At Castle Dental Care we have a specialist orthodontist dedicated to treating children and adults who are not happy with the appearance of their teeth. In the past the only option that was available to patients was the highly visible braces, comprising of metal wires and brackets. There are now more options than ever before for the treatment of crooked teeth. A number of braces now try to minimise the aesthetic impact of wearing a brace. At Castle Dental Care we offer invisalign, these are clear aligners that can be removed so patients do not need to avoid any types of food. We also offer Lingual braces, these are fitted to the inner surfaces of the teeth and therefore cannot be seen when speaking and smiling.
For those patients wanting quick and efficient results we also offer 6 month smile.
Orthodontics is derived from the Greek word “orthos” which means perfect teeth. This branch of dentistry treats misaligned teeth.
Misaligned teeth affects your ‘bite’ which in dental terms is referred to as occlusion. Occlusion is the normal meeting of the upper and lower jaws which fit together when the mouth is closed. Any misalignment or problem with the closing of the jaws is called malocclusion.
Malocclusion can prevent you from chewing your food properly and can also have a negative effect on your facial appearance.
In most cases malocclusion occurs during childhood as the teeth erupt. External factors such as thumb sucking can contribute to this. For adults the most likely scenario is that of crooked teeth that have never been treated or where retainers were not worn following orthodontic treatment. More and more adults are seeking treatment for badly aligned teeth which is mainly due to advances in dental technology.
Orthodontics and young people.
The majority of orthodontic patients are children and teenagers. Most young people will have treatment around 11-13 years of age. This is because the permanent teeth are erupting making them easier to move into the correct position. The brace exerts gradual pressure on these developing teeth, re-aligning them, resulting in improved facial structure and appearance. Treatment can start earlier or later depending on the development of the teeth.
NHS ORTHODONTIC TREATMENT
Orthodontic treatment within the NHS is free to anyone under 18 as long as there is clear, demonstrable need. The definition of ‘need’ is governed by the Index of Orthodontic Treatment Need ( IOTN) which grades this according to the extent of the orthodontic problem.
Who decided who needs treatment?
Children and teenagers are assessed using a rating system that uses grades or severity ratings to determine the need for treatment.
It is a question of funding: the NHS has limited resources and has to prioritise treatment according to need. They have to decide who is most likely to benefit from orthodontic treatment.
Unfortunately adults are not able to access NHS treatment, however, there are exceptions to this. Each case is individually assessed and treatment may be considered if there is a strong need.
Initial consultation with the Orthodontist
Your dentist will refer you to an orthodontist who will assess your teeth. Every patient is different with different needs and requirements. If you qualify for NHS treatment you will be placed on the NHS waiting list for treatment, if you do not qualify for NHS orthodontic treatment you will be offered the private option for treatment.
The orthodontist will plan an individual course of treatment which suits your needs. The consultation will involve a discussion between you and the orthodontist followed by an assessment. This includes an examination of your teeth and jaws followed by x-rays, photographs and impressions of your teeth. The orthodontist will then discuss the various treatment options with you. Treatment time varies but usually last about 2 years and it is important that you understand this from the outset. You need to be satisfied with what the treatment entails before you decide to go ahead. The orthodontist will discuss the benefits and risks of treatment with you and also explain your part in the process.
Start of orthodontic treatment
This depends upon the following factors:
- Most or all of the permanent teeth being present.
- Dental hygiene; if you have poor oral hygiene or dental decay then this will need to be treated first.
- Length of waiting list.
- Whether your treatment is high priority or not.
Types of braces;
There are various types of braces including removable, fixed, functional and headgear. The commonest types are fixed braces.
Will I need an extraction?
This can be a worry for some patients who dislike the thought of having one or more teeth removed as part of the treatment plan. Fewer extractions are performed now compared to the past. Advances in dental technology means there are newer ways of creating extra space rather than extracting teeth. Many cases help to widen the jaw which is particularly useful in cases of overcrowding.
However in cases of severe crowding extractions may be the best option to create sufficient space to contribute to the success of the orthodontic treatment. Your orthodontist will advise you at your assessment appointment whether extractions are needed. The extractions are then carried out by your own dentist and can be either before the brace is fitted or afterwards.
Benefits of orthodontic treatment
- Improved positioning of the teeth
- Correction of over-crowding teeth
- Correction of a poor occlusion: both jaws are perfectly aligned and upper and lower teeth meet when closed
- Remove or reposition impacted teeth
- Close any unsightly gaps in between teeth
- Realign the jaws or relieve clicking or painful jaws
- Improve function and appearance of the teeth which boosts confidence and self esteem
Orthodontics can be used in conjunction with other forms of dental treatment, for example dental implants or as part of a smile makeover.
Risks of orthodontic treatment
These will be discussed with the orthodontist at the initial consultation. Always follow any instructions given to you by your orthodontist and maintain an excellent oral hygiene regime throughout orthodontic treatment. This involves brushing at least 3 times a day, using tepe brushes to clean under the wire every time you eat and using a fluoride mouthwash once a day at a different time to toothbrushing.
Sore gums: red, swollen gums usually occur within the first few days and usually disappear quickly. If this occur during treatment it usually indicates poor oral hygiene and can lead to tooth decay and gum disease.
Painful teeth: This usually occurs when the brace is first fitted and each time it is adjusted. Your orthodontist will advise you on pain relief.
