We offer treatment of crowding with full and partial banding or removable plates. Treatment times can vary from 2 months to 18 months. All stages are done here so no referrals are required.
Orthodontics refers to the diagnosis, prevention and correction of dental Malocclusion; misaligned, crooked, crowded and spaced teeth, overjets (protruded) and deep overbites whether they only involve teeth or teeth and bone. They may be purely inherited (genetic), acquired (environment) or both.
Most malocclusions involve crowding of teeth. The most accepted theory to explain this refers to the effect of modern diets on jaw bones. Modern soft processed foods do not give muscles and bones enough stimulus for adequate growth (environment influence). The size of teeth is genetically predetermined (not environment) and thus discrepancy often arises. This is also the theory of wisdom teeth impaction (i.e. smaller jaws and not enough room).
Another reason may be mouth breathing as a result of nasal blockage. This is most commonly due to dust mite allergy. Here, the tongue controls the shape of the jaw bone resulting in a “Gothic Arch” shape i.e. pointed and narrow as opposed to a broad and well developed “Roman Arch” (look at the two ends of an egg). In such cases or as general prevention use:
Dust mite protectors for pillows and mattresses.
Remove carpets in bedrooms.
Occasional oils sparingly e.g. eucalyptus, tea tree, lavender,Vicks.
“Breath Right” nasal expanders available from chemists.
Tongue thrusting, pacifiers and thumb sucking (if still done after five years of age) usually results in an open bite (note that pacifier sucking habits are also correlated with otitis media.).
Yet another reason may be the early loss of baby teeth usually from gross decay. Here, only the loss of posterior teeth can cause loss of space and in such cases a space maintainer should be utilised.
Correction is achieved by one or a combination of three methods:
Jaw bone expansion (slow or rapid) to increase the room for teeth.
Interdental stripping with diamond polishing strips.
The correction may reduce the risk of tooth decay, trauma to teeth, speech impediments and gum disease or may be purely for aesthetic reasons (which may increase confidence and self-esteem). A cost/risk/benefit analysis is discussed as part of the process.
The appliance(s) used may be fixed (e.g. braces, space maintainers or rapid maxillary expanders) or removable (i.e. plates e.g. aligners, twin blocks, slow maxillary expanders or Invisalign) or both.
Major skeletal discrepancies may also require some surgery (orthognathic surgery).
The best time for treatment is just after all baby teeth are lost, usually around twelve or thirteen but adults of any age can have treatment too. Sometimes, plates or other appliances are used when baby teeth are present. This is usually:
To correct a crossbite at the front of the mouth. If not corrected this will usually encourage the lower jaw to grow too far forward and also risk jaw joint problems.
To possibly avoid the need for braces.
To improve the results from braces. This can cause “burnout” with regards to the childs compliance and many practitioners prefer to wait until all baby teeth are lost.
Before treatment commences:
Any decay must be attended to.
Excellent oral hygiene must be established.
Photos are taken.
Models are constructed from impressions.
Panoramic (OPG) and Lateral Cephalometric X rays are taken and analysed. From this,
A case specific diagnosis and treatment plan is established.
Adjustments are usually done every 4 weeks.
Treatment times vary greatly between 2 and 24 months on average but much depends on patient cooperation. Chewing lollies, not cleaning properly, breaking appliances and missing appointments all will lengthen the time required and affect the result.
Braces can be stainless steel, porcelain or tooth coloured plastic. Generally, stainless steel are cheaper, stronger and slightly quicker as there is minimal friction between wire and bracket (brace).
At the completion of treatment retainers are fitted to hold the teeth steady in their new position. These appliances may be removable plates or wires fitted behind the teeth. If they are not worn according to instructions, the teeth may move back towards their original position.
At SAS Dental we strongly recommend fixed lower retainers and removable upper retainers.
Risks involved :
Oral health — Tooth decay, gum disease, and permanent markings (decalcification) on the teeth can occur if orthodontic patients eat foods containing excessive sugar. Inflammation of the gums and loss of supporting bone can occur if bacterial plaque is not removed regularly with good oral hygiene.
Relapse — Teeth may have a tendency to change their position after treatment. The faithful wearing of retainers will reduce this tendency. Teeth can however, move at any time whether-or-not they have been orthodontically treated. This may be caused by growth and maturational changes, mouth breathing, playing a musical instrument and other oral habits such as unresolved tongue thrusting.
Root shortening — Some patients suffer problems in the jaw joints, including joint pain, clicking, headaches, or ear problems. Generally, literature demonstrates that orthodontics play a neutral role in regard to jaw joint problems. Therefore, these problems may occur with or without orthodontic treatment. However, any of the above symptoms should be reported.