Braces/orthodontic treatment


Dental braces (also known as orthodontic braces, or simply
braces) are devices used in dentistry that align and straighten teeth.
Conventionally metal braces were being used since long time but recently newer techniques
have been developed. Tooth color or ceramic braces are equally efficient but more
esthetic due to color match.
Braces can also be placed on inside surface (lingual) of tooth, thus known as lingual
or hidden braces. Different type of braces are used for the purpose. Though slightly
uncomfortable for the tongue initially, these are completely invisible for others.
Braces have two parts :-
- Brackets- they are attached to each
tooth.
- Arch wire- a thin metal wire that
runs from bracket to bracket.
HOW BRACES WORK :-
The application of braces moves the teeth as a result of
force and pressure on the teeth.This application of slow,continous and guided force
onto the teeth helps loosen the tooth from its original place and then shifts to
a new position. A tooth will usually move by about a millimeter per month during
orthodontic movement but there is high individual variability.Orthodontic mechanics
can vary in efficiency which partly exlpains the wide range of response to orthodontic/braces
treatment.
TYPES OF BRACES:-
1) Traditional metal wired braces are stainless steel,sometimes
in combination with titanium and are the most widely used.
2) CERAMIC /CLEAR BRACES:-They serve as a cosmetic alternative to
traditional metal braces by blending im more with the natural colour of the teeth
and having a less conspicuous or hidden appearance.Typically,these brackets are
made of ceramic or plastic materials and function in a similar manner to traditional
metal brackets.
3) HIDDEN/LINGUAL BRACES:-These are custom made fixed braces,bonded
to the back of the teeth,making them invisible to other people. Hence,lingual braces
are a cosmetic alternative to those who do not wish the braces to be visible.
PROCEDURE FOR GETTING BRACES
The first step is to determine whether braces are suitable for the patient.If braces
are appropriate,an appointment is set up where X-rays,models and impressions are
made.The records are then analysed to determine the problems and the course of action.
Typical treatment time varies from 6 months to two and a half years depending on
the complexity and type of problems.Orthognathic surgery may be required in extreme
cases.
Teeth to be braced will have an adhesive applied to help the cement bond to the
surface of the tooth. A metal wire will be threaded in between the brackets and
affixed with elastic or metal ligatures. Wires are bent,shaped and lightened frequently
to achieve the desired results.
POST TREATMENT PROCEDURES
In order to avoid the teeth moving back to theit original position,retainers may
be worn once the treatemnt with braces is complete.
COMPLICATIONS AND RISKS:-
1) Plaque forms easily when food is retained in and around the braces. It is important
to maintain oral hygiene by brushing and flossing thoroughly when wearing braces
to prevent tooth decay. Patients with gum/periodontal disease must obtain periodontal
treatment before getting braces.
2) Mouth sores may be triggered by irritation from components of the braces.
3) Braces can also be damaged if proper care is not taken. It is important to wear
a mouthguard to prevent breakage and/or mouth injury while playing sports. Certain
sticky or hard foods such as toffees,raw vegetables,hard nuts etc. should be avoided
because they can damage braces.Frequent damage to the braces can prolong treatment.
4) In the course of the treatment, orthodontic brackets may pop off due to the forces
involved or due to cement weakening over time. The orthodontist should be contacted
immediately for advise if this occurs. In most cases,the bracket will be replaced.
EXTRACTIONS IN ORTHODONTICS
In patients where crowding of teeth is severe,the dentist might consider taking
a few teeth out to make space for other teeth.Where extractions are indicated,usually
first premolars are extracted but ther are reasons for extracting teeth elsewhere
in the arch.The dentist will discuss the probable options with you.