An orthodontist is a qualified dentist who has undergone further extensive and specialized postgraduate training of a further three years after they have qualified as a dentist. During their post-graduate training they carry out orthodontic treatment on over 100 patients and have to successfully pass the Royal College of Surgeons examination. This extensive training enables them to provide professional and proficient treatment for their patients.
The teeth and the associated facial structures (lip position, jaw position and profile) are affected by orthodontic treatment. It is important that the orthodontic treatment is planned and properly completed to achieve successful treatment with long-term stability.
At your orthodontic consultation the first step is discussing your concerns with the positions of your teeth, function and appearance. The assessment will analyse all the associated facial features which are supported by your teeth and jaws – profile, lip position. Your teeth will be assessed in three dimensions – the crowding or spacing, the straightness, how they meet (the bite) in addition to a dental assessment. Often an x-ray is required to assess the roots and bone levels of the teeth and jaws to complete a comprehensive examination.
Following the assessment, your orthodontist will be able to discuss your treatment plan:
Before treatment is started, a ‘record’ is needed of how your teeth are before treatment to always have a starting reference point. The record is taken in three ways:
The first steps are the teeth being cleaned by polishing and then applying a gel similar to painting the fingernails. This gel cleans the surface of the teeth to allow the 'adhesive' to attach the brackets to the teeth.
Then there are two ways in which braces can be fitted
The majority of cases, each bracket is individually attached to each tooth, and the adhesive is 'set' by the blue light. The first initial wire is then attached to each tooth by being tied onto the bracket.
There are some types of braces where the brackets are already set up in a special tray which is then inserted. Once the brackets are attached and 'set', the tray is removed leaving just the brackets – Lingual Braces
The initial wires are very light and flexible. They have a shape memory effect which means however the wires are deformed they want to return to their original shape. As the wire returns to its original shape, it moves the tooth along with it.
Throughout your treatment, you will be reviewed every 6-8 weeks to adjust the brace. As the teeth straighten, the wires are changed from the initial light flexible wires to progressively stronger wires. The stronger wires are less flexible and are able to start moving the roots into the right positions. Fixed braces work very well and are able to move your teeth into the correct positions as your teeth and roots are moved.
Orthodontic treatment should only apply light amount of pressure to move the teeth. Therefore the teeth move in small increments over a period of time, to reduce the risk of any possible root complications. Also once the teeth are straight, it is important that the roots which anchor your teeth are also in the correct positions. During this stage of treatment, often you will not notice visible changes but is a crucial stage of treatment.