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Exploring Orthodontic Treatment Choices

Mother Teresa told us that we should always meet each other with a smile, and that “we shall never know all the good that a simple smile can do.” A smile conveys the appearance of warmth, cordiality and happiness, and usually prompts others to feel at ease and to smile back. Almost all respondents to an American Academy of Cosmetic Dentistry survey (99.7 percent) believe a smile is an important social asset, and 96 percent believe an attractive smile makes a person more appealing. Most of us, however, were not born with picture-perfect teeth, and this causes some people to hide their teeth when they smile, or worse, to avoid smiling altogether.

Fortunately, advancements in modern orthodontics have made it possible for those dissatisfied with their teeth to make changes to achieve the look and function they desire. According to the American Dental Association (ADA), orthodontics is the “dental specialty concerned with the diagnosis, prevention, interception, guidance and correction of bad bites. The purpose of orthodontic treatment is to create a healthy bite — straight teeth that properly meet opposing teeth in the opposite jaw.”

BENEFITS OF ORTHODONTICS

In addition to boosting your confidence and self-esteem and improving how you look, the ADA says that if your teeth are crowded, protrusive, spaced too far apart, meet in an abnormal way or do not meet at all, you may need orthodontic treatment to prevent related cavities, gum disease, ear pain, headaches, jaw pain, snoring, sleep apnea, chewing difficulties or speech problems. Because some of these issues can worsen with age, orthodontics can be an important part of oral and overall health for not only youths, but also adults.

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ORTHODONTIC OPTIONS

Orthodontic treatments use appliances, some fixed and some removable, to put constant force on your teeth to gradually move them into alignment and/or to reposition an abnormally formed or set jaw. Depending on your needs and priorities, there are several different orthodontic appliances from which to choose.

Traditional Metal Braces.

Trad­itional metal braces are stainless steel brackets that are affixed to your teeth using a dental bonding agent and connected by thin alloy arch wires. They apply consistent pressure to your teeth, usually over a period of one to three years, to shift them into alignment. Bands and/or springs can be used with traditional metal braces to provide supplemental force to pull or push stubborn teeth into place or to move the jaw. Traditional metal braces are usually the most affordable orthodontic treatment option, but also the most noticeable when you speak or smile.

Ceramic Braces.

Ceramic braces, also known as clear braces, are similar to traditional metal braces, but their brackets are made of tooth-colored composite ceramic or porcelain so only the connecting wires are clearly visible. The wires can also be coated with a tooth-colored veneer, but this is rare because coated wires are not as efficient as uncoated wires. Ceramic braces, while effective, are more brittle than traditional metal braces, and they can chip and crack without appropriate care. This can make them undesirable for children who are not always as conscientious with their orthodontics as they would need to be to make this option practical.

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Clear Acrylic Aligners.

Acrylic aligners are removable, nearly invisible appliances that are custom-made to fit over your teeth and apply pressure to move them into place. Each aligner adjusts the teeth slightly toward the desired position and then is replaced with a new aligner to make another adjustment. This process is repeated approximately 20 to 30 times until the teeth are finally straight. Acrylic aligners are easier to clean than braces and are removable during eating and brushing. This treatment requires more self-discipline than affixed appliances because patients face a constant temptation to remove them, which can significantly slow the treatment process. Even though clear acrylic aligners are more expensive than braces and typically take longer to achieve alignment, they have become very popular, particularly among adults and teens who prefer their appearance. Clear acrylic aligners, while effective for aligning the teeth, cannot be used like braces to address other dental issues, such as bite abnormalities or jaw problems.

Lingual Braces.

Lingual braces are metal braces attached to the back of your teeth rather than the front, so they are not visible when you speak and smile. Your orthodontist makes these braces with a computer program that custom designs the appliance to fit behind your teeth. While this option is more aesthetically pleasing than other braces, it is more intrusive to the movement of the tongue, which can cause discomfort and speech difficulty. Because these braces are custom-made, they are generally more expensive than other orthodontic options.

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Orthodontic Headgear.

Sometimes braces alone are not enough to move your teeth and/or jaw into the position needed to remedy certain orthodontic problems, such as a lack of space for braces inside your mouth, severe bite problems and abnormal jaw development. In these cases, your orthodontist may prescribe orthodontic headgear, an appliance that is worn outside the mouth, with either a strap that wraps around your head or neck or a facemask frame, and is attached to braces on the teeth. Orthodontic headgear provides force to the jaw and teeth that can not be accomplished from inside the mouth, and when worn as prescribed, can guide the growth of the face and jaws.

Retainers.

After the orthodontist completes the active alignment treatment, patients usually use a retainer to hold the teeth in place while the bones around them stabilize. Retainers can be clear, plastic coverings that are custom made to fit over the teeth, or arch wires that are affixed to the back of the teeth. It is important to wear and care for your retainer as prescribed by your orthodontist so your teeth don’t regress toward their original positions.

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Getting Started Toward Your New Smile

If you are considering treatment to align your teeth or correct bite or jaw problems, the American Association of Orthodontists (AAO) strongly recommends that you consult a licensed orthodontist for a personal assessment and to discuss options. There are mail order, do-it-yourself orthodontic products on the market, but the risks associated with these options are significant. On its website, the AAO warns, “Rem­ember that orthodontic treatment is not a product or device – orthodontic treatment is a professional, medical service.” Further, “Ortho­dontic treatment involves the movement of biological material, which if not done correctly could lead to potentially irreversible and expensive damage such as tooth and gum loss, changed bites, and other issues.”

If you are considering orthodontic care, schedule an appointment with a licensed orthodontist who will recommend a treatment plan and discuss your options with you to determine which would be best for meeting your specific needs, timeframe and budget. Keep in mind that some medical and dental insurance plans cover at least a portion of orthodontic work, so check with your insurance providers regarding your benefits before you initiate treatment.

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