Orthodontics

Orthodontics therapy, commonly involving braces, is typically utilized to enhance the aesthetic and alignment of misaligned, protruding, or overcrowded teeth, and to rectify any malocclusion or improper bite. (1)

Definition and Overview

Orthodontics is a field of dentistry that specializes in preventing and correcting irregularities in the teeth, which may include misalignment or malocclusion of teeth, or unacceptable contact of opposing teeth caused by factors such as abnormal growth of the jaws, defective development, or tooth loss.

Tooth eruption is an important area of interest for orthodontists as it helps determine proper tooth position. Optimal results are obtained before the age of 18, as human bones respond better to tooth movements at younger ages. Therefore, orthodontic treatment is generally more beneficial to children than adults. (2)

The duration of orthodontic treatment varies and is determined by factors such as age, the severity of the dental problem, and the treatment method used. The treatment process includes regular visits to the dentist or orthodontist for months to years. Typically, adults require a longer treatment period compared to children or adolescents. The average wearing time of braces is about two years.

Procedures

Depending on the severity of orthodontic disorder, the orthodontist or dentist may recommend using one or multiple orthodontic interventions including 

• Braces 

Braces are orthodontic appliances that help align and straighten teeth, help position a person's bite problems, and work to improve dental health.

• Headgear

In order to keep the rear teeth in place while the front teeth are being treated or to improve their alignment, headgear is employed. The majority of the time, people only need to wear headgear at night and in the evening.

• Removable appliances 

Despite being less precise compared to braces, removable appliances are capable of shifting a single or a group of teeth. They are custom-fitted by an orthodontist or dentist and can be worn independently for targeted treatment, or in conjunction with braces either before or during the use of braces.

• Retainers

After the removal of braces, retainers may be utilized to maintain the teeth in their corrected position. Retainers may be either removable or fixed, and they may require continuous or occasional wear.

Orthodontic therapy is a time-consuming process and the duration of treatment depends on various factors, such as the patient's age, the extent of the issue, and the chosen intervention method. Typically, orthodontic treatment involves regular visits to the dentist or orthodontist over several months to years. Treating adults generally takes longer than teenagers or children, with the average duration of wearing braces being approximately two years. (3)

Candidates

Orthodontic treatment is generally recommended for people who need 

• teeth straightening and dental crowding repair,
• bite adjustment to ensure that the front and back teeth meet evenly,
• lowering the potential for damage to prominent teeth. (4)

Orthodontic treatment is generally recommended for people who have problems with tooth and jaw alignment, which can cause poor closing or malocclusion. These problems can occur due to various factors such as genetics, tooth loss, thumb sucking, and injuries. Age is also a factor, as orthodontic treatment is usually most effective during childhood and adolescence when the teeth and jaws are still developing.

However, orthodontic treatment can be beneficial for people of all ages with tooth alignment problems. A dentist or orthodontist can evaluate a patient's teeth and jaws and recommend appropriate treatment options based on their individual needs. (5)

Risks and Side Effects

Before starting orthodontic treatment, it is very important to discuss all the risks and possible complications with the orthodontist in depth. An in-depth conversation with the orthodontist will help make an informed decision, taking into account the patient's personal situation and treatment choice. Here are a few typical minor risks and side effects that may occur during orthodontic treatment.

• Toothache and mild discomfort
• Scratches and ulcers
• Gum infection
• Enamel demineralization
• Root shortening
• Tooth vitality (6)

Post-Procedure and Follow-up

It is highly important to take good care of the teeth as it requires a significant time commitment to preventing potential problems such as gum disease and tooth decay after the treatment is complete during the long orthodontic treatment process. It is extremely important to follow certain guidelines, such as the use of consistent rubber or head restraints.

Proper oral hygiene practices should be followed, including brushing after each meal and avoiding sweets between meals unless the teeth are cleaned immediately. Dental appointments should not be neglected, and regular cleaning and examinations are very important, especially during orthodontic treatment. For children who have difficulty maintaining adequate oral hygiene at home, it may be necessary to go to a dental cleaning every 3-4 months during orthodontic treatment. (7)

Recovery

Retainers are necessary during the "retention period" of orthodontic treatment to stabilize the teeth. After dental braces are removed, a retainer is usually placed within one to two weeks, although sometimes it can be done at the same appointment as braces removal. The retainer is custom-made for the patient's mouth and may need to be worn full-time for six months, followed by nighttime wear at the orthodontist's discretion.

 Patients should see their regular dentist for teeth cleaning after braces removal and may consider teeth whitening to address any noticeable color differences. It is recommended to wait until after braces removal for teeth whitening to prevent color mismatches or damage to orthodontic components. (8)

Results

The successful outcome of orthodontic treatment can be expected between 18 and 24 months, provided that the patient follows certain rules. These include maintaining good oral hygiene by taking care of teeth and gums, strictly following the instructions for use of orthodontic appliances, following the orthodontist's dietary recommendations, and wearing a retainer every night to ensure results are permanent. The orthodontist will give the patient the necessary information about how long he should wear the retainer. (9)