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Orthodontics

Orthodontic treatment in Cornwall

What is orthodontics?

Orthodontics is a specialised branch of dentistry. Our primary concern is with the development of the teeth, face and jaws and how we can influence the teeth to produce a healthy and stable bite as well as greatly improving your smile. Whether it is a complex case or a straightforward cosmetic correction, Absolute Orthodontics Ltd has the answer for you.

How do you start the treatment process?

You can be referred by your general dentist or, if you prefer, you can refer yourself directly.

The most common reasons for a referral are:

  • Protruding upper front teeth - one of the most common dental problems
  • Crowding or spacing – a combination of a small jaw and large teeth may result in there not being enough room for your teeth, resulting in crowding. Conversely, some patients have significant gaps between their teeth.
  • Asymmetry – If the centre lines of the upper and lower front teeth do not match an asymmetry may become evident. This may be caused by drifting of teeth or if the position of the jaw has shifted.
  • A deep bite – This is an increased overlap of your lower teeth by the top teeth in a vertical direction. This can cause trauma to your palate.
  • A reverse bite – when your upper teeth bite inside the lower teeth
  • An open bite – when your front teeth remain apart when your back teeth meet; the tongue is often still visible between the upper and lower front teeth.
  • Impacted teeth - in some patients, secondary teeth come through in the wrong position or do not erupt at all. Orthodontic treatment can help bring these teeth into the correct position.

Your Consultation

In order to decide what treatment is required for you, we will need to carry out a full assessment of your teeth which is likely to include x-rays, impressions (moulds of the teeth) and photographs. It is important that you are happy from the outset with what is recommended.

What types of braces are there?

A fixed brace – this is the most common type of brace today, often known as "train tracks". Brackets are glued onto the teeth. Wires pass through these brackets and their interaction brings about tooth alignment. Small elastic ties are often used to hold the wire in position or newer self-ligating brackets can be used. The wires exert gentle pressure to move the teeth into a new position. The brackets can be metal, ceramic or even gold and the elastic hoops come in many colours.

You will be surprised how unobtrusive braces can be nowadays, as techniques and equipment have evolved

Braces can also be bonded onto the tongue side of the teeth, called lingual braces.

Braces

A removable brace – this is sometimes used for correcting a simple problem, such as moving a single tooth or expanding the dental arch. It has a plastic base plate with wires and springs attached. Removable braces need to be worn all the time except for cleaning or sport.

Functional appliances – these are used to harness the growth of the jaws and improve way the upper and lower teeth meet. There are several designs all of which fit on to both the upper and lower teeth and hold the lower jaw forward. They are mostly removable but should be worn as near to full-time as possible.

Aligners - these are a series of removable, gum-shield-type stents that gradually move teeth into new positions. Invisalign and Clear step are the most common systems used by the practice. They have uses in correcting minor tooth discrepancies.

Retainers – at the end of treatment, all patients should wear retainers to hold their teeth in the new position. These can be removable or fixed and are an important part of treatment.

 

When can treatment be carried out?

Orthodontic treatment can be carried out at any age – although results may be achieved more quickly in younger patients. Anybody can have treatment as long as they have a healthy teeth and gums and as long as they are committed to improving their smile. This may include some pre-cursory treatment to ensure you have a healthy mouth. This will give the best chance of an excellent result.

However it is never too late to consider orthodontic treatment. Although adult faces and jaws are no longer actively growing, teeth can still be moved to improve the aesthetics and create a better bite.

The main differences arise because adults are not growing so we cannot harness the natural growth of the jaws to correct problems. Treatment may take a little longer in adults.

Active Treatment

Active treatment takes, on average, 18-24 months, although it does vary with complexity and patient co-operation.

Most cases require fixed braces. These can be bonded onto the either side of the teeth. Sometimes it is necessary to consider using a combination of fixed and removable braces to achieve the best results possible.

Retainers

After the active treatment is completed it will be necessary to wear retainers to maintain the new position of the teeth and to prevent relapse.

The tissues around the roots take time to adjust to the new tooth positions and there is a particular risk of relapse in the early months after the brace is removed. Even in the longer term some risk remains and the best advice is to continue retention indefinitely if at all possible.

  • Removable retainers are usually gum shield type retainers worn at night times only. They are effective but obviously depend on the patient remembering to wear them. They will need occasional repair or replacement, a relatively simple task.
  • Fixed retainers are thin wires bonded to the back of either the upper or lower incisors. They are therefore in place all the time and are highly effective at helping to prevent relapse. They do need regular checks because if any of the bonds fail, the teeth may start to drift out of position.

Our retention regime is as follows:

Every night for the first year after removal of the braces. Alternate nights for the second year. Two nights per week ad infinitum


©Absolute Orthodontics Ltd, Dr Nick Wenger 2008

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