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Posts for tag: orthodontic treatment

OrthodonticsCouldbeinYourSmileMakeoverPlan

When considering “smile makeover” options, it’s easy to focus on whitening, veneers or implants — techniques and materials focused mainly on the teeth and gums. But if you don’t also consider the bigger picture of how your upper and lower teeth come together to form your bite, these efforts may be a lot like picking out paint colors for a house with foundation problems.

That’s why orthodontics, the dental specialty concerned with the bite, could be a consideration in your smile makeover plan. Moving teeth into better positions not only improves your teeth’s function and health it could also help facilitate any cosmetic changes that follow.

The first step, of course, is to visit an orthodontist, a dentist with advanced training and experience in tooth alignment and function, for a comprehensive evaluation. Orthodontists are also knowledgeable in the growth and development of the bite, and so can develop a treatment approach that reflects the patient’s needs, whether a child or adult.

Treatments vary, depending on your particular needs. Fixed appliances like metal or clear braces that can’t be removed by the patient are the standard treatment for most malocclusions (bad bites). Clear aligners, removable trays that fit over the teeth with programmed incremental movements of the teeth, find the greatest application with adults. Orthodontists may also use specialized appliances, like temporary anchorage devices (TADs), which work to isolate teeth that need to be moved from those that don’t.

In comprehensive makeovers, orthodontists will work with a team of other dentists and specialists, including periodontists (specializing in the gums, bone and other supporting structures of the teeth) and oral surgeons. In these cases, orthodontic treatment may occur before or after other treatments with the overall goal of producing a beautiful, transformed smile.

If you would like more information on how orthodontics can transform your smile, 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 “The Magic of Orthodontics: The Original Smile Makeover.”

OrthodontistscanUseOtherToolswithBracesforComplexBiteProblems

Braces utilize the mouth’s existing teeth-moving mechanism by applying pressure in the direction of the desired movement. This is done with a wire laced through metal brackets affixed to the outside of the teeth that’s then usually anchored to brackets on the back teeth to maintain constant tension.

This anchorage set-up alone, however, may not work effectively with all bite situations, which might require other points of anchorage. That’s where these other tools in the orthodontist’s toolkit can come in handy.

Headgear. These appliances not only aid with moving teeth but they also help influence the proper growth of facial structures (as when one of the jaws is too far forward or too far back). Because of this influence on jaw growth you’ll only find them used with pre-teens. The most typical application is a strap running around the back of the head or neck (or sometimes over the chin or forehead) that attaches in the front to brackets usually bonded to the molars. In this case the back of the patient’s skull serves as the anchor point.

Temporary anchorage devices (TADs). Orthodontists sometimes wish to isolate the teeth to be moved from nearby teeth that shouldn’t be. For example, they may want to move front teeth back to close a space without the back teeth moving forward. In this case, it may be necessary to create a separate anchorage point in the jaw. This can be done with TADs, which are made of either biotolerant (stainless steel, chromiumâ??cobalt alloy), bioinert (titanium, carbon), or bioactive (hydroxyapatite, ceramic oxidized aluminum) materials and shaped like mini-screws. Orthodontists insert them into the bone and then attach them to the braces using elastics (rubber bands). After completing orthodontic treatment they’re easily removed.

Elastics. We’ve already mentioned them, but elastics deserve their own category because they can be used in various kinds of anchorage. They play an important role, for example, in cross-arch anchorage that maintains tension between the upper and lower jaws. They can also be used to help move one or more groups of teeth — or isolate certain teeth from moving. They truly are flexible (no pun intended) in their uses for fine-tuned tooth movement.

All these devices can be used in various combinations to match and correct whatever bite situation a patient may have. The end result is straighter and better-functioning teeth — and a more attractive smile.

If you would like more information on orthodontic treatment, 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.”

By Andrew Brown, DDS
May 30, 2019
Category: Dental Procedures
3OrthodonticOptionsforCorrectingBadBites

Malocclusions (bad bites) may cause more than an appearance problem — with teeth and jaws not working together properly, you’re at higher risk for dental disease or accelerated tooth wear. Fortunately, most malocclusions can be corrected through orthodontics, a specialty for moving teeth to better functioning and more attractive positions.

If you’re considering orthodontic treatment for a malocclusion, here are the basics on 3 of the most common orthodontic appliances used for straightening misaligned teeth.

Metal Braces. These appliances have a proven track record for correcting most forms of malocclusion. Braces consist of metal brackets bonded to the front teeth and an anchor band to the back teeth. A thin metal wire passes through the brackets to attach to the bands in the back. Gradually increased tension in the wire incrementally moves the teeth to the desired position.

