What is orthodontics?
Orthodontics is the area of dentistry that specializes
in the diagnosis, supervision, guidance and correction
of problems involving the alignment of the teeth and
jaws. The technical term for these problems is
“malocclusion,” which means “bad bite.” The practice of
orthodontics requires professional skill in the design,
application and control of corrective appliances, such
as braces, to bring teeth, lips and jaws into proper
alignment and to achieve facial balance.1
What causes orthodontic problems (malocclusions)?
Many malocclusions are inherited, which means genetics
plays a key role in their appearance. Inherited problems
include; crowding of teeth, too much space between
teeth, or the improper alignment of the teeth to each
other. Another cause of malocclusion is acquired
characteristics. This happens by trauma (accidents),
thumb; finger or pacifier sucking causes some acquired
malocclusions. Whether inherited or acquired, many of
these problems affect not only permanent alignment of
the teeth but facial development and appearance as well.2
Is orthodontic treatment important?
Crooked and crowded teeth are hard to clean and
maintain. This may contribute to conditions that cause
not only future tooth decay but also eventual
periodontal disease and potential tooth loss.
Orthodontic problems can also contribute to abnormal
wear of tooth surfaces, inefficient chewing or
misalignment of the jaw joints, which can result in
chronic headaches or facial pain. If left untreated,
many orthodontic problems may become worse. Orthodontic
treatment to correct the problem, is often less costly
than dental care to treat the problems that can develop
in later years.3
At what age can people have orthodontic treatment?
Children and adults can both benefit from orthodontics,
because healthy teeth can be moved at almost any age.
Because monitoring growth and development is crucial to
managing some orthodontic problems, the American
Association of Orthodontics recommends that all children
have an orthodontic screening no later than age 7.4 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 orthodontic problems more difficult.
An orthodontic evaluation at any age is advisable if a
parent, family dentist or the patient’s physician has
noted a problem.
How is treatment accomplished?
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 to a new desirable position. Other orthodontic
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 other appliance can dramatically reduce the
protrusion of upper anterior teeth (the top four front
teeth), while making upper and lower jaw lengths more
How do braces feel?
Many people have some discomfort after their braces are
first put on their teeth or when adjustments are made
during treatment. After braces are placed or adjusted,
teeth may become sore and may be tender to biting
pressures for two to three days. The orthodontist may
recommend pain medication commonly used for a headache.
The lips, cheeks and tongue may also become irritated
for two to three days as they become accustomed to the
surface of the braces, and can be alleviated or
controlled by wax that your orthodontist will provide
and proper rinsing. Overall, orthodontic discomfort is short-lived and
Are there alternatives to metal braces?
Today’s braces are generally less noticeable than those
of the past when a metal band with 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
ceramic, depending on the patient’s preference. In some
case, brackets may be bonded behind the teeth (lingual
or tongue side braces). Modern 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. Braces
are typically smaller and more efficient.77
Do teeth with braces need special care?
The orthodontist and staff will teach patients how to
best care for their teeth, gums and braces during
treatment. The orthodontist will instruct patients
(and/or their parents) how to brush, floss, and, if
necessary, suggest other cleaning aids that might help
the patient maintain good dental health. Keeping the
teeth and the braces clean requires more precision and
time than normal cleaning, and must be done two to three
times every day if the teeth and gums are to be remain
healthy during orthodontic treatment. Patients with
braces must be careful to avoid hard and sticky foods.
They must not chew on pens, pencils or fingernails
because chewing on hard things can damage the braces.
Damaged braces will almost always cause treatment to
take longer, and will require extra trips to the
orthodontist’s office. If the patient plays contact
sports the orthodontist may recommend a special mouth
guard to protect the braces and the patient’s lips,
tongue and teeth. Braces usually do not interfere with
the playing of musical instruments, but practice and a
period of adjustment may be necessary.
Talk to your dentist about your
questions and concerns regarding