Orthodontics for Children
It’s usually best for the orthodontist to see children by age 8 to advise if orthodontic treatment is required and when it is sometimes the best time for that patient to be treated. The first permanent molars and incisors have usually come in by that time and crossbites, severe crowding, and other problems can be evaluated. In severe cases, when treatment is begun early, the orthodontist can augment the growth of the jaw and guide incoming permanent teeth. Early treatment can also improve the width of the dental arches, gain space for permanent teeth, avoid the need for permanent tooth extractions, reduce likelihood of impacted permanent teeth, correct thumb-sucking, and eliminate abnormal swallowing or speech problems. In other words, early treatment can simplify later treatment.
Orthodontics for Adults
Orthodontic treatment can be successful at any age and adults especially appreciate the benefits of a beautiful smile. One of every five patients in orthodontic treatment is an adult over 21. Jaw surgery is sometimes required for adult orthodontic patients because jaws may not be growing. As a result of this malocclusion, adults also may have experienced some breakdown or loss of their teeth and bone that supports the teeth and may require periodontal treatment before, during, and/or after orthodontic treatment.
For most people, a beautiful smile is the most obvious benefit of orthodontics. After your braces come off, you’ll feel more self-confident. Equally important, properly fitting teeth are healthy teeth that will last a lifetime. During your treatment, we want you to feel as comfortable as possible.
How Orthodontic Treatments Work
Orthodontic appliances can be made of metal, ceramic, or plastic. They may be removable or they may be brackets bonded to the teeth. By placing a constant, gentle force in a carefully controlled direction, braces slowly move teeth to a corrected position. This is a great time to wear braces! Gone are the days when a metal band with a bracket was placed around each tooth. You can choose brackets that are clear or metallic in color. You can choose the color of the ties that hold the wire in brackets. Wires are also less noticeable than they used to be, and the latest memory wire alloys move teeth faster with less discomfort to patients.
Duration of Treatment
Treatment time typically ranges from six months to 2 ½ years, depending on the growth of the patient’s mouth and face and the severity of the problem. Patients grow at different rates and will respond variously to orthodontic treatment, so the proper timing of orthodontic treatment is crucial to minimizing treatment duration.
A child will accomplish two-thirds of their overall growth in the early adolescent years (11-14 years for girls and 13-15 for boys). Therefore, we find that approximately 9-18 months of treatment during this rapid growing period will generate greater and more stable jaw bone growth than four or five years of treatment either too early or too late during the child’s slower growing years.
Early orthodontic treatment (before the early adolescent years) is begun for two reasons only: 1) To avoid extraction of permanent teeth and 2) To correct severe skeletal or dental imbalances. In both cases, the early treatment stimulates bone growth in the jaws.
The following graph depicts this concept:
What Are the Ill Effects Of a Poor Bite?
In a normal bite, the upper teeth should fit between teeth in the lower arch. This is so that when you chew, the cusp tips travel between the grooves of opposing teeth. (See Fig. 1)
- If teeth do not fit together in this manner, they are said to be in malocclusion. When you consider the amount of force which is produced during chewing, how the teeth fit becomes very important. Every time you chew, 760 pounds per square inch of stress is generated. Therefore, teeth in a bad bite or malocclusion continually clash against each other in a traumatic end-to-end relationship. This causes the teeth to wear down and loosen in their supporting bone, and eventually the teeth can be lost. (See Fig. 2)
- Teeth biting on gum tissues, such as seen in severe overbites and underbites, causes the gums to recede, resulting in further loss of supporting bone structures and tooth loss. (See Fig. 3)
- A poor bite places undue forces on the jaw joints, forcing them out of their natural position every time the mouth closes. Pain, muscle spasms, and joint damage frequently result from such a poor bite. (See Fig. 4)
Interceptive Two-Phase Orthodontics: A special Kind of Orthodontic Treatment
First-Phase Treatment (Ages 7 to 9)
The goal of first-phase treatment is to develop the jaw size in order to accommodate all the permanent teeth and to proportionately relate the upper and lower jaws to each other. Children sometimes exhibit early signs of severe problems as they grow and develop. An upper or lower jaw that is growing too much or not enough can be recognized at an early age. If children after age 7 are found to have his jaw discrepancy, they are sometimes candidates for early orthodontic treatment.
