can move teeth with braces or aligners, which put pressure on the teeth toward a desired direction of movement while the periodontal ligament does the rest.
But the mechanics can also work in reverse: With pressure relieved when the braces are removed, the teeth could revert to their original positions through a kind of “muscle memory.” The light pressure provided by a retainer is enough to keep or “retain” teeth in their new positions.
The best known retainer is a removable appliance. Initially, a patient wears it continuously and only takes it out during oral hygiene. Wear duration may later be reduced to night time only and eventually not at all, depending on a patient’s individual needs.
While effective, removable retainers do have some downsides. Like braces, they’re visible to others. And because they’re removable, they’re frequently misplaced or lost, leading to the added expense of a new one.
An alternative is a bonded retainer, a thin piece of wire attached to the back of the newly moved teeth to keep them in place. Because it’s behind the teeth it’s not visible—and there’s no misplacing it because only a dentist can take it out.
A bonded retainer is a good option, especially if a patient is immature and not as diligent about wearing or keeping up with their appliance. But it can make flossing difficult to perform, and if they’re removed or broken prematurely, the teeth could revert to their former positions.
If you decide to go with a bonded retainer, be sure you get some tips from your dental hygienist on how to floss with it. And if you decide later to have it removed early, be sure to replace it with a removable retainer. Either of these two options can help you keep your new and improved smile.
If you would like more information on bonded retainers, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Bonded Retainers.”
The monarchs of the world experience the same health issues as their subjects—but they often tend to be hush-hush about it. Recently, though, the normally reticent Queen Elizabeth II let some young dental patients in on a lesser known fact about Her Majesty's teeth.
While touring a new dental hospital, the queen told some children being fitted for braces that she too “had wires” once upon a time. She also said, “I think it's worth it in the end.”
The queen isn't the only member of the House of Windsor to need help with a poor bite. Both Princes William and Harry have worn braces, as have other members of the royal family. A propensity for overbites, underbites and other malocclusions (poor bites) can indeed pass down through families, whether of noble or common lineage.
Fortunately, there are many ways to correct congenital malocclusions, depending on their type and severity. Here are 3 of them.
Braces and clear aligners. Braces are the tried and true way to straighten misaligned teeth, while the clear aligner method—removable plastic mouth trays—is the relative “new kid on the block.” Braces are indeed effective for a wide range of malocclusions, but their wires and brackets make it difficult to brush and floss, and they're not particularly attractive. Clear aligners solve both of these issues, though they may not handle more complex malocclusions as well as braces.
Palatal expanders. When the upper jaw develops too narrowly, a malocclusion may result from teeth crowding into too small a space. But before the upper jaw bones fuse together in late childhood, orthodontists can fit a device called a palatal expander inside the upper teeth, which exerts gentle outward pressure on the teeth. This encourages more bone growth in the center to widen the jaw and help prevent a difficult malocclusion from forming.
Specialized braces for impacted teeth. An impacted tooth, which remains partially or completely hidden in the gums, can impede dental health, function and appearance. But we may be able to coax some impacted teeth like the front canines into full eruption. This requires a special orthodontic technique in which a bracket is surgically attached to the impacted tooth's crown. A chain connected to the bracket is then looped over other orthodontic hardware to gradually pull the tooth down where it should be.
Although some techniques like palatal expanders are best undertaken in early dental development, people of any age and reasonably good health can have a problem bite corrected with other methods. If you are among those who benefit from orthodontics, you'll have something in common with the Sovereign of the British Isles: a healthy, attractive and straighter smile.