Posts for tag: orthodontic treatment
Moving teeth through orthodontics may involve more than simply wearing braces. There are many bite conditions that require extra measures before, during or after traditional orthodontic treatment to improve the outcome.
One such measure is extracting one or more teeth. Whether or not we should will depend on the causes behind a patient's poor dental bite.
Here, then, are 4 situations where tooth extraction before orthodontics might be necessary.
Crowding. This happens when the jaw isn't large enough to accommodate all the teeth coming in. As a result, later erupting teeth could erupt out of position. We can often prevent this in younger children with space maintainers or a palatal expander, a device which helps widen the jaw. Where crowding has already occurred, though, it may be necessary to remove selected teeth first to open up jaw space for desired tooth movement.
Impacted teeth. Sometimes an incoming tooth becomes blocked and remains partially or fully submerged beneath the gums. Special orthodontic hardware can often be used to pull an impacted tooth down where it should be, but not always. It may be better to remove the impacted tooth completely, as well as its matching tooth on the other side of the jaw to maintain smile balance before orthodontically correcting the bite.
Front teeth protrusion. This bite problem involves front teeth that stick out at a more horizontal angle. Orthodontics can return the teeth to their proper alignment, but other teeth may be blocking that movement. To open up space for movement, it may be necessary to remove one or more of these obstructing teeth.
Congenitally missing teeth. The absence of permanent teeth that failed to develop can disrupt dental appearance and function, especially if they're near the front of the mouth. They're often replaced with a dental implant or other type of restoration. If only one tooth is missing, though, another option would be to remove the similar tooth on the other side of the jaw, and then close any resulting gaps with braces.
Extracting teeth in these and other situations can help improve the chances of a successful orthodontic outcome. The key is to accurately assess the bite condition and plan accordingly.
If you would like more information on orthodontic options, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Removing Teeth for Orthodontic Treatment.”
When considering “smile makeover” options, it’s easy to focus on whitening, veneers or implants — techniques and materials focused mainly on the teeth and gums. But if you don’t also consider the bigger picture of how your upper and lower teeth come together to form your bite, these efforts may be a lot like picking out paint colors for a house with foundation problems.
That’s why orthodontics, the dental specialty concerned with the bite, could be a consideration in your smile makeover plan. Moving teeth into better positions not only improves your teeth’s function and health it could also help facilitate any cosmetic changes that follow.
The first step, of course, is to visit an orthodontist, a dentist with advanced training and experience in tooth alignment and function, for a comprehensive evaluation. Orthodontists are also knowledgeable in the growth and development of the bite, and so can develop a treatment approach that reflects the patient’s needs, whether a child or adult.
Treatments vary, depending on your particular needs. Fixed appliances like metal or clear braces that can’t be removed by the patient are the standard treatment for most malocclusions (bad bites). Clear aligners, removable trays that fit over the teeth with programmed incremental movements of the teeth, find the greatest application with adults. Orthodontists may also use specialized appliances, like temporary anchorage devices (TADs), which work to isolate teeth that need to be moved from those that don’t.
In comprehensive makeovers, orthodontists will work with a team of other dentists and specialists, including periodontists (specializing in the gums, bone and other supporting structures of the teeth) and oral surgeons. In these cases, orthodontic treatment may occur before or after other treatments with the overall goal of producing a beautiful, transformed smile.
If you would like more information on how orthodontics can transform your smile, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “The Magic of Orthodontics: The Original Smile Makeover.”
Your teen is about to embark on an orthodontic journey to a straighter, more attractive smile. But although you're excited about the outcome, you both may be steeling yourselves for a few years of "life with braces."
But maybe not—your teen may be able to take advantage of a different kind of corrective appliance: clear aligners. This 21st Century teeth movement method has a number of advantages over braces. For teens, though, there's one big one that could have a huge impact on their social life—clear aligners are nearly invisible to other people.
Clear aligners consist of a series of clear, removable, computer-generated trays based on photographs, models and x-rays of an individual patient's teeth and bite. Each of the trays is slightly different from the previous one in the series, and by wearing each one for about two weeks before moving on to the next, the aligners gradually move the teeth to the desired new positions.