Because they are growing rapidly, children can benefit enormously from an early interceptive phase of orthodontic treatment utilizing appliances that properly re-direct the growth of the jaw and align teeth. Thus, a good foundation and dental arches, can be established, providing adequate room for eruption of all remaining permanent teeth. This early correction may prevent later removal of teeth to correct overcrowding and/or prevent surgical procedures to align the upper and lower jaws. Leaving such a condition untreated until all permanent teeth erupt could result in a jaw discrepancy too severe to achieve an ideal result with just braces alone or ultimately require the unnecessary removal of permanent teeth.
Resting Phase: (3 to 5 years)
In this phase, the remaining permanent teeth are allowed to erupt. Retaining devices are not usually recommended since they interfere with tooth eruption and inhibit jaw growth. It is best to allow the jaws and permanent teeth some freedom of growth and development while final eruption occurs. A successful first phase will have created room for teeth to find proper eruption paths. Otherwise, they may become severely displaced.
Periodic recall appointments for observation are necessary, usually on a 9-month basis during this resting phase of treatment.
Second-Phase Treatment (11-14 years)
Each tooth has an exact location in the mouth where it is in harmony with the lips, cheeks, tongue and other teeth. When this equilibrium is established, the teeth will function and wear together properly. They will be more stable and stay healthy as well as look attractive. This is the goal for the second phase of treatment.
The second phase is initiated when all the permanent teeth have erupted and usually requires braces on all the teeth for an average of 9 to 18 months for ideal bite alignment. Final retainers are worn after this phase since growth is completed.
Advantages of Two-Phase Orthodontic Treatment
Interceptive two-phase orthodontic treatment is a process that encompasses early jaw development, tooth straightening and physical facial changes. The major advantages of two-phase treatment is to maximize the opportunity to accomplish the ideal healthy, functional, aesthetic result that will remain more stable without tooth removal.
The disadvantage of waiting for complete eruption of permanent teeth and having only one phase of treatment, for someone with severe discrepancy, is having to face the possibility of permanent tooth extraction or having a compromised result that may not be as stable.
Types of Braces
Traditional Metal Braces
Traditional metal braces are the most common type of braces and are more comfortable today than ever before. Made of high-grade stainless steel, metal braces straighten your teeth using metal brackets and archwires. With metal braces, you have the option of adding colored elastics (rubber bands) for a more unique and colorful smile. We use a very low nickel content brace to reduce allergies and hypersensitivity. Orthodontic Specialists uses twin brackets to provide extra-secure control and more efficient tooth-movement guided by gentle but continuous force.
Similar to traditional metal braces in many ways, they are uniquely coated in gold. The gold coating may be considered a more cosmetic option than traditional metal braces. And, the cost of gold braces is surprisingly comparable to most clear braces, plus they are more hypoallergenic.
Ceramic braces are made of clear materials and are therefore less visible on your teeth than metal braces. For this reason, ceramic braces are used mainly on older teenagers and adult patients who have cosmetic concerns. While they are visually less prominent, they do require more attention as ceramic braces are larger and are more brittle than their metal counterparts. For these reasons, ceramic braces tend to be used more on upper front teeth than on lower teeth.
Invisalign® uses a series of invisible, removable, and comfortable aligners to straighten your teeth. And, no one can tell you are wearing Invisalign because it’s invisible! Not only are the aligners invisible, they are removable, so you can eat and drink what you want while in treatment, plus brushing and flossing are less of a hassle. The aligners are comfortable and have no metal to cause mouth abrasions and allergies during treatment. Click here to learn more about Invisalign.