Orthodontics

Orthodontic Treatment

Orthodontics is a specialty of dentistry that examines malpositioned teeth and the relationship between the jaws and other bones of the skull, diagnoses the associated problems, and provides a treatment.

Orthodontic treatment can easily correct dental malposition and gaps to achieve a healthy smile.

What causes crooked teeth?

Both genetic factors, such as overcrowding, as well as external factors may cause crooked teeth. Early loss of baby teeth due to poor oral hygiene and caries may result in the adjacent teeth tilting into the gap, and improper guidance of the erupting permanent teeth. This can cause dental malposition and malocclusion.

Oral parafunctional habits, such as mouth breathing, thumb sucking, lip or tongue sucking, nail biting, pen chewing, or using bottles and pacifiers for a prolonged time can also lead to permanent skeletal problems. Moreover, tonsils and adenoids are common conditions among children that can cause permanent facial deformities if left untreated.

If the physician suspects that your child has tooth alignment or occlusion deformities, they will examine your child’s oral structures, teeth, jaw muscles, and jaw joints and record the findings. If required, they will request X-ray images of the head, joints, and teeth, with your permission. These records are kept during clinical follow-up in routine practice and can be used to guide future decisions and diagnoses.

Orthodontic Treatment with Removable Appliances

Removable orthodontic appliances need to be used for 6 months to 3 years in order to correct the defects in teeth, jaw, and facial structures within biological limits. You will need to come in for follow-up visits at intervals depending on the type of treatment. Problems that may occur during and after orthodontic treatment with removable appliances are as follows:

1) Appliance use: Depending on the type of removable appliance, you may need to use it all day and all night, and only remove it during meals. Your physician will explain to you the best treatment plan.

 

2) Feeling pain or pressure: When the elements of the removable appliance are engaged, your child may feel some pain for the first 1-2 days, which may affect activities of daily living. In addition, some mild soreness or pain is normal after the orthodontic wire is engaged. For appliances with screws, some mild soreness or pain is normal after the screws are tightened and may last 1-2 days. Other than that, if you feel persistent and increasing or stinging, throbbing, or sharp pain, consult your physician by phone.

3) Your child’s speech may be affected on the day that the orthodontic appliance is installed. This is temporary and should improve in less than a week. During this time, reading aloud and speaking a lot will shorten this process. Some drooling and a frequent urge to spit is normal for the first few days after the appliance is installed. Continue using the appliance.

4) a) Poor oral hygiene and irregular brushing during treatment may result in color changes and caries on the teeth.

b) Keeping the appliance clean is important for dental and soft tissue (gums, palate, lips) health. If the appliance is not properly cleaned, your child may develop soft tissue injuries or various infections. After every meal, your child should hold the appliance from its acrylic body and brush it with a toothbrush as recommended by your physician.

5) Removable appliances are made of a chemical named acrylic. Some people develop allergic reactions against this substance, however rarely. In this case, contact your physician immediately.

6) Foods to avoid: Hard foods such as plums, nuts, walnuts, and sticky foods such as chewing gum may cause the appliance to fracture or to become deformed. It is crucial for you to avoid these foods during the course of your treatment. We believe you will work with your physician in this, and thank you in advance.

7) Your physician will inform you whether a different treatment is required after treatment with the removable appliance.

8) If your appliance is broken, you may need to pay a certain fee for a new appliance. Apart from this, your appliance may need to be renewed during your treatment if your physician deems it appropriate.

9) Patient compliance: The patient is personally responsible for complying with the treatment. Cooperating with your physician and doing what is asked of you will make your child’s treatment easier and shorter. If you do not work with your physician, your physician will not be liable for the progress or lack of progress in treatment.

Orthodontic Treatment with Fixed Appliances

Fixed orthodontic appliances need to be used for approximately 3 years in order to correct the defects in teeth, jaw, and facial structures within biological limits, followed by maintenance treatment with removable appliances. Fixed and removable appliances are routine orthodontic treatment methods applied in our clinic. You will need to come in for follow-up visits at intervals depending on the type of treatment. Problems that may occur during and after orthodontic treatment with fixed appliances are as follows:

A) Pain: The forces exerted on orthodontic brackets can cause pain for up to 1-2 weeks and may affect activities of daily living. In addition, some mild soreness or pain is normal after the orthodontic wire is engaged and may last 1-2 days. Other than that, if you feel persistent and increasing or stinging, throbbing, or sharp pain, consult your physician by phone.

