Orthodontics is a great way to give people with crooked teeth a perfect smile.
We generally prefer to move teeth when the bone is not fully mature, as it is softer that that of an adult. Usually the ideal age is just when the baby teeth have fallen out. Somewhere between 11-14 years old.
There are certain cases where interceptive orthodontics can be done at an early age in order to prevent problems later. Oral habits like thumb sucking cause the teeth to protrude. Stopping the habit is a sort of interception that might use an orthodontic appliance. Another example is if a baby tooth is lost early and the space where it was is not held open. Then the drifting teeth might prevent the permanent tooth from coming down into place. In these cases, a space maintainer is the solution, as it holds the space open till the adult tooth comes in.
Sometimes, the upper teeth erupt into a position that is inside the lower teeth. A normal esthetic bite is such that the upper teeth are outside of the lower teeth. By placing a simple appliance in the child’s mouth, we can easily guide the permanent tooth into place.
The most common orthodontics is that done to an adolescent. The teeth have just come in, the body is still growing and we can easily move them to where we want them. While it may look simple there are many factors an orthodontist takes into account while he is planning the treatment. The Dr. must evaluate the skeletal pattern of the child and the estimated growth that will happen later on. Specialized x-rays called a cephalometric and a panoramic x-ray are needed for this. Digital x-rays greatly reduce exposure to radiation.
Once the plan has been made there are two basic approaches to treatment. The standard was always using brackets to hold a wire which imparts the gentle forces on the teeth. Ultimately a rectangular wire fits in a slot in the bracket and the teeth move into a very precise location as well as being tilted in the ideal direction.
In recent years, a new approach is used where a computer calculates all of the steps needed to get from the beginning to the end. Clear plastic is molded into a form which fits on the teeth with slight pressure. That pressure causes slight movement. After two weeks or so another plastic form is placed on the teeth causing a bit more movement. After 12-24 months or so, the teeth have moved into the desired location due to orthodontics without wearing any unsightly brackets.
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