Home Dentistry Articles Orthodontics
Orthodontics or orthodontia is the specialty
of dentistry that is concerned with the study and treatment
of malocclusions, which may be a result of tooth irregularity,
disproportionate jaw relationships, or both.
Orthodontic treatment can be carried out for purely aesthetic
reasons - improving the general appearance of patients' teeth
for cosmetic reasons- but treatment is often prescribed for
practical reasons, providing the patient with a functionally
improved bite (occlusion).
Treatment includes fixed appliances, most
commonly dental braces, which can be made from stainless steel
or a more esthetic ceramic material; removable appliances, or
"plates"; headgear; elastic bands; and other appliances,
including expansion appliances, and functional appliances.
After a course of active orthodontic treatment,
patients will often wear retainers, which will maintain the
teeth in their improved position whilst the surrounding bone
reforms around them. The retainers are generally worn full-time
for a short period, perhaps 6 months to a year, and then worn
periodically (typically nightly during sleep) for as long as
the patient desires. It is possible for the teeth to stay aligned
without regular retainer wear. However, there are many reasons
teeth will crowd as a person ages and thus, there is no guarantee
that teeth, orthodontically treated or otherwise, will stay
aligned without retention.
An orthodontist is a dentist who specializes
in diagnosing and treating malocclusions, which are mis-alignments
of the teeth, jaws, or both.
The orthodontist will align teeth with respect
to the surrounding soft tissues, with or without movement of
the underlying bones (which can be moved either through orthopaedic
or orthognathic movements). Orthopaedic movements are attained
through the judicious use of (mainly) acrylic appliances (functional
appliances), that influence the position of the jaws relative
to one other and the face, and will be carried out on growing
children. The correct application of orthopaedic appliances
can influence the development of an adolescent's jawline, giving
a much improved aesthetic and functional result.
Orthognathic movement is achieved by surgically
repositioning the jaw(s), in patients that have completed their
growth. Such surgical treatment is carried out by maxillofacial
surgeons who work closely with the orthodontic team.
One of the most common situations leading to
orthodontic treatment is crowding of the teeth. In this situation,
there is insufficient room for the normal complement of adult
teeth, which can sometimes result in teeth being extracted.
Crowding of teeth is recognised as an affliction that stems
in part from our modern, western lifestyle. We do not know for
sure whether it is due to the consistency of our diets; a result
of mouthbreathing; or the result of an early loss of deciduous
(milk, baby) teeth due to decay. It is also possible that Homo
sapiens have evolved smaller jaws without a concomitant reduction
in the number of teeth they will house.
Much has been made in the media of links between
tooth extraction and tempero-mandibular joint dysfunction (problems,
including clicking and jamming, of the jaw joint). No research
has shown a definitive link between extraction of teeth and
jaw joint problems. Most tempero-mandibular joint problems are
a result of the patient having a clenching habit - that is the
patient bites the teeth together on a regular basis (e.g. when
Various countries have their own systems for
training and registering specialist orthodontists; generally
a period of post-graduate study is required for a qualified
dentist to qualify as an orthodontist.
In the United Kingdom, this training period
lasts three years, after completion of a fellowship diploma
from a Royal College. In Europe and the United States, a similar
pattern is followed. It is always worth contacting the professional
body responsible for registering orthodontists to ensure that
the orthodontist you wish to consult is a recognized specialist.