Description

Orthodontics is the branch of dentistry that corrects
teeth and jaws that are positioned improperly.  It is the discipline of
achieving near-ideal functioning and aesthetics of the teeth and jaws in order
to improve an individual’s quality of life.

No matter the age of the individual, untreated
orthodontic problems will only get worse in the future.  Crooked teeth and
teeth that do not fit together correctly are harder to keep clean, are at risk
of being lost early due to tooth decay and periodontal disease, and cause extra
stress on the chewing muscles that can lead to headaches, TMJ syndrome and
neck, shoulder and back pain.  Additionally, crooked jaw closing and early
tooth contact can lead to abnormal erosion on the tooth surfaces, difficulty in
chewing and speech, excess pressure on the teeth, and can result in lesions
forming on the root apex and damage to the supporting bone and gum tissues.

Teeth that are crooked or not in the right place can
also detract from one’s appearance.  The benefits of orthodontic treatment
include a healthier mouth, a more pleasing appearance, and teeth that are more
likely to last a lifetime.

Only your dentist or orthodontist can determine
whether you can benefit from orthodontics. Based on diagnostic tools that
include a full medical and dental health history, a clinical exam, plaster
models of your teeth, and special X-rays and photographs, an orthodontist or
dentist can decide whether orthodontics are recommended, and develop a
treatment plan that’s right for you.

Cases that require immediate treatment:

• Unbalanced face and jaw structure
• Breathing from the mouth
• Bad habits such as thumb sucking, nail biting,
  cheek – lip biting
• Long-term pacifier or baby bottle use
• Difficulty chewing or speaking
• Extremely forward or backwardly positioned jaw
  structures
• Teeth positioned forward (potrusive)
• Crooked, wrongly positioned, or not visible
  (buried) teeth
• Early or late milk teeth loss
• No contact between the top and bottom teeth, or
  having them enclose themselves altogether

A child’s first orthodontic treatment should be no
later than the age of seven.  Even though the teeth may appear properly
lined up, an invisible closing problem may be an issue.  Even though the
child has passed the age of seven, an orthodontic examination should be
arranged.  Despite the advantages of having inspections at an early age,
most active orthodontic treatments start between the ages of 9-14.

While orthodontic treatment started at an early age
has good outcomes for both the patient and the doctor, orthodontic treatment is
also given to adults; as long as he/she has healthy teeth, gums, and
surrounding bone tissue.  Patients of all ages that meet these criteria
will benefit from good results.  While the duration of treatment changes
from case to case, they can last from 6 to 36 months.  This period greatly
depends on the patient’s growth and development phase, level of deformity, oral
care, conformity to treatment, and unity with the doctor.  Adaptation to
new apparatuses usually lasts 7-10 days.
 
Orthodontic treatment should without question be performed by an orthodontist.

Many different types of appliances, both fixed and
removable, are used to help move teeth, retrain muscles and affect the growth
of the jaws. These appliances work by placing gentle pressure on the teeth and
jaws. The severity of the problem will determine which orthodontic approach is
likely to be the most effective.

Fixed appliances include:

Braces: the most common fixed appliances, braces
consist of bands, wires and/or brackets. Bands are fixed around the teeth or
tooth and used as anchors for the appliance, while brackets are most often
bonded to the front of the tooth. Arch wires are passed through the brackets
and attached to the bands. Tightening the arch wire puts tension on the teeth,
gradually moving them to their proper position. Braces are usually adjusted
monthly to bring about the desired results, which may be achieved within a few
months to a few years. Today’s braces are smaller, lighter and show far less
metal than in the past. They come in bright colors for kids as well as clear
styles preferred by many adults.

Removable appliances include:

Aligners — an alternative to traditional braces for
adults, serial aligners are being used by an increasing number of orthodontists
to move teeth in the same way that fixed appliances work, only without metal
wires and brackets. Aligners are virtually invisible and are removed for
eating, brushing and flossing.

Jaw repositioning appliances — also called splints,
these devices are worn on either the top or lower jaw, and help train the jaw
to close in a more favorable position. They may be used for temporomandibular
joint disorders (TMJ).

Palatal expander — a device used to widen the arch of
the upper jaw. It is a plastic plate that fits over the roof of the mouth.
Outward pressure applied to the plate by screws force the joints in the bones
of the palate to open lengthwise, widening the palatal area.

Removable retainers — worn on the roof of the mouth,
these devices prevent shifting of the teeth to their previous position. They
can also be modified and used to prevent thumb sucking.

