Orthodontics

Introduction
No More “Metal Mouth”
Bad Bites
Conclusion
 

Introduction

Whether you like it or not, we live in a society that places a tremendous emphasis on first impressions. Studies have shown how first impressions can influence job recruiting as well as salary offers. It is generally understood that your smile is one of the first characteristics noticed by others. A smile filled with beautifully aligned pearly whites will make a better impression than one that is poorly aligned. Children can be quite cruel to the child with bucked or severely crowded teeth. These comments can have a lasting effect on that child’s self-esteem. Fortunately, treatment is available to correct most of these problems of poorly aligned teeth known as orthodontics. The purpose of this article is to describe the many benefits orthodontic treatment offers along with those dental conditions most commonly treated.
 

No More “Metal Mouth”

Even today, when most adults think about orthodontics they have images of the character “Jaws” from the James Bond movie series. This mouth full of shining metal is truly a thing of the past compared to modern-day braces that are smaller and less noticeable. For many adolescent patients and even some adults, braces have become a fashion statement—some are decorated in various colors at each visit to the orthodontist. There are clear, ceramic braces for those of you who want to try and conceal the fact that you are wearing them. There are braces that can be placed behind the teeth for this same purpose. Braces in one form or another have been in use for 100 years and continue to be the primary mechanism used to move teeth. While braces definitely have their pain-evoking moments, whether by sore teeth and/or mouth ulcers, these episodes are usually limited to short periods of time and in the end, not a reason to avoid treatment. As more and more people of all ages are seeking the benefits of orthodontic treatment, it is this author’s opinion that what is really being sought is the number-one benefit of orthodontic treatment—improved esthetics.

Looking good, feeling good
In my practice ten years ago, it was not acceptable to tell an adult that the primary benefit from orthodontic treatment was improved esthetics. Even though I sensed that this benefit was being sought, unless I could also find a functional reason for braces, the patient usually felt that it was vain to want braces simply to look better. More to the point, they were concerned that others would think they were acting vain. Today, I have adults readily admitting that they want their teeth and smile improved. Parents have made orthodontic treatment a top priority for their children. As discussed above, the improved confidence and self-esteem that can come with an attractive smile is better understood today than it was in the past. Such improvement in self-image is valuable at any age—and the earlier the better.

The American Association of Orthodontists recommends that a child’s first visit to an orthodontist take place at age seven. This allows for early identification and treatment of significant dental and skeletal imbalances of the teeth and developing jaw structures. Children no longer have to be the object of ridicule just because their teeth or jaws are out of alignment. Early intervention in a young growing patient allows for corrections that are not always easily achieved in a nongrowing adult. I have seen a shy, reserved child gradually bloom as they begin to feel better about themselves as a result of their orthodontic treatment. It is for these reasons that I feel improved esthetics, or a smile that can last a lifetime, is one of the greatest benefits of orthodontic treatment.
 

Bad Bites

Another very important benefit of orthodontic treatment is improved function. The back teeth function like gears, and work most efficiently when they mesh properly. Teeth that do not mesh properly are called a malocclusion or “bad bite.” Untreated malocclusions can lead to teeth that wear poorly with time. Sometimes this wear can be severe enough that tooth structure must be replaced by the family dentist in the form of a cap, bonding, or veneers. Poorly fitting teeth can contribute to stress and strain on the muscles that support the jaws. This can lead to muscle pain in the chewing muscles. Also, poorly fitting teeth can result in unhealthy forces on teeth, which can negatively affect bone and gum support of the teeth. This could ultimately result in loss of teeth. Not all malocclusions lead to these problems. However, someone with a malocclusion can be more susceptible to these problems.

Besides the back teeth not meshing properly, the malocclusion can also include the front teeth. Protruding front teeth, or “bucked” teeth is called overjet and creates facial imbalance as well as risk for dental injury—a concern in young, active patients. The opposite problem—called an underbite—also creates facial imbalance and is best intercepted during the growing years. Both of the above malocclusions of the front teeth usually correspond with a malocclusion of the back teeth. When the back teeth touch, the amount of overlap of the upper front teeth with the lower front teeth is termed overbite. Too much overbite can lead to excess and/or unusual wear of the enamel of the lower front teeth. In time, the lower teeth can start chipping, which is an esthetic problem and a difficult area for the dentist to fix. When the front teeth don’t overlap at all, this is termed openbite, and can lead to excessive wear of the back teeth. All of the above conditions result in less than ideal function with potentially negative affects on the long-term health of the teeth and supporting bone. Orthodontic treatment is intended to treat malocclusions to bring the teeth and jaws into proper balance and function.

Crowded teeth
Severely crowded teeth are more difficult to brush and floss—and teeth with spacing can have areas for food impaction. Both conditions can make the teeth harder to clean and floss. Over the long term, these problems can lead to periodontal disease with associated gum and bone loss and possible loss of teeth. Orthodontic treatment can correct these conditions, allowing for teeth that are easier to maintain. The loss of teeth can result in the tipping and/or spacing of teeth around the missing tooth. Orthodontic treatment can often reposition these shifted teeth prior to the family dentist placing a replacement tooth. This allows the replacement work, either a bridge or implant, to have the best long-term prognosis because it is being done in more ideal conditions. Thus, orthodontic treatment can be quite beneficial in helping to restore a mouth that requires significant rehabilitation.
 

Conclusion

While still considered a treatment for adolescents, orthodontic treatment has extended its treatment range to children as young as seven in specific instances as well as adults of any age. Some of my most appreciative patients are in their 60s. While there are risks with any treatment modality, those associated with orthodontic treatment are minimal compared to other medical and dental procedures. These risks need to be discussed with your orthodontist prior to initiating any treatment. If you want to know if orthodontic treatment is appropriate for you or your child, a good referral source is your family dentist. You can also find an orthodontist in your area who is a member of the American Association of Orthodontists by going to their Web site at http://www.aaortho.org.
 

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