Banner.  Girl flossing

simplesteps

Orthodontics: Braces and More

What Is Orthodontics?

Orthodontics is a specialty field of dentistry that diagnoses, prevents and treats irregularities of the teeth and face. Treatment can correct an irregular or "bad" bite, also known as a malocclusion.

Orthodontic care involves the use of appliances. There are two main types. Braces are attached to the teeth. Removable appliances are put in and taken out by the patient. These devices can be used to:

  • Straighten teeth
  • Correct an irregular bite
  • Close unsightly gaps
  • Bring teeth and lips into proper alignment

They also can help with procedures in other areas of dentistry. Examples include cosmetic and implant dentistry.

In young children, orthodontic treatment also may guide proper jaw growth and permanent tooth eruption.

Bite Irregularities

Many people's teeth are irregular in some way. For example, teeth may be slightly crowded or unevenly spaced. Sometimes the main problem with a "bad" bite is appearance. In other cases, it can cause difficulty in chewing or talking.

You may have inherited an irregular bite, but not all bite problems are genetic. Other causes include:

• Trauma — When teeth are broken or knocked out and then replaced, they may fuse with the bone that surrounds them. This is called ankylosis or abnormal root fusion to the bone. If this happens in a growing child, the teeth will not be able to line up properly in the jaw. An irregular bite will result. • Prolonged thumb sucking or pacifier use — These habits can cause bite problems. For example, they may cause your upper teeth to protrude (stick out) in front of your lower teeth. A tongue-thrusting habit when you swallow can cause a similar problem. • Premature loss of primary (baby) teeth — If a primary (baby) tooth is lost too early, the permanent tooth loses its guide. It can drift or come into the mouth (erupt) incorrectly. In some cases, the permanent teeth may be crowded, or they may come in only partially. Sometimes the teeth next to the lost primary tooth can move or tilt into the space left by the missing tooth. This may prevent the permanent tooth from coming in.

Why Seek Orthodontic Care?

Whether to seek orthodontic care is a personal decision. Many people live with crowding, overbites or other types of bite problems and do not seek treatment. However, many people feel more comfortable and self-confident with properly aligned, attractive teeth. Orthodontic care can help improve appearance and build self-confidence. It also may help you to chew better or speak more clearly.

Orthodontic care is not just cosmetic in nature. It also can benefit long-term dental health. Straight, properly aligned teeth are easier to brush and floss. This can help reduce the risk of tooth decay. It also can help prevent gingivitis, an inflammation that damages gums. Untreated gingivitis can lead to periodontitis. This type of gum disease can destroy bone that surrounds the teeth and lead to tooth loss.

People with bad bites also may chew less efficiently. Some people with a severe bite problem may even have problems getting enough nutrition. This especially may occur when the jaws are not aligned correctly. Fixing bite problems can make it easier to chew and digest foods.

When the upper and lower front teeth don't align right, people also can have speech difficulties. These can be corrected through orthodontic treatment, often combined with speech therapy.

Finally, orthodontic treatment can help to prevent premature wear of back tooth surfaces. As you bite down, your teeth withstand a tremendous amount of force. If your front teeth don't meet properly, it can cause your back teeth to wear more.

Who Can Benefit from Orthodontic Care?

The American Association of Orthodontists recommends that children have an orthodontic screening no later than age 7. By then, enough of the permanent teeth have emerged to identify potential problems. Don't hesitate to ask your child's dentist for guidance in this matter.

Don't wait until all the permanent teeth erupt in the mouth. Starting orthodontic treatment early in life may have many advantages. For example, while children are still growing, expansion devices can be used to widen the palate. This can help teeth come in straighter by providing more space. It also may help to correct the way the top teeth and bottom teeth meet or come together. Such treatment should be done at an early age for best results.

Many people undergo orthodontic treatment during preteen and teenage years. At this time, most of the permanent teeth have come in and treatment can be most effective. About 3 million teenagers in the United States and Canada wear braces. Millions more would benefit from treatment.

An increasing number of adults now have orthodontic treatment as well. However, adult treatment can be more complicated. It may require more than one dental professional to fully correct a problem. For example, adult patients may be more susceptible to gum problems. They will need to take care of these problems before orthodontic treatment can begin. Sometimes they also have jaw alignment problems that require corrective surgery. One of the biggest limitations in adult treatment is that adults are no longer growing.

Types of Bad Bites

An improper bite doesn't look good. That is the usual reason that people seek treatment from an orthodontist. In addition, an improper bite causes difficulty in chewing. In people with crowded teeth, it can lead to more cavities or gum disease. Treatment of an irregular bite can improve your overall oral health and stabilize your bite.

Incorrect bites are grouped into categories. Common bite problems include:

  • Crossbite — Here, the upper teeth rest significantly inside or outside the lower teeth. A crossbite often can make it difficult to bite or chew. It also may cause the jaw to shift to one side as it grows.
  • Crowding — Permanent teeth may not have room to move into the right position:
    • If there is not enough room for the teeth
    • If the teeth are unusually large compared with the size of the dental arch
    • If the jaw is narrower than it should be
  • Deep overbite — This occurs when the upper front teeth (incisors) overlap too far over the lower teeth. In some cases, the biting edges of the upper teeth touch the lower front gum tissue and the lower front teeth may bite into the roof of the mouth.
  • Underbite — A crossbite of the front teeth is commonly referred to as an underbite if the lower teeth are ahead of the upper teeth. This may also be a sign that the jaws are not in the correct position. Sometimes surgery is needed.
  • Open bite — If your upper and lower front teeth don't meet when you bite down, this is called an open bite. This may make it impossible to bite off food with the front teeth. It also can affect speech. Because the front teeth don't share equally in the biting force, the back teeth may receive too much pressure. This makes chewing less efficient. It can lead to premature wear of the back teeth.
  • Spacing problems — Some people have missing teeth or unusually small teeth in a normal sized jaw. This can result in large spaces between the teeth. People who have lost one or multiple teeth may have uneven spacing because adjacent teeth may drift into the unoccupied areas. Braces can be used to shift the position of these teeth so the missing tooth or teeth can be replaced.

Treatment: Braces and Retainers