Orthodontics is the specialty which deals with prevention and correction of all dental and dento-facial discrepancies including teeth and jaws protruding out,  teeth out of alignment ( crooked ), inter-dental spaces, disproportionate jaws, in the young or in grown-ups , for results with pleasing esthetics and proper function and health.

The Orthodontic facilities are comprehensive and advanced , with use of the highest quality material and techniques. The TMJ (jaw joint ) treatment and evaluation receives careful consideration. Orthodontics often can produce dramatic results and beautiful smiles in the growing child.

What is Orthodontics?

Orthodontics is the specialized branch of dental science which deals with correction of position of teeth and the upper and lower jaws during and after growth of a person.

Fault in  position  of teeth (orthodontic problems ) may arise due to a multitude  of factors but are associated with causes or disturbances during growth of the child i.e. commonly –decayed milk (deciduous ) teeth , oral habits , constant nose/throat infections, etc and also due to what may be inherited from parents (referred to as genetic causes).

Orthodontic treatment possibilities are based on the ability to move teeth within the bone by applying force and the ability to mould bone itself especially during growth of a child. So the key to good results is so often the utilization of growth of a child.

Orthodontic force is given by devices called orthodontic appliances, which may be simple or complex,  removable  or fixed, applied to teeth or jaws also.

Most corrections require use of fixed appliances for proper results.

Growth of the jaws and thus of the face in esthetic harmony is possible only by devices known as functional (orthopedic) appliances which work best  during  growing ages in children. They are mostly removable if put to use at an early period of growth , and quite often are followed by fixed appliances for best results.

Orthodontic treatment depends for much of its success on the understanding and co-operation of patients. Please read this form carefully and ask your orthodontist to explain anything you do not understand . While recognizing the benefits of healthy teeth  and a pleasing smile, you should also be aware that orthodontic treatment has limitations and potential risks and there may be alternative treatment options. You should clarify what is expected of you as a patient, or as a parent of a  young  patient, to achieve excellent results. Keep in mind that with orthodontic treatment , like other healing arts, results cannot be guaranteed. The unknown factor in any orthodontic correction is the response of the patient to the orthodontic treatment. It may vary to some extent but usually is quite predictable if careful consideration is given to cooperation by  the patient and to orthodontic principles by the orthodontist. So it follows that time of treatment may vary from as little as less than 12 months for minor corrections to more than 5 years of single phase treatment for more severe conditions.

Treatment planning may involve deliberate and timed extraction of deciduous (milk) teeth in the child and quite often certain permanent teeth also, for effective and stable correction of various conditions. Such a procedure is referred to as ‘extraction treatment’ and may be planned at the commencement of  treatment,  or may be re-evaluated or deferred to mid-way into treatment for best results .Such sacrifice of certain permanent teeth ( usually some premolar teeth ) has a definite purpose , validated through a thorough diagnostic process and does not  impair esthetics or function under stringent orthodontic principles.

Orthodontic treatment is followed always by a retention phase whereby the result of the correction is held by means of appliances which are usually removable, but may be fixed if the need is felt so. Duration of retention is usually at least a year, but may be required longer in certain conditions. Stability of result is most related to proper retention but the type of anomaly corrected is also an important factor. Certain conditions have a higher tendency to revert back to a mild form of their initial state which is described as relapse. To overcome this tendency to relapse, longer and even permanent  periods of retention phase may be recommended. However in most cases a major part of the correction done is not only retained, it will perhaps have caused an immense  difference from the self-deteriorating initial state allowed to aggravate uncorrected over the years.

Orthodontics is a developing science and evolution of better material and techniques  continues to give enhanced results.

Should you have any questions, please ask.

Benefits

Orthodontic treatment promotes a healthy smile, pleasing looks (esthetics), healthier teeth and gums and a better bite for normal chewing and function.

Orthodontics  plays an  important role in improving overall oral health and achieving balance and harmony  between the face and teeth for a beautiful, healthy smile, which may enhance one’s  self esteem.

Properly aligned teeth are easier to brush and so the tendency to decay may be decreased as may be the likelihood of developing disease of the gums and supporting bone. Also, well aligned teeth  are less likely to experience wearing down of teeth.

Because of the individual conditions present and the limitations of treatment imposed by nature, each specific benefit may not be attainable for each patient.

A variety of conditions, obvious or innocuous may require orthodontic correction and accordingly age or time of correction may differ , sometimes significantly. But again generally speaking , most orthodontic interventions are done at the age of 9 to 12 years, a little earlier perhaps in girls than in boys.

Scope of orthodontic correction varies from individual or multiple teeth position correction , orthopedic or bone changes and teeth-bone ‘orthognathic’ correction by combining with surgery.

Risks

All forms of medical and dental treatment including orthodontics, have some risks and limitations. Fortunately in orthodontics, complications are infrequent and when they do occur they are usually of  only minor consequence. Nevertheless, they should be considered  when making the decision to undergo orthodontic treatment . The principal risks in orthodontic treatment pertain to :

1.Oral hygiene

Orthodontic appliances do not cause tooth decay. Gum disease, tooth decay  and permanent  markings(decalcification) on the teeth can occur  if orthodontic patient eat food containing excessive sugar or do not brush their teeth frequently or properly. These same problems can occur without orthodontic treatment but the risk is greater to an  individual wearing braces.

