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What is Orthodontics?
Orthodontics is the branch of dentistry that specializes in the diagnosis, prevention and treatment of
dental and facial irregularities, called "malocclusion" by dentists. The practice of orthodontics
requires specialized, professional skills to effectively design, apply and control corrective
appliances, such as braces, to bring teeth, lips and jaws into proper alignment and to achieve
facial balance. Your orthodontist is specially trained in this field, having completed college,
a four-year dental graduate program at an institution accredited by the American Dental Association
(ADA), plus an additional two- to three-year ADA-accredited residency program of specialized training
in orthodontics. Only dentists who have successfully completed this advanced education may call
themselves orthodontists. Out of all dentists, only about 6 percent are orthodontists.
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Why Your Smile Deserves SureSmile
One of the most common questions at our office is "when do I get my braces off?" With traditional treatment methods, it typically takes two years to achieve a beautiful healthy smile and involves regular office visits and interruptions to work and school.
If you want straight teeth faster and easier, you will be interested in a system now available at our office called SureSmile® that offers: shorter treatment times, fewer office visits, and less overall discomfort.
With SureSmile, Dr. Nelson can still deliver outstanding treatment results, but with less time and inconvenience for the patient.
It starts with a 3-D camera that takes pictures of the patient's teeth and produces a 3-D model for Dr. Nelson to examine and use to plan treatment. On his computer, Dr. Nelson moves the teeth in the model to decide the best position for each tooth. Finally, the doctor orders special custom-made archwires designed to move teeth precisely to these target positions.
On average, SureSmile patients are finishing treatment 40% faster than traditionally treated patients and are achieving the same great results! See www.suresmile.com for more information or inquire if your smile is eligible to become a SureSmile at your next office visit.
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Is orthodontic treatment only for children?
Both children and adults can benefit from orthodontics, because healthy teeth can be moved at almost any age. So, if you, your family dentist or family physician have noticed a problem in yourself or your children, an orthodontic evaluation is advisable, whatever the patient's age.
Because monitoring growth and development is crucial to managing some orthodontic problems well, the American Association of Orthodontists recommends that all children have an orthodontic screening no later than age 7. Some orthodontic problems may be easier to correct if treated early. Waiting until all the permanent teeth have come in, or until facial growth is nearly complete, may make correction of some problems more difficult.
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What causes orthodontic problems (malocclusions)?
Most malocclusions are inherited, but some are acquired. Inherited problems include crowding of teeth, too much space between teeth, extra or missing teeth, and a wide variety of other irregularities of the jaws, teeth and face.
Acquired malocclusions can be caused by trauma (accidents), sucking a thumb, finger or pacifier, airway obstruction by tonsils and adenoids, dental disease or premature loss of primary (baby) or permanent teeth. Whether inherited or acquired, many of these problems affect not only alignment of the teeth, but also facial development and appearance as well.
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What are some of the problems that orthodontists treat?
Crowding: Teeth may be aligned poorly because the dental arch is small and/or the teeth are large. Extremely crowded teeth may result in the bone and gums over the roots of the teeth becoming thin and receding. Impacted teeth (teeth that should have come in but have not), poor biting relationships and undesirable appearance may all result from crowding.
Overjet or protruding upper teeth: Upper front teeth that protrude beyond normal contact with the lower front teeth are prone to injury, often indicate a poor bite of the back teeth (molars), and may indicate unevenness in the growth of the upper and lower jaws. They may also cause an undesirable facial appearance. A lower jaw that is proportionally shorter than the upper jaw, and thumb and finger sucking habits can cause a protrusion of the front teeth.
Deep overbite: A deep overbite or deep bite occurs when the lower front teeth bite too close to or actually into the gum tissue behind the upper teeth. This can result in significant bone damage and discomfort. A deep bite can also contribute to excessive wear of these teeth.
Open bite: An open bite results when the upper and lower front teeth do not touch when biting down, causing all the chewing pressure to be placed on the back teeth. This excessive biting pressure and rubbing together of the back teeth makes chewing less efficient and may contribute to significant tooth wear.
