Orthodontics is the part of dentistry that moves teeth and corrects the way they meet. Whether you are thinking about braces for yourself or for your child, it starts with an assessment of the teeth and the bite, a discussion of the options that would work, and a treatment plan that fits your goals and your life.
What orthodontic treatment can correct
- Crowded or overlapping teeth
- Gaps between teeth
- Upper front teeth that stick out, which are also more easily damaged
- A deep bite, an open bite, an underbite or a crossbite
- Teeth that have moved again after earlier treatment
Straight teeth are easier to clean, and a bite that meets evenly spreads the load of chewing. For many people the reason is simply wanting to smile without thinking about it, and that is reason enough.
The assessment
The clinician examines the teeth, the jaws and the way they bite together, and takes photographs, X-rays and a scan or impressions. From these they can tell you what is causing the problem, whether the teeth can be straightened in the space there is or whether space has to be made, and what result is realistic. You are given a written plan with the options, how long each takes and what it costs.
The options
- Fixed braces: small brackets bonded to the teeth and joined by a wire that is adjusted every few weeks. They can be metal or tooth-coloured ceramic. Fixed braces give the most control and handle the most complex movements.
- Clear aligners: removable, nearly invisible trays changed every week or two. See Invisalign.
- Removable and functional appliances: used mainly in growing children to guide the jaws or create space.
Sometimes the plan involves removing teeth to make room. This is explained and discussed before anything is decided.
Children and teenagers
Most treatment starts once the adult teeth are through, at around 11 to 13, but an assessment earlier, from about 7 or 8, is worthwhile if you notice crowding, a crossbite, thumb-sucking that has not stopped or front teeth that stick out. A few problems are simpler to correct while the jaws are still growing. Often the advice at that age is to wait and watch.
During and after treatment
Treatment commonly takes between 12 and 24 months. Teeth are tender for a few days after each adjustment. Braces trap food, so brushing after every meal and regular hygiene visits matter more than ever: marks on the enamel around brackets are permanent. When the braces come off, retainers hold the teeth in their new place, and they need to be worn for as long as you want your teeth to stay straight.
Common questions
Am I too old for braces? No. Adults make up a large share of orthodontic patients.
Does it hurt? Aching for a few days after fitting and after each adjustment is normal and manageable.
Can I choose between braces and aligners? Where both would work, yes. The assessment tells you whether they would.
