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A guide to Orthodontics

Have you noticed how dentistry is changing? In the past, going to the dentist usually meant ‘a check-up’. Definition: you sit in the chair and try to think of something else while your dentist has a look at your teeth. If you’re lucky, you’re ok for six months. Unlucky means the drill comes out.

Let’s be honest, it was rarely any more complicated than that. Nowadays, however, there is a whole new emerging field of dentistry that deals with the diagnosis, prevention and correction of dental irregularities. It means that if you pay a visit to your dentist now, you can expect access to many more treatments that can help to improve your teeth, your smile and your confidence.

We thought it might be helpful to take a closer look at Orthodontics. What does it involve? What does it mean for customers? And most importantly, what will the end result look like? These are just a few of the questions most patients want their dentists to answer.

First things first. Can you explain more about Orthodontics?

Orthodontics is formally defined by the American Association of Orthodontics as 'The area of dentistry concerned with the supervision, guidance and correction of the growing and mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of the functional forces within the craniofacial complex'.

So far, so confusing. And maybe that’s part of the problem. Orthodontics is really fast-growing. More and more products are appearing on the market, at different costs, with different benefits, most of which claim to make a dramatic difference to your teeth. If only someone could explain it without all the dental jargon!

So, in less the 50 words…?

Orthodontics helps move teeth, cures overbites and overcrowded mouths, with the aim of improving your smile and allowing your teeth to grow naturally. It’s what we used to call ‘wearing a brace’. (32 words exactly!).

How does orthodontics work?

Recent developments in dentistry means that there are now a number of different types of braces on the market. Your dentist will recommend a particular type of product based on your requirements. For example, in milder cases, the patient may require a brace that is less forceful and less visible. Alternatively, it could be that you choose a brace that has a faster-working mechanism, or a brace that uses ceramics rather than metal. A wide range of products means a wide range of choices.

Ultimately, the type of procedure that suits you will be decided through an open, clear discussion with your dentist or specialist orthodontist. Everybody has a unique mouth and no two sets of teeth look or grow the same. So the choice you make will probably be based on a number of factors.

Such as?

Well, the first factor to take into consideration is why you need the treatment in the first place. There are a number of dental irregularities that orthodontic work can help to fix. We’ve already mentioned crooked teeth or a crowded mouth. However, orthodontic work will also help with missing or extra teeth, misaligned teeth or jaw, a bad bite or malocclusion.

In essence, therefore, your orthodontist can help with a wide variety of issues that range from purely cosmetic to functional dental work such as improving chewing and biting.

What is a malocclusion?

A ‘bad bite’, or malocclusion, is a misalignment causing difficulty in chewing and talking and/or affecting the cosmetic appearance of a person. It could occur for genetic reasons, because of a trauma, or for a number of factors in childhood, such as prolonged thumb-sucking or premature loss of baby teeth. Orthodontic treatment of a malocclusion can improve oral hygiene, improve speech and improving chewing.

What other factors will affect my choice?

Cost will obviously be an important factor. Orthodontic work isn’t cheap (and if it is cheap the alarm bells should ring and you should ask yourself why!) and fees vary from dentist to dentist and according to the complexity of the work involved. At the same time, orthodontic work is becoming more affordable and more accessible. As more dentists become qualified to perform the more complex procedures, treatment is becoming more widely available. More and more practices are also offering finance deals that allow you to pay monthly on very low interest rates.

If you decide to have treatment privately, the orthodontist will be able to estimate the cost of your treatment and give you details. It is always a good idea to discuss the cost fully before treatment and, if necessary, have the cost confirmed in writing to avoid any confusion.

Is Orthodontic work available on the NHS?

Orthodontic treatment is only available free of charge on the NHS for young people who are under 18 years of age and students up to the age of 19, who have a clear clinical need for treatment. Everybody else has to pay NHS or private charges. Furthermore, patients are only entitled to free treatment under the NHS if their condition is serious. Minor problems will generally be classed as cosmetic and are therefore charged privately. The NHS assesses cases according to a clear rating system:

Grade 1: almost perfect teeth.

Grade 2: minor irregularities with the teeth, such as slightly protruding upper front teeth.

Grade 3: greater irregularities with the teeth do not require treatment for health reasons. For example, upper front teeth that protrude 4mm (0.15 inches) or less.

Grade 4:  a severe degree of irregularity with the teeth that requires treatment for health reasons. For example, upper front teeth that protrude more than 6mm (0.25 inches).

Grade 5:  severe dental health problems. For example, upper front teeth that protrude more than 9mm (0.35 inches).

What’s the orthodontic process?

Broadly speaking, there are two stages in an orthodontic treatment:

1. The active phase — which involves the use of braces or other appliances to correct the alignment and bite. The orthodontist will assess the teeth that need to be aligned and create either a fixed or removable brace, which can be adjusted during the course of the treatment to achieve the desired effect. The fixed braces, as their name implies, are permanent fixtures and are removed at the end of the treatment period, whereas removable braces can be taken off for eating and cleaning but are generally worn at all other times. This improves the function of the teeth and the general appearance of the person.

2. The retention phase — involves the use of a retainer to hold the teeth that have been adjusted into their new position and ensure their long-term results. How long you have to wear your retainer braces for will depend on how much your teeth needed to be realigned. Every patient is different.

Does it matter how old you are?

Many orthodontic problems are diagnosed in childhood and treatment is at its most effective during adolescent and teenage years. However, more and more adults are having orthodontic work as the products, treatments and results become more widely available. Sometimes, the only difference is that the process can take longer for adults.

Should I be nervous about orthodontics?

Orthodontics is becoming very advanced. As new treatments become available, greater emphasis is being placed on braces that are comfortable to wear, discreet and fast-working. So there is no need to be nervous. Just don’t forget that this isn’t an overnight fix. Most people wear their braces for between one and three years, so you’ve got to be prepared to stick to the treatment if you want the best results.

Is orthodontic work permanent?

Even after retention, it is normal for minor tooth movements to happen throughout life. So no permanent guarantees can be given. As a rule of thumb however, it is unusual for teeth to alter enough so that further treatment is required.

How do I look after my brace and teeth?

While you are having orthodontic treatment, it is important to have your teeth checked regularly by your dentist. Dentists recommend that you clean your teeth thoroughly but also with care. Braces can be delicate and you need to make sure that they do not break. Ask you dentist for more information. They will usually be able to show you different brushing techniques to avoid damaging your brace.

You will also probably have to change your diet slightly while you wear your braces. Sugary, sticky and hard foods are out. Fizzy drinks are too. 

How can I find a good orthodontist?

If your dentist feels that orthodontic treatment is clinically necessary, he or she will contact your local primary care trust (PCT) to arrange a referral to an NHS orthodontist. In some PCTs the number of NHS orthodontists is limited, and waiting lists for treatment can range from six to 18 months. The cost of private treatment depends on the type and duration of the treatment required. The average cost for a course of treatment is around £2,000-£2,500.

The website of the British Orthodontic Society provides a search facility for orthodontist services in your local area. 

 

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