Dentistry focuses on diagnosing, preventing, and treating conditions of the teeth, gums, and oral structures, supporting oral health and overall well-being.
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Orthodontic treatment is the active phase of moving teeth and guiding jaw growth. It involves the application of controlled forces to remodel the bone and reposition the dentition. The 21st century has brought a diverse array of appliances, moving beyond the “metal mouth” era to aesthetic and invisible solutions.
Regardless of the appliance used—whether fixed braces or removable aligners—the biological principles remain the same. The treatment is a journey that requires partnership. The orthodontist designs the force systems, but the patient’s compliance and biology dictate the speed and success of the outcome.
Modern treatment is characterized by efficiency, aesthetics, and comfort. From self ligating brackets to robotic wire bending, technology is leveraged to reduce treatment time and improve the patient experience.
Fixed braces remain the gold standard for comprehensive control. They consist of brackets bonded to the teeth and an archwire that connects them. The wire acts as a track, guiding the teeth into position.
Modern braces are smaller and lower profile. They allow for three-dimensional control of the tooth, including the root torque, which is critical for stability. They are non-removable, ensuring 100 percent compliance with the force application.
Clear aligners have transformed the industry. These are a series of custom-made, transparent plastic trays. Each tray is engineered to move specific teeth a fraction of a millimeter.
Aligners are removable, allowing for easier eating and hygiene. They use small tooth colored shapes called “attachments” bonded to the teeth to provide grip. They are highly aesthetic and popular among adults and responsible teens.
For true invisibility, lingual braces are the solution. These custom brackets are bonded to the back (lingual) surface of the teeth. They are completely hidden from the outside view.
Lingual systems are highly sophisticated, often using CAD/CAM technology and robotically bent wires to fit the unique anatomy of the inner tooth surface. They offer the control of fixed braces with the aesthetics of aligners.
Self-ligating brackets are a technological evolution in fixed appliances. Instead of using elastic ties to hold the wire, they use a built-in sliding door or clip. This reduces friction in the system.
The passive nature of the clip allows teeth to slide more freely along the wire. This can result in lower force levels, potentially less discomfort, and easier hygiene since there are no elastic ties to trap plaque.
Temporary Anchorage Devices (TADs) are mini screws placed into the jawbone. They act as immovable anchors. This allows the orthodontist to move teeth against the screw rather than against other teeth.
TADs enable movements that were previously impossible without surgery, such as intruding molars to close an open bite or closing large spaces without compromising the position of the other teeth.
In growing patients, functional appliances are used to correct skeletal discrepancies. Devices like the Herbst, Twin Block, or Forsus springs work by positioning the lower jaw forward.
By holding the mandible in a forward position, these appliances modify the muscle activity and guide the growth of the jaw joint. This helps to correct Class II (overbite) skeletal patterns during the pubertal growth spurt.
Palatal expanders are used to widen a narrow upper jaw. In children, a Rapid Palatal Expander (RPE) separates the mid palatal suture. This widens the skeletal base, creating room for teeth and broadening the smile.
In adults, Miniscrew Assisted Rapid Palatal Expansion (MARPE) uses TADs to apply force directly to the bone. This can achieve skeletal expansion even after the suture has fused, often avoiding the need for surgical expansion.
For patients seeking faster results, adjunctive technologies are available. High frequency vibration devices are worn for a few minutes daily to stimulate cellular activity and potentially reduce discomfort.
Surgical facilitation, such as micro osteoperforation (MOPs), involves creating tiny dimples in the bone. This triggers a regional acceleratory phenomenon (RAP), increasing the rate of bone remodeling and speeding up tooth movement.
Orthodontics often sets the stage for other dental work. The orthodontist positions the teeth to facilitate ideal implants, veneers, or crowns. This is common in adult cases with missing or worn teeth.
Spaces are opened for implants, and roots are uprighted to allow for proper bridge placement. This collaboration ensures that the final restorative result is functional, aesthetic, and long lasting.
Retention is the lifelong phase of orthodontics. Once active treatment ends, teeth naturally want to relapse. Retainers are required to hold the teeth in their new positions while the bone stabilizes and indefinitely thereafter.
Protocols typically involve a combination of fixed lingual wires bonded behind the front teeth and removable clear retainers worn at night. Compliance with retention is the only guarantee of stability.
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With modern appliances, appointment intervals are typically every 6 to 10 weeks. Because space age wires work over long periods and aligners are changed at home, frequent monthly visits are rarely needed anymore, making treatment more convenient.
The placement of braces is painless. However, patients typically experience soreness for a few days after the wires are activated or when switching to a new aligner. This mild discomfort is a sign that the biology of tooth movement is working.
If a bracket breaks loose, it is usually not an emergency unless it is causing pain. It will stay attached to the wire. You should call your orthodontist to schedule a repair. Leaving it broken can delay your treatment progress.
You can eat most foods, but you must avoid hard, sticky, and chewy items. Popcorn, nuts, ice, and caramel can break brackets and bend wires. Healthy foods like apples and carrots should be cut into small, bite-sized pieces.
Braces straighten the teeth, but rubber bands (elastics) fix the bite. They connect the upper and lower jaws to pull them into the correct relationship. Without consistent rubber band wear, the overbite or underbite will not be corrected.
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