Spacing: If teeth are missing or small, or the dental arch is very wide, space between the teeth can occur. The most common complaint from those with excessive space is poor appearance.
Crossbite: The most common type of a crossbite is when the upper teeth bite inside the lower teeth (toward the tongue). Crossbites of both back teeth and front teeth are commonly corrected early due to biting and chewing difficulties.
Underbite or lower jaw protrusion: About 3 to 5 percent of the population has a lower jaw that is to some degree longer than the upper jaw. This can cause the lower front teeth to protrude ahead of the upper front teeth creating a crossbite. Careful monitoring of jaw growth and tooth development is indicated for these patients.
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Why is orthodontic treatment important?
Crooked and crowded teeth are hard to clean and maintain. This may contribute to conditions that cause not only tooth decay but also eventual gum disease and tooth loss. Other orthodontic problems can contribute to abnormal wear of tooth surfaces, inefficient chewing function, excessive stress on gum tissue and the bone that supports the teeth, or misalignment of the jaw joints, which can result in chronic headaches or pain in the face or neck.
When left untreated, many orthodontic problems become worse. Treatment by a specialist to correct the original problem is often less costly than the additional dental care required to treat more serious problems that can develop in later years.
The value of an attractive smile should not be underestimated. A pleasing appearance is a vital asset to one's self-confidence. A person's self-esteem often improves as treatment brings teeth, lips and face into proportion. In this way, orthodontic treatment can benefit social and career success, as well as improve one's general attitude toward life.
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How long will orthodontic treatment take?
In general, active treatment time with orthodontic appliances (braces) ranges from one to three years. Interceptive, or early treatment procedures, may take only a few months. The actual time depends on the growth of the patient's mouth and face, the cooperation of the patient and the severity of the problem. Mild problems usually require less time, and some individuals respond faster to treatment than others. Use of rubber bands and/or headgear, if prescribed by the orthodontist, contributes to completing treatment as scheduled.
While orthodontic treatment requires a time commitment, patients are rewarded with teeth that are easier to clean and maintain, proper jaw alignment and a beautiful smile that lasts a lifetime. Teeth and jaws in proper alignment look better, work better, contribute to general physical health and can improve self-confidence.
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How is treatment accomplished?
Custom-made appliances, or braces, are prescribed and designed by the orthodontist according to the problem being treated. They may be removable or fixed (cemented and/or bonded to the teeth). They may be made of metal, ceramic or plastic. By placing a constant, gentle force in a carefully controlled direction, braces can slowly move teeth through their supporting bone to a new, more desirable position.
Orthopedic appliances, such as headgear, Bionator, Herbst and maxillary expansion appliances, use carefully directed forces to guide the growth and development of jaws in children and/or teenagers. For example, an upper jaw expansion appliance can dramatically widen a narrow upper jaw in a matter of months. Over the course of orthodontic treatment, a headgear or Herbst appliance can dramatically reduce the protrusion of upper incisor teeth (the top four front teeth) or retrusion of the lower jaw (a lower jaw that is too far behind the upper jaw), while making upper and lower jaw lengths more compatible.
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How are teeth moved?
Your orthodontist designs your braces to apply the type and amount of pressure to your teeth that will cause them to move to their more ideal positioning. Tissue on the side that the tooth is moved toward is compressed, while tissue on the other side is stretched. Gradually the bone on the compressed side accommodates the tooth's new position, while new bone grows in to fill in the gap created on the stretched side to support the tooth. This process is repeated over and over again as your orthodontist adjusts, adds or removes appliances during your treatment. Once the teeth reach their desired location, a retainer is placed to hold your teeth while the supporting bone fully regains strength and stability to hold your teeth firmly in their new position.
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How noticeable are braces?
