Orthodontics

There are many reasons you might visit an orthodontist. For example, if you have:

• protruding upper front teeth – a very common problem.
• crowding or gaps between teeth – jaw size can mean there isn’t enough room for your teeth or that you have gaps between your teeth.
• asymmetry of upper and lower teeth – your teeth or jaw position may have moved.
• malocclusion (misalignment of your upper and lower jaw). This can be: open bite (front teeth remain apart when your back teeth meet), deep bite (upper teeth overlap lower teeth) or reverse bite (upper teeth bites inside the lower teeth).
• impacted teeth – your teeth, often wisdom teeth, emerge at an angle or only partially emerge.  

Orthodontic treatment will depend on the problems affecting your teeth and jaw. It may involve: aligning your upper and lower dental arches, correcting dental crowding or closing spaces between your teeth, bite correction or accommodating impacted teeth.

Often devices such as a brace are used to correct the position of your teeth. You may need to wear headgear at night too or have some teeth removed. Treatment is usually between 18 and 24 months but it will depend upon your exact problem.

Your first appointment with an orthodontist will involve an assessment of your teeth and how they are likely to develop in the future. Often X-rays, an impression of your teeth (biting into a mould filled with dental putty leaves an 'impression' of your teeth), and taking photographs of your teeth are required. Your orthodontist will discuss their recommendations for treatment and its likely results.

Braces

The most common orthodontic treatment is a brace. There are various types of braces including:

• removable braces – most often these are plastic plates that cover the roof of your mouth and clip on to some teeth. They can only achieve very limited tooth movements and so are used to correct minor problems, such as slightly crooked teeth or to prevent thumb sucking in children.
• fixed braces - a non-removable brace made up of brackets that are glued to each tooth and linked with wires. These are the most common type of orthodontic appliance. They are used to correct a number of teeth or to prevent future teeth problems. Fixed braces are usually made out of metal, but ceramic and clear plastic braces are also available. Your orthodontic surgeon will discuss your suitability based on your particular problem and tooth position.
• functional braces - a pair of removable plastic braces that are joined or interact together and fit on to your upper and lower teeth. They treat jaw and teeth position problems.
• headgear- used with other appliances. They are usually only worn for a few hours, often at night. They correct the position of your back teeth or keep your back teeth in position whilst your front teeth are being treated.

Retainers

Retainers are fitted at the end of your orthodontic treatment once your braces are removed. They are used to hold your teeth in their new straight positions. Teeth have a tendency to relapse and move back to their original position as well as moving as you age.

Retainers can either be removable or fixed onto your teeth. Your orthodontist will discuss the options available to you.

Dental splints

A dental splint looks similar to a gum shield worn by sportspeople. It is worn over your upper or lower teeth to protect them and it can also be used to keep your airway open whilst you’re asleep.

They can be used to treat sleep apnoea (sleep disorder), teeth grinding (bruxism), loose teeth and temporomandibular joint (TMJ) disorder.

Orthognathic surgery

Orthognathic treatment is surgery to reposition your upper, lower, or both jaws. It’s used if your jaws differ largely in relation to each other or if your jaws are abnormally positioned in relation to the base of your skull.

This jaw surgery is often performed if you have significant facial deformity that is causing you distress and affecting your quality of life, and/or if your jaw function is compromised and is causing: difficulty eating certain foods, damage to your gums and palate, jaw muscle and joint problems, sleep apnoea, or speech difficulties.

Treatment may involve surgery and the use of braces to ensure the correct alignment of your teeth and jaws.

Tooth extraction

Advances in dental technology have led to fewer extractions being performed these days. Instead newer types of braces such as functional braces are used when possible to widen your jaw and create extra space in your upper or lower jaw.

However, sometimes extraction is advisable as part of your orthodontic treatment.

Orthodontic mini-implants

Mini-implants are a relatively new option for people who have bite problems and may offer an alternative to jaw surgery.

A mini-implant is a tiny titanium alloy screw that acts as an anchor point in your jaw. They are often placed between the roots of your teeth, or sometimes in the roof of your mouth. They are then connected to a fixed brace to help move your teeth.