B) Oral hygiene: Oral hygiene is crucial in orthodontic treatment. The orthodontic brackets attached to the teeth create grooves that act as reservoirs for food deposits, therefore, the teeth become more prone to plaque accumulation. Poor oral hygiene and irregular brushing during treatment may result in color changes and caries on the teeth. It can also cause periodontal disease, characterized by swelling, bleeding, and inflammation of the gums, which can also lead to bone loss. This could result in your child losing one or more teeth. Another possible relevant problem is bad breath. During orthodontic treatment, the patient and their parents are responsible for oral hygiene and the problems that may develop due to the lack of hygiene. Sensitive individuals can develop allergic reactions such as redness, rash, and swelling on the mouth or the body. If this is the case, contact your physician immediately.


C) Foods to avoid: During treatment with fixed appliances, your physician may ask you to avoid certain foods. Acidic and carbonated beverages can cause tooth erosion and discoloration. They can also lead to the fracture of orthodontic brackets. Hard foods such as plums, nuts, walnuts, and sticky foods such as chewing gum may cause the brackets to fracture and break. It is crucial for you to avoid these foods during the course of your treatment.


D) Patient compliance: The patient is personally responsible for complying with the orthodontic treatment with fixed appliances. Your physician may require you to use a number of auxiliary orthodontic devices and pieces that can be inserted and removed during different times of treatment. Cooperating with your physician and doing what is asked of you will make your child’s treatment easier and shorter. If you do not work with your physician, your physician will not be liable for the progress or lack of progress in treatment. Problems that may arise during the course of the treatment will be explained to the patient themselves or their parent/guardian.

Frequently Asked Questions

How do I know I need orthodontic treatment?

The first orthodontic exam is performed by an orthodontist around the ages of 6-7 years when permanent teeth begin to erupt. The following check-ups will be performed by your dentist. Your dentist may require another consultation by an orthodontist around 10-12 years of age. In addition, orthodontic treatment can be performed even in adulthood to supplement prosthetic treatment or for cosmetic purposes.

What is the ideal age for orthodontic treatment?

Generally, the ideal age for the correction of malpositioned teeth is around 10-12 years, when canine teeth erupt. That said, early treatment is critical for the correction of certain jaw conditions and to stop parafunctional habits. So, you should ask your dentist for an orthodontist consultation around the age of 6-7 years, when fissure sealants are applied.

How long does orthodontic treatment last?

Active treatment lasts an average of 1.5-2 years. But this time depends on the type of treatment, age, and co-operation. It can be longer or shorter.

How long will dental appointments take? How often do I need to come in?

The first appointment or two can take up to an hour. These visits will include creating your patient file and installing orthodontic brackets. The following visits will be every 3-4 weeks and last between 15–30 minutes unless a bracket falls off or the wire is broken.

Will my braces be visible?

The main actor of fixed orthodontic treatment is the orthodontic bracket. The brackets can be made of metal, plastic, or porcelain, and are glued to the enamel surface of the teeth. Orthodontic treatment can also include lingual brackets or removable transparent trays. During treatment, orthopedic devices (extraoral appliances) can be used to achieve skeletal correction by applying forces to the jawbone, especially at an early age when the body is still growing.

Does it hurt when the wires are installed, or will they hurt my teeth or me?

The brackets are glued to your teeth with a special adhesive and do not hurt at all. For the first few days, they can cause some soft tissue injuries in the lips and cheeks, but this is temporary.

Orthodontic treatment is associated with an increased risk of tooth decay; therefore, it is very important to remove any food residues on the brackets. The teeth and bracket should be cleaned after every meal.

What can we do to prevent orthodontic problems?

The family can help to prevent or minimize environmental factors that contribute to orthodontic conditions. First, periodic dental visits are essential. After the eruption of primary teeth, regular fluoride applications, and sealant applications on permanent molars will help to preserve the teeth. If any baby teeth were extracted, space maintainers should be placed to maintain spacing in the dental arch.


Parafunctional habits such as finger sucking or mouth breathing, and prolonged bottle-feeding should be discouraged and weaned by the age of 4. Any deformities after this point will be permanent.

If you or your dentist suspect any deformities of the jaw or teeth, assessment by an orthodontist is preferable.

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