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Q&A: Orthodontics
What is orthodontics?
Orthodontics is the specialty of dentistry that involves the treatment of malocclusion, which is when the upper and lower teeth or jaw do not meet correctly. Individuals may need to be treated by an orthodontist if they have problems with their bite (such as an over or underbite), crooked teeth or overcrowding in the mouth. An orthodontist may move the teeth into position or correct the bite using braces, which are appliances bonded to the teeth and use brackets, wires, rubber bands or other ways of moving the teeth. An orthodontist may also use removable appliances to reposition the teeth. In more serious cases, a patient may need jaw surgery to align the bite. Children and adults can be treated for malocclusion. A dentist or orthodontist can perform an initial evaluation to determine if braces are needed.
What if my teeth are not straightened?
Left untreated, an individual may suffer from chewing or jaw (TMJ or temporomandibular joint) problems because the bite is off, increased tooth decay because teeth may be difficult to clean, or gum disease. An individual with crooked teeth and an unattractive smile may suffer from low self-esteem, social problems or even depression.
When should treatment begin?
It's never too late to correct the teeth and bite. One Chicago area dentist reports successfully treating a 78-year-old woman with braces. Interceptive treatment (first stage) may begin with the baby teeth or later on permanent teeth. A dentist or orthodontist should evaluate a youngster by the age of 6. The dentist will analyze the problem and determine when treatment should be started. Every case is different and there is no blanket rule that applies to the treatment of malocclusion. Treatment depends on the severity of the problem.
As a general rule, however, functional problems -- such as TMJ disorders, tongue thrusting or speech/lip function problems -- are usually corrected at an early age, such as 6 to 9 years old. Skeletal or structural problems, such as when the teeth and jaw don't line up, are generally corrected at a later age when the permanent teeth are available.
What are the types of problems?
There are three main types of malocclusions, including:
- Type I -- The upper and lower jaw are proportionally related from front to back, but there are problems with the teeth lining up straight within the jaws.
- Type II -- The upper jaw is too far forward and/or the lower jaw is too far back resulting in an overbite, and there may also be problems with alignment of teeth.
- Type III -- The upper jaw is too far back and/or the lower jaw is too far forward resulting in an underbite, and the teeth may also be crooked.
How long will treatment take?
It's impossible for an orthodontist to project the actual treatment time. In most cases, however, treatment will range from 15 to 48 months for those with severe problems. In calculating total treatment time, the "resting stages" between multi-stage treatment periods (when the teeth are not actually being moved), should not be included. If a patient does not follow instructions from the dentist (e.g., to wear rubber bands or appliances), treatment may take longer. If the interceptive stage is a success, subsequent stages may be avoided. An orthodontist develops a tailored treatment plan for each patient.
How effective is treatment on adults?
More and more adults are getting braces. There is an array of treatment options for adults on the market -- including ceramic braces and removable appliances -- but they may have limited applicability and effectiveness. Many dentists report that metal braces are still the most effective and least expensive option.
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