Orthodontic Treatment (BRACES)

Orthodontic treatment is a way of straightening or moving teeth, to improve the appearance of the teeth and how they work. It can also help to look after the long-term health of the teeth, gums and jaw joints, by spreading the biting pressure over all the teeth.

Many people have crowded or crooked teeth. Orthodontic treatment will straighten the teeth or move them into a better position. This can not only improve their appearance but also the way the teeth bite together, while also making them easier to clean.

In some patients the upper front teeth can stick out and look unsightly. These ‘prominent’ teeth are more likely to be damaged, but orthodontic treatment can move them back into line. In others, the way the upper and lower jaws meet can cause teeth to look unsightly and lead to an incorrect bite. Orthodontic treatment may be able to correct both.

When the teeth don’t meet correctly, this can put strain on the muscles of the jaw, causing jaw and joint problems and in some cases headaches. Orthodontic treatment can help you to bite more evenly and reduce the strain.

Orthodontic treatment is generally best carried out in children, but adults can have orthodontic treatment too – and more and more are doing so. Age is less important than having the proper number of teeth. In children it may be necessary to wait for enough teeth to come through before starting treatment.

Any dentist may carry out orthodontic treatment. Or the dentist may send the person to a specialist who has extra qualifications. The specialist may be in a practice or in a hospital department, and is called an orthodontist.

The most important thing is to have a full examination. This will usually involve looking at your teeth, taking x-rays and making plaster models of your teeth.

Your dentist or orthodontist will then discuss what treatment is possible. Once you are sure you want to go ahead, the treatment can begin as soon as you have enough permanent teeth.
Will I need to have teeth taken out to make room?
You may not have enough room for all your permanent teeth and so it may be necessary to take out some permanent teeth to make space. Your dentist will tell you whether this is the case. Sometimes space can be created using other forms of treatment.

Orthodontic treatment can be done by many sorts of appliances, which most people know as ‘braces’.

Simple treatment may be carried out with a removable appliance (a plate that can be taken out to be cleaned). It has delicate wires and springs attached, which move the teeth using gentle pressure.

It is sometimes possible to change the way the jaws grow, using orthodontic appliances. These functional appliances use the power of your jaw muscles and can help with certain types of problem.

Often, teeth need to be guided more accurately than they can be using a removable plate. So fixed appliances are used. These have brackets and bands temporarily stuck to the teeth. A flexible wire joins all the brackets and allows the teeth to be moved. It is not possible for the patient to take the appliance out and so it is called a fixed appliance.

Fixed braces are not always made of metal. Plastic and ceramic can be used, especially for adults.

The length of treatment depends on how severe the problem is, and may take anything from a few months to two and a half years. Most people can be treated in one to two years.

When treatment is finished the teeth need to be held in position for a time. This period is called retention, and the appliances that hold the teeth in place are called retainers.

The retainers hold newly straightened teeth in position while the surrounding gum and bone settles. The retainers can be removable or fixed depending on the original problem.

Orthodontic appliances usually need adjusting every 4 to 6 weeks. Your orthodontist will tell you how often your appliance will need adjusting.

All appliances may feel strange to begin with and can cause discomfort. If the problem doesn’t go away the orthodontist may be able to carry out adjustments to help. Teeth are usually uncomfortable immediately after adjustment but this will settle.

Success depends on a partnership between the skills of the orthodontist, and the enthusiasm and help of patient and parents. It is important to attend regularly and carry out any instructions given by the orthodontist. The success of the treatment also depends on the commitment of the patient. For children’s orthodontic treatment it is very important that the patient is as keen as the parent.

All appliances may feel strange to begin with and can cause discomfort. If the problem doesn’t go away the orthodontist may be able to carry out adjustments to help. Teeth are usually uncomfortable immediately after adjustment but this will settle.

Even after retention, it is normal for minor tooth movements to happen throughout life, so no permanent guarantee can be given. However, it is unusual for teeth to alter enough to need further treatment.

The first thing to do is to go along to your own dentist and get his or her advice. Your dentist will know whether you need treatment and make the necessary arrangements.

It is important to continue to have your teeth checked by your dentist while having orthodontic treatment. You also need to take extra care of your teeth and mouth:
Clean your teeth carefully every day, including between your teeth where you can. Your dentist or hygienist will be able to show you the special techniques to use depending on the appliance you are wearing.
Keep sugary foods and drinks to a minimum. Avoid ‘snacking’ with foods or drinks containing sugar, especially fizzy drinks. Your dentist will help. Also, sticky and hard foods may damage the delicate orthodontic appliances.
Always use a fluoride toothpaste and mouthwash. Your dentist or hygienist may recommend a fluoride toothpaste or application for you to use.

Your teeth can be damaged if they are not properly looked after during treatment. Appliances will not in themselves cause damage, but poor cleaning and too many sugary drinks and snacks can cause permanent damage.