Living with a brace
A brace often feels strange at first but you will soon adjust to it. This usually applies to eating and speaking and will soon pass.
Dealing with sore gums and teeth: You will need to visit your orthodontist every 6-8 weeks to have your brace adjusted and to allow the orthodontist to check to see if your brace is functioning normally. It is vital that you attend these appointments, if you don’t then the chances are that your treatment will take longer and potential problems will not be spotted. In addition to this you will need to continue your 6 monthly check ups with your regular dentist to make sure your teeth and gums are assessed for tooth decay and gum disease.
Sports: if you engage in contact sports such as rugby or boxing it is advisable that you wear a gumshield. You may have to temporarily stop contact sports during fixed orthodontic treatment, your orthodontist will advise you of this at the initial assessment.
Eating and drinking: Limit your intake of sugary foods and fizzy drinks because they increase the risk of tooth decay. Avoid hard and chewy foods which can damage the brace. Stick to soft foods and cut your food into smaller pieces until you are used to the new brace.
Cleaning your brace: Your brace needs to be cleaned and cared for. Brush your teeth and brace after every meal, at least 3 times a day, ideally use an electric toothbrush. Use tepe brushes to remove food and plaque underneath the wire and use a fluoride mouthwash once a day at a different time to brushing.
If your brace becomes damaged or is causing extensive soreness then book an appointment to see the orthodontist as soon as possible.
Do I need a retainer?
A retainer is worn after the bracework is completed in order to maintain the new position of the teeth. This is usually worn all day to start with and gradually reduced to night time only.
Retainers can be fixed or removable. If a retainer is not worn there is a risk of the teeth moving back into their original position. If this happens the only way to align them again is to have the brace put back on at an additional cost.
If you have a removable retainer always brush and floss your teeth before inserting your retainer. Do not eat or drink anything when the retainer is in, except plain water. Use a retainer cleaner such as Retainer Brite to keep your retainers clean and fresh and free from bacteria.
Take your retainers with you each time you attend for your regular check ups so that your dentist can assess your retainers. Contact your dentist immediately if your retainers become damaged or broken or if you lose them.
Invisalign (Clear Braces)
This is becoming an increasingly popular form of orthodontic treatment and are preferred for their comfort and convenience. Aesthetically they are much preferred to the metal brackets and wires of traditional braces. They are made from a very strong, clear plastic and fabricated using the latest dental technology and are designed to fit snugly and comfortably over your teeth.
They are suitable for many orthodontic cases but are not recommended for more severe cases. Your orthodontist will advised you if your are suitable for this type of brace.
Advantages of Invisalign
The main benefit is their discreet appearance, the brace is virtually unnoticeable. They are comfortable because you remove them to eat and clean and so your diet is not restricted. They are easier to clean because there are no wires or metal brackets.
How do Invisalign braces work?
They work in a similar way to any other brace ad gradually realign your teeth. The brace is worn for approximately 22 hours a day and is only removed for cleaning and when eating. Every 2 weeks a new aligner is worn to enable very gradual tooth movements to occur. Treatment will usually take between 6 and 18 months for most cases.
Fitting and Invisalign Brace
You will have an initial consultation with the orthodontist to assess your suitability for Invisalign treatment. If you are suitable for treatment then impressions will be taken of your teeth and these are then scanned into a computer. A few weeks later you will be shown a computerised ClinCheck of how your teeth will move with each aligner. Your orthodontist will fit your first aligners and give you instructions on how to wear them, how long for and how to take care of your aligners.
Six Month Smile
This is a fixed brace that treats badly aligned teeth in a short space of time. It consists of brackets and wires that blend in with the rest of your teeth. They are not as discrete as invisalgn braces but they do have the advantage of giving a faster result than invisalign and other types of braces. They are designed to correct only the front teeth which is the main reason for the shorter period of treatment.
Advantages of Six Month Smile
- Small, natural coloured wires
- Quicker treatment time
- Cheaper than many other types of braces
The attraction of this type of brace for many patients is the fact that it straightens the teeth in half the time of other braces. But it is important to remember that it applies to the front teeth only.
This brace is not suitable for severe orthodontic problems and is more difficult to clean compared to removable aligners.
How does Six Month Smile work?
This brace helps to close the gap between teeth as well as realign teeth which have moved out of position. It is a fixed type of brace which means that it is designed to be worn all the time and is removed only by your orthodontist.
The brace is securely attached to your teeth via ‘dental glue.’ Once the brace has been fitted it will start to move your teeth into the desired position. This is a quick process. The orthodontist will check this process every 6 weeks to ensure everything is progressing as expected. The orthodontist will make any necessary adjustments at these visits. Treatment takes approximately 6 months, however this only applies to front teeth and not the entire upper and lower arch.
Realignment of the upper and lower arch is a comprehensive form of treatment which requires another type of brace and a longer period of time.
The brace will cause some initial pain but this will settle after a few days. Your orthodontist will advise you of any necessary painkillers. You may also experience some difficulty with your speech but don’t worry, this will pass.
Once treatment has been completed you will be given a retainer to wear to keep your teeth in their new position. This retainer is available as a removable device that is worn overnight or a permanent, fixed retainer that is fitted to the inside of the front teeth. This stops the teeth from relapsing or moving back into their original position.