Orthodontics (braces)

Treatment of orthodontic disorders in children and adult customers using removable and fixed (attached) orthodontic appliances (i.e. braces). Diagnosis of orthodontic problems and preventive monitoring of their development.

Orthodontics is a specialized branch of dentistry dealing with irregularities in position of teeth, dental arch and jawbones. In advanced societies orthodontic care is an integral part of comprehensive dental care. With increasing emphasis on human influence, on the appearance, more and more people realize that teeth and smile are an essential part of the image; it is even possible to say they represent a crown of beauty.

Previously, orthodontists were striving to achieve straight teeth. With increasing possibilities the appliances offer, this effort has spread to achieving nice straight teeth, in recent years, even to the aim of “nice straight teeth in a pretty face.” Therefore, the orthodontist studies not only teeth but also the overall facial expression, the appearance when speaking and/or smiling. He/she also evaluates the shape of individual teeth, level of the gums, side profile of the customer. Therefore, orthodontics is not a mere “straightening of teeth”.

Only a negligible fraction of population have absolutely regular teeth, about 50% of the remaining population do not need treatment, deviations and irregularities being small, 30% suffer from a medium defect correctible with orthodontic treatment, 15% suffer from a defect, the treatment of which is appropriate, and in the remaining 5% treatment is necessary – this regards e.g. cleft palates, absence of some tooth buds, conditions after injuries, serious irregularities.

Previously, the customers were ashamed for their braces, now these (fortunately) have become a sort of sign of social status, almost a matter of being “in”. There are regions where even 50% of schoolchildren have braces, on the other hand, there are also towns where the orthodontic appliances are not so widespread; patients are still ashamed of orthodontic treatment and refuse it, only about 1% of schoolchildren have braces. In some regions, people are ashamed of crooked teeth; in other regions they are ashamed of wanting them straight.

Orthodontic appliances may be removable or glued to teeth, i.e. fixed. Removable appliances are used more as a preparatory phase before treatment with fixed appliances and may rarely solve the problem completely. In adults, for example, treatment with only removable appliances is really rare. A frequently asked question is whether the fixed appliances damage teeth. With proper care, i.e. when cleaning the teeth after each meal, there is no danger, no bacteria get onto the tooth under the glued bracket, and caries cannot develop under the bracket. Many materials used for gluing the brackets even have a protective effect on enamel. However, when good dental hygiene is not observed, teeth are affected - just as the caries normally develops. If the areas around the brackets are not cleaned for a long time, bacteria start to multiply there and begin to damage the tooth. The first stage of such damage is whitish spots around the brackets. Fortunately, this process is slow and at regular follow-up visits the orthodontist has enough time to warn about insufficient dental hygiene, if the situation remains unsatisfactory, the appliance must be removed because it is better to have crooked but healthy teeth then have them straight and full of caries.

The treatment does not concern only children, as it is sometimes said, advanced age does not represent an obstacle. Missing teeth do not mind, either; the orthodontist, in collaboration with the attending stomatologist may move the remaining ones to create better conditions for the prosthesis; he/she often works with an implantologist – who adjusts the space intended for the implant, shapes the bone by shifting teeth, etc.

Treatment plan is created with regard to many aspects - function, stability, and aesthetics. It is the most challenging part of the treatment; they report that about 1 / 4 - 1 / 3 of the in-office time one needs to spend making plans, analyzing X-rays and models. In some cases, there are so many options that it is not uncommon that each orthodontist creates a different treatment plan, even with substantial differences, and each of them leads to a good result. Some may put a greater emphasis on stability, some on face at rest, some on smile. That is why orthodontics is a beautiful field, which never becomes a routine; it is possible to discuss each case and, for the physician, there is always something to learn.

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