It is imperative during orthodontic  treatment that extra care be taken with oral hygiene and tooth brushing in particular.

During tooth position change, initial / incipient proximal decay between teeth may become evident on opening of contacts and may require restoration as advisable.

2.Relapse

Teeth may have a tendency to change their position after treatment . This is usually only a minor change, and on  average, 90% to 95% of a correction is retained. The faithful wearing of retainers  should reduce this tendency. Teeth can however, move at any time, whether or not they have had orthodontic treatment. This is specially true  during the late teen period  when active growth of the lower jaw is coming to an end. The most vulnerable  of the teeth are those at the front. Throughout life, the bite can change adversely  from various causes such as : eruption of wisdom teeth (third molars ), growth or maturational changes, mouth breathing, playing of musical instruments and other oral habits. Very occasionally tooth movements will be severe enough to merit a further short course of treatment to ensure a satisfactory result.

Deterioration in the health of the tooth-supporting bone and gums is the most important cause of major shifts in the position of the teeth during the lifetime of an individual, driven by the oral masticatory and muscle forces.

3.Periodontal health

The health of the bone and gums which support the teeth  may be affected by orthodontic tooth movement if a condition already exists, and in some rare cases  where a condition does not appear to exist. In general, orthodontic treatment  lessens the possibility of tooth loss or gum infection  due to mal-alignment of teeth or jaws. Inflammation of the gums and loss of supporting bone can occur if bacterial plaque is not removed daily with  good oral hygiene.

4.Root shortening

In some patients the length of the roots of the teeth may be shortened during orthodontic treatment. Some patients are prone to this happening, some are not. It is nearly impossible to predict susceptibility. Usually this shortening does not have significant consequences, but on very rare occasions it may become a threat to the longevity of the teeth involved.

5.Jaw joints

Occasionally patients may suffer from pain or dysfunction in the jaw joints (T.M.J).This may present as joint pain, headaches or ear problems. These problems may occur with or without orthodontic treatment. Any of the above noted problems should be reported  to the orthodontist .Some patients are susceptible to T.M.J. problems and some are not. Stress is the major contributing factor in temporomandibular disorders. Just as for painful conditions in other joints, discomfort in T.M.J.s can last from a few days to several weeks or longer.

6.Tooth vitality

Sometimes a tooth may have been traumatized  by a previous accident  or a tooth may be decayed  or have large fillings which can cause damage to the nerve of the tooth. In such event,  the pulp of a tooth may in the process of de-vitalization. Orthodontic tooth movement in some cases aggravates this condition and in rare instances may lead to loss of tooth vitality and discoloration of the tooth vitality of the tooth requiring root canal treatment  and other dental treatment to restore the color of the tooth.

7.Loose appliances and discomfort

The gums, cheeks or lips may be scratched or irritated by newly placed appliances or by loose or broken appliances or by blows to the mouth. You will be given  instructions on minimizing these effects. Very rarely, loose orthodontic appliances may be accidentally swallow ed or aspirated. You should inform your orthodontist  of any unusual symptoms, or broken or loose appliances, as soon as they are noted.

Usual post adjustment tenderness should be expected, and the period of tenderness or sensitivity varies with each patient and the procedure performed(Typical post adjustment tenderness may last 24 to 48 hours).

8.Atypical growth

Insufficient, excessive or asymmetrical  changes in the growth of the jaws  may limit our ability to achieve the desired result. If growth becomes disproportionate during orthodontic treatment, the treatment may be prolonged. Growth changes  that occur after orthodontic treatment may alter the quality of treatment results and may require further orthodontic treatment. In some cases of atypical growth. The bite may change so much  that oral surgery is required to achieve the best possible result.

9.Headgear

If improperly handled, head gear may cause injury to the face. Patients are warned not to wear the appliance during times of horseplay or competitive activity.

10.Treatment time

The total time required to complete treatment may exceed the estimate. Poor co-operation in wearing the appliance the required hours per day, poor oral hygiene, broken appliances and missed appointments can lengthen the treatment time and affect the quality of the results.

11.Co-operation

Co-operation throughout treatment is your best guarantee of achieving a pleasing smile and a good bite. Failure to co-operate  could force the orthodontist to change the procedures and goals of your treatment. As a last resort treatment may have to be suspended. The consequences of early suspension  may be worse than no treatment at all.

12.Ceramic brackets

Where ceramic brackets have been used, there have been some reported incidents of patients experiencing bracket breakage or damage to teeth , including wearing down of tooth enamel and flaking or fracturing of the tooth’s enamel on de-banding. Fractured brackets may result in remnants which may be harmful to the patient especially if they are chewed on, swallowed or aspirated.

13.Complementary esthetic dentistry

If your teeth vary from the normal in the number, size or shape of the teeth, achievement of the ideal result (for example complete closure of excessive space) may require restorative treatment. The most common types of complementary treatment are cosmetic bonding, crown and bridge restorative dental care and periodontal therapy.

14.General health

General medical problems can affect orthodontic treatment. You should keep your orthodontist  informed  of any changes  to your medical  health.