Besides reducing embarrassment often associated with wearing metal braces, clear aligners have other benefits. Unlike braces, they can be removed for eating, easier oral hygiene or for rare special occasions (although for best effectiveness, they should be worn for 20 to 22 hours each day). Recent developments like added elements that help target certain teeth for movement or "power ridges" for more controlled and efficient force have increased the range of bite problems they can be used to correct.
While this means clear aligners can be used for many bite problems, in some severe cases braces and other orthodontic treatments might still be necessary. And because they're not fixed like braces (only the orthodontist can remove them) the patient must have the maturity and self-discipline to wear them consistently.
Your teen will need to undergo a thorough orthodontic examination to see if clear aligners are a viable option for them. If so, it could make the next few treatment years less stressful for both of you.
If you would like more information on clear aligners, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Clear Aligners for Teens: User-Friendly Orthodontics.”
“To gain something, sometimes you have to give up something else.”
No, that isn't the latest viral meme on the Internet. It's actually a practical consideration that could arise in orthodontics.
In this case, the “something” to gain is a straighter, more attractive smile; the “something” you may have to part with is a few teeth. This may be necessary if there are too many teeth on a dental arch for its capacity, a situation called crowding. A lack of space is the main reason teeth come in misaligned.
Before we can correct this, we'll need to free up space to allow for tooth movement by removing one or more of the existing teeth. The ideal candidates are those that are near to the teeth we wish to move but not highly visible. The first bicuspids are the most frequent choices for removal: they're located behind the cuspids or eyeteeth (the pointed teeth right under the eyes).
Ideally, we'll remove the target teeth some time before we apply braces to give the gums a chance to heal. At the same time we want to preserve the bone that once supported the teeth we've extracted. This is because when we chew the forces generated by the teeth stimulates bone replacement growth. When a tooth is no longer there the supporting bone doesn't receive this stimulation and may ultimately reduce in volume.
We may try to prevent this by placing a bone graft in the empty socket immediately after removing the tooth. The graft serves as a scaffold to encourage new bone to grow. Hopefully when we're ready to apply braces, the bone will be strong and healthy to handle the movement of the teeth.
As the teeth move under the influence of braces, they'll begin to fill up the space created by tooth removal. Once it's completed, the extracted teeth won't be missed — the other teeth now straightened will completely fill out the smile.
The different steps in this process must be carefully planned and executed precisely, and it will take months or even years to complete. In the end, though, this complicated bite problem can be corrected and replaced with an attractive, straight smile.
If you would like more information on correcting a poor bite, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Tooth Removal for Orthodontic Reasons.”
If your teenager is in need of orthodontic treatment, you might automatically think braces. But while this decades-old appliance is quite effective, it isn’t the only “tooth movement” game in town any more. Clear aligners are another choice your teenager might find more appealing.
Clear aligners are a sequential set of computer-generated plastic trays that are worn by a patient one after the other, usually for about two weeks per tray. The trays are fabricated using 3-D computer modeling of the patient’s mouth, each one slightly different from the last to gradually move teeth to the desired new positions.
So, why choose clear aligners over braces?
They’re nearly invisible. Because they’re made of a clear polymer material, they’re not nearly as noticeable as metal braces. In fact, they may go completely unnoticed to the casual observer.
They’re removable. Unlike metal braces, which are fixed in place by an orthodontist, clear aligners can be removed by the wearer. This makes brushing and flossing much easier, and they can also be removed for eating or special occasions. That said, though, they should be worn at least 20 to 22 hours each day to be effective.
They’re becoming more versatile. With some complicated malocclusions (poor bites), braces and other orthodontic appliances may still be necessary. But innovations like added power ridges in clear aligners can more precisely control which teeth move and which don’t. This has greatly increased the number of poor bite scenarios where we can appropriately use clear aligners.
If you’d like to consider clear aligners, just remember they require a bit more self-discipline on the part of the wearer than braces. And once the treatment finishes, they’ll still need to wear a retainer just as with metal braces to help keep the repositioned teeth from reverting to their old positions.
If you think your teen is up to the challenge and their particular situation can be corrected with this innovative technology, then clear aligners could be a great choice.
If you would like more information on clear aligners orthodontic treatment, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Clear Aligners for Teens.”