Orthodontics

What is orthodontics?

Orthodontics is a branch of dentistry concerned with tooth position and how the jaws have developed over time. It aims to improve the alignment, function and look of teeth that are crooked, crowded, or don't come together as they should.

What conditions does orthodontics treat?

• teeth that are crowded, sitting too close together, or protruding
• upper and lower jaws that fail to meet correctly, resulting in an overbite or underbite
• noticeable gaps between teeth
• difficulty chewing or maintaining clean teeth as a result of how they've grown in

General dental practices carry out most orthodontic treatment, though hospital-based units also take on trickier cases, including situations tied to a cleft in the lip or roof of the mouth, cases calling for jaw surgery, or anything needing input from several dental specialists at once.

What are the benefits of orthodontics?

Teeth that sit straighter and align better are generally simpler to keep clean and can take some pressure off the jaw's muscles and joints. Plenty of people also find that a better-looking smile lifts their confidence.

It's worth being aware that firm scientific proof of orthodontic treatment's health benefits still isn't fully settled, even though those who've been through treatment tend to report feeling better about their quality of life than people with comparable problems left untreated.

Are there different types of orthodontic treatment?

• fixed braces, small brackets bonded onto each tooth and linked together by a wire, offering the most precise control over how teeth move; these remain in place for the whole course of treatment and are the usual NHS choice for under-18s
• removable appliances, taken out at mealtimes and for cleaning, generally reserved for more straightforward tooth movements
• functional appliances, occasionally referred to as growth modification devices, used in children who are still growing to help correct a mismatch in upper and lower jaw size
• clear aligners, a sequence of custom, removable plastic trays worn one after another; how effectively these manage tooth movement next to fixed braces still lacks strong supporting evidence
• headgear, worn externally and sometimes paired with a brace, working best while the jaw itself is still developing
• jaw surgery, kept for severe cases once jaw growth has finished; the bone gets repositioned and held with plates and screws, followed by further brace work to fine-tune the teeth afterwards

What happens before orthodontic treatment?

Your dentist refers you on to an orthodontist if they believe treatment could help. Given how much demand there is for NHS care, a fairly long wait before being seen isn't unusual.

From there, the orthodontist checks over your teeth and jaws, which might involve X-rays, photos or scans. Getting NHS-funded treatment hinges on how much impact your teeth are genuinely having on everyday life, difficulty eating or cleaning being the kind of thing that counts, and a formal scoring system, the Index of Orthodontic Treatment Need, helps keep that decision consistent.

Flagging any earlier knock or damage to a front tooth is worth doing beforehand, since it can affect what extra care your treatment needs. Making room by removing teeth features in roughly half of cases overall, the premolars being the teeth most often taken out.

What happens during orthodontic treatment for fixed braces?

1. Small brackets get bonded onto each tooth with a dental adhesive.
2. A wire runs through the brackets, linking them together and applying gentle, ongoing pressure that shifts the teeth into place gradually.
3. Small elastic ties, or the shape of the bracket itself, keep the wire secured against each tooth.

Appointments typically fall somewhere between 4 and 10 weeks apart, giving the orthodontist a chance to adjust things and track how treatment's coming along.

What does recovery look like?

Wearing a brace can feel unfamiliar at first, and some tenderness in the days right after a fitting or adjustment is normal. Softer foods and painkillers can help you through this stretch.

A typical course usually runs one to two years, occasionally longer, depending on how severe things were to start, how much space the teeth had to shift into, and how well you kept up with looking after your teeth and brace throughout.

Teeth have a tendency to shift back once the brace comes off, something that affects more than half of people to some degree within ten years of finishing up. A retainer helps guard against this, either a wire permanently fixed behind your teeth or a removable one worn constantly to begin with, then just overnight from then on. Your orthodontist will confirm exactly how long yours needs to stay in use.

What are the risks and complications?

Possible risks of orthodontic treatment include:

• tooth decay and gum trouble, since brackets and wires make thorough cleaning that bit harder
• general discomfort, especially in the days following a fitting or adjustment
• a small chance of harm to tooth roots or gums as treatment progresses
• teeth shifting back towards where they started if a retainer goes unworn afterwards as advised
• with jaw surgery specifically, the usual risks tied to any operation carried out under general anaesthetic

Get in touch with your orthodontist if tooth pain drags on beyond a few days following a fitting or adjustment, your gums turn very red, swollen or sore, or your brace breaks.