Clear Bracket Braces. While metal braces do an effective job of tooth movement, they leave less to be desired in appearance. Made of polymer material rather than metal, clear bracket braces offer a more appealing look. But while they’re similar in construction to the metal version, they’re more susceptible to breakage. Wearers must be extra cautious and avoid hard foods or extreme physical sports contact.

Clear Aligners. The previous appliances are fixed and can’t be removed by the wearer. Clear aligners take a different approach with removable plastic trays that fit snugly over the dental arch. A series of trays are computer generated to carefully match the patient’s mouth structure, each incrementally smaller than the previous one in the series. After wearing the first tray for two or three weeks, the wearer changes to the next (and slightly smaller) tray in the series, repeating the process until all the trays have been worn. Of the three options, the clear aligners offer the best appearance; however, they’re best suited for cases that don’t require complex movements.

We can advise you which option is best for you after a complete evaluation, factoring in age, lifestyle and the complexity of your malocclusion. Regardless of the choice, the aim is the same — achieving a healthier mouth, better function and a more attractive smile.

If you would like more information on orthodontic treatment, 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 “The Magic of Orthodontics.”

HowtoTreattheProblemofTeeththatNeverDeveloped

About one-quarter of people have teeth that never developed. While most of these congenitally missing teeth are wisdom teeth, they can also include premolars or lateral incisors (the teeth right next to the two front teeth, the central incisors).

Missing teeth can have an adverse effect on smile appearance. But that’s not all: because each type of tooth performs a specific function, one or more missing teeth can lead to bite problems and disruption of dental function. In the case of missing lateral incisors, the canines (eye teeth) normally positioned beside and toward the back of the mouth from them may begin to drift into the empty space and grow next to the central incisors. This can result in greater difficulty chewing and a smile that “doesn’t look right.”

To correct this situation, we must often first attempt to orthodontically move any out of place teeth to their normal positions. This re-establishes the space needed for the missing teeth to be replaced, which we can then restore with prosthetic (artificial) teeth. If the permanent restoration of choice involves dental implants, we’ll usually need to wait until the completion of jaw development around early adulthood. In the mean time, we can use a retainer appliance to hold the teeth in their new positions with prosthetic teeth attached to fill the empty space for a better smile appearance in the interim.

The real issue is timing—beginning orthodontic treatment when appropriate to a person’s oral development, as well as completing the implant restoration when the mouth has matured sufficiently. There are other considerations such as bone volume, which may have diminished due to the missing teeth. At some point we may need to consider grafting to build up the bone sufficiently to support dental implants.

This all may entail a team approach by various specialties like orthodontics, periodontics and implantology. Working together and coordinating within a timely schedule, a mouth and smile marred by undeveloped teeth can be transformed.

If you would like more information on treating smiles with underdeveloped permanent teeth, 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 “When Permanent Teeth Don’t Grow.”

KeepWatchforBiteProblemswithyourChildsTeeth

Around ages 6 to 8, a child's primary teeth will begin to loosen to make way for their permanent teeth. If all goes well, the new set will come in straight with the upper teeth slightly overlapping the bottom.

But sometimes it doesn't go that well: a child may instead develop a poor bite (malocclusion) that interferes with normal function. If we can detect the early signs of a developing malocclusion, however, we may be able to intervene and lessen its impact. You as a parent can play a vital role in this early detection.

The first thing you should be watching for is teeth spacing. Normal teeth come in straight with a slight gap between them. But there are two abnormal extremes to look for: teeth having no space between them or crowded together in a crooked, haphazard manner; or they seem to have too much space between them, which indicates a possible discrepancy between the teeth and jaw sizes.

You should also notice how the teeth come together or “bite.” If you notice the lower front teeth biting in front of the upper (the opposite of normal) it may be a developing underbite. If you see a space between the upper and lower teeth when they bite down, this is a sign of an open bite. Or, if the upper front teeth seem to come down too far over the lower, this could mean a deep bite: in extreme cases the lower teeth actually bite into the roof of the mouth behind the upper teeth.

You should also look for crossbites, in which the teeth in one part of the mouth bite abnormally in front or behind their counterparts, while teeth in other parts bite normally. For example, you might notice if the back upper teeth bite inside the lower teeth (abnormal), while the front upper teeth bite outside the lower front teeth (normal).

The important thing is to note anything that doesn't look right or seems inconsistent with how your child's teeth look or how they function. Even if you aren't sure it's an issue, contact us anyway for an examination. If it really is a developing bite problem, starting treatment now may lessen the extent and cost of treatment later.

If you would like more information on bite development in children, please contact us or schedule an appointment for a consultation.