Headgear — with this device, a strap is placed around
the back of the head and attached to a metal wire in front, or face bow.
Headgear slows the growth of the upper jaw, and holds the back teeth where they
are while the front teeth are pulled back.

What rules must patients follow during orthodontic treatment?

• Prior to orthodontic treatment, decaying teeth
  must be treated and gums must be healthy.  
• During the treatment, an orthodontic specialist
  will recommend an apparatus depending on the diagnosis.If the appliance is
  removable, they must be worn day and night at all times (including sleep)
  except for while eating.  They should be cleaned, similarly to the
  teeth, with toothbrush and toothpaste.  Care should be taken to not
  lose them- otherwise treatment will stagger or even retrogress.

If the appliance is fixed (braces), they should be
brushed with the teeth after every meal.  Regular brushing is very
important.  Tooth decay is more common in patients receiving orthodontic
treatment and if inadequately cleaned, white stains may form around the
braces.  Brushing should continue until all deposit has been cleaned
around the braces.  The health of the gums also depends on proper
brushing. 

• Refrain from consuming acidic beverages (Cola,
  Fanta, Sprite…) as they harm both the braces and the teeth and increase
  the chances of forming cavities.
• Do not consume very sticky or sugary foods
  (chewing gum, Turkish delight, caramel).  These may remain lodged
  between the braces making them impossible to clean, leading to easy tooth
  decay and inflammation of the gums.
• There are also rules regarding consumption of
  very tough foods.  For example fruits like apples and pears, and
  vegetables like cucumbers and carrots should not be eaten traditionally,
  by biting, but by small pieces with the back teeth or by having them
  grated beforehand. 
• The teeth must be brushed with orthodontic or
  interdental toothbrushes, and floss should be used where necessary. 
  The patient should carry their toothbrush with them at all times so they
  can brush their teeth everywhere when they are not at home. 
• Once the braces have been applied, there may be
  sensitivity and pain, and injury on the inner cheek (canker sores or
  thrushes).  These complaints will cease in a week to 10 days. 
  Pain killers may be taken to relieve the pain, and special waxes given by
  the orthodontist may be used. 
• Attention must be paid to recommendations given
  by the orthodontist during check-ups.   
• Throughout the treatment, the patient will have
  check-ups once every 4-5 weeks.  In order for the treatment to
  achieve its goal, appointments should not be missed. 
• Breaking or snapping, or removal of fixed
  appliances will hinder the progress of the treatment.  In such cases,
  the patient must contact his/her orthodontist.
• In reinforcement treatment the patient should not
  give up; the apparatus should be protected. 

Crooked Teeth

What causes crooked teeth?

During infancy when the milk teeth change and
permanent teeth start to emerge, many children show signs of crooked
teeth.  Parents often visit their dentist stating that their child’s teeth
emerged crooked.  The main reason for this is attendance.  However,
precautions not duly taken can also lead to crooked teeth.  The reasons
for crooked teeth and precautions are as follows:

Genetic nonconformity between the child’s jaw size and
width of the teeth, or respiratory problems which negatively affect the
development of the jaws are all factors.  Factors that affect breathing in
the child’s nasal passages first negatively affect the growth of the upper jaw
followed by the lower jaw, hence preventing the teeth to properly align. 
Orthodontic intervention is required in such as case.

One other reason for crooked teeth is the extraction
of milk teeth before their time to change has come.  Having milk teeth
extracted based on the notion that they are going to be replaced anyway, is

extremely wrong.  These milk teeth save the spot
for the permanent teeth that will emerge in their place, preventing
crookedness.  If prematurely extracted, the neighboring teeth will fill
the position of the

missing tooth, blocking the space from which the new
permanent tooth will emerge and will force it to erupt from any space
available, or not at all.  In both situations, the teeth system’s balance
will be

disrupted and crookedness will occur. 

If cavities between the sides of the milk teeth are
not treated on time, the neighboring teeth will fill the space created by the
cavities.  This is another cause of crooked teeth.  Therefore it is
very important to have milk tooth cavities treated. 

Do crooked teeth only pose an aesthetic problem?

Uniform alignment of the teeth is important, not only
in terms of aesthetics.  Crookedness in the teeth make it difficult for
these areas to be cleaned, leading to cavities, gum disease, and joint
pains. 

Can crooked teeth always be treated?

Crooked teeth can be treated by orthodontists with varying treatment
methods at all ages.