orthodontics

Orthodontics is the treatment to straighten teeth and correct bites using various mechanical appliances, such as small dental plates with wire springs that push the teeth, for minor tooth movements such as moving one or two teeth. Brackets that are fixed onto the teeth are used on crooked and overcrowded teeth and for incorrect bites. A variety of different types and shapes of wires are fitted into the brackets to produce different types of tooth movements, and a combination of springs, elastics, loops, headgears and other means are used to push the teeth along the wires into their new positions. The teeth can be drawn out or pushed into the bone, or they can be tipped into position. Specialist orthodontists best treat many cases.

Other methods of moving teeth have become available recently that do not require wires or springs or brackets. These methods use a series of graduated trays that are made using computer imaging technology, with or without the guidance of a specialist orthodontist, to put pressure on the teeth in order to get the teeth to move.

Advantages: Plastic dental plates with wire springs  are very efficient for treating minor tooth movements. They are easy to maintain and fairly comfortable to wear. Bracket and wire orthodontics have been used for many years with excellent results. It is the treatment of choice for teenagers and children as it is relatively quick to get results, and easy to maintain with little patient cooperation needed. This is an excellent way of treating complex cases. The NHS funds it for children. Clearstep and Invisalign are user friendly, aesthetically acceptable during active treatment and gives excellent results. The trays are removed for eating and drinking, so oral hygiene is simple to maintain. They are see-through so they are not noticeable or intrusive, and are extremely comfortable to wear. Treatment takes no longer than any other type of orthodontic treatment.

Disadvantages: Plastic removable appliances are not aesthetically beautiful. They take a while to get used to and become loose over a short period. The patient needs to return to the dentist often to have the plate adjusted and the springs activated. Brackets and wires are not aesthetically pleasing, even with the newer see-through brackets and wires. The brackets may be fitted to the inside of the teeth, so as not to be visible, but this is extremely uncomfortable and treatment is much more difficult. Oral hygiene maintenance is difficult with wire-based orthodontics. On removal of the brackets there may be discolouration of the teeth around the bracket, and cement may be left on the teeth that is uncomfortable and may need to be cut off the teeth with a drill. After treatment is completed, a retainer needs to be made that is generally charged for.

Clearstep plates are taken out during eating and cleaning so they can be mislaid or lost. The treatment is dependent on the placement of sequential plates by the patient at regular intervals. If the patient does not change plates regularly as instructed, or does not even wear the plates, no tooth movement will occur. A retainer will need to be fitted on completion of treatment to maintain the changes made to the teeth.