Today's braces are generally less noticeable than those of the past when a metal band with a bracket (the part of the braces that hold the wire) was placed around each tooth. Now the front teeth typically have only the bracket bonded directly to the tooth, minimizing the "tin grin." Brackets can be metal, clear or colored, depending on the patient's preference. In some cases, brackets may be bonded behind the teeth (lingual braces). Modern wires are also less noticeable than earlier ones. Some of today's wires are made of "space age" materials that exert a steady, gentle pressure on the teeth, so that the tooth-moving process may be faster and more comfortable for patients.
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How do braces feel?
Most people have some discomfort after their braces are first put on or when adjusted during treatment. After the braces are on, teeth may become sore and may be tender to biting pressures for three to five days. Patients can usually manage this discomfort well with whatever pain medication they might commonly take for a headache. The orthodontist will advise patients and/or their parents what, if any, pain relievers to take. The lips, cheeks and tongue may also become irritated for one to two weeks as they toughen and become accustomed to the surface of the braces. Overall, orthodontic discomfort is short-lived and easily managed.
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Do teeth with braces need special care?
Patients with braces must be careful to avoid hard and sticky foods, as well as chewing on pens, pencils or fingernails because chewing on hard things can damage the braces. Damaged braces will almost always cause treatment to take longer, require extra trips to the orthodontist's office, and in some cases, increased expense.
Keeping the teeth and braces clean requires more precision and time, and must be done every day if the teeth and gums are to be healthy during and after orthodontic treatment. Patients who do not keep their teeth clean may require more frequent visits to the dentist for a professional cleaning.
The orthodontist and staff will teach patients how to best care for their teeth, gums and braces during treatment. The orthodontist will tell patients (and/or their parents) how often to brush, how often to floss, and, if necessary, suggest other cleaning aids that might help the patient maintain good dental health.
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What about patient cooperation?
Successful orthodontic treatment is a "two-way street" that requires a consistent, cooperative effort by both the orthodontist and patient. To successfully complete the treatment plan, the patient must carefully clean his or her teeth, wear rubber bands, headgear or other appliances as prescribed by the orthodontist, and keep appointments as scheduled. Damaged appliances can lengthen the treatment time and may undesirably affect the outcome of treatment. The teeth and jaws can only move toward their desired positions if the patient consistently wears the forces to the teeth, such as rubber bands, as prescribed.
To keep teeth and gums healthy, regular visits to the family dentist must continue during orthodontic treatment. Adults who have a history of or concerns about periodontal (gum) disease might also see a periodontist (specialist in treating diseases of the gums and bone) on a regular basis throughout orthodontic treatment.
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Glossary of Terms
Appliances
An orthodontist's tools are called "appliances." Here is a list of common orthodontic appliances, any one or more of which may be used to accomplish the desired results.
Archwires: Provide the guide or track along which the teeth move. Wires are changed throughout treatment; with each change bring the teeth closer to their ideal position. Archwires are held in place by "O" rings.
Bands: Thin bands of metal placed around the teeth and used as "handles" to hold the brackets, tubes or rotating levers used to move the teeth.
Brackets: Hold the archwires that are designed and adjusted by the orthodontist to move the teeth.
- Steel: these may be attached to bands that go around teeth or they may be bonded directly to the tooth surface.
- Ceramic: although made of a translucent material, they are as strong as and function the same way as steel brackets. They are smooth and less visible than steel brackets.
Functional Appliances: Help achieve facial balance by helping the muscles to function normally and encouraging normal growth of jaws and teeth. They are worn full-time. Common examples are the Fränkel, the Bionator and the Twin Block.
Headgear: Works to alter the direction of facial growth by inhibiting forward or downward growth of the upper jaw, or by encouraging teeth to move forward.
Herbst: Encourages the lower jaw to grow forward and catch up to upper jaw growth.
Palate Spreaders: Help widen the upper jaw to accommodate larger teeth and/or to more closely match the width of the lower jaw.
Rubber Bands: Used to apply gentle, continuous force to help individual teeth move or to help align one arch of teeth over the other.
Spacers: Small springs or pieces of plastic used to slowly and gently move selected teeth apart enough to allow placement of bands.
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