My dentist tells me I have malocclusion. What is a malocclusion? Do all types of malocclusion really need braces?
Malocclusion is a prevalent problem around the world. Although not as life threatening as the other diseases out there, this particular problem can lead to changes in your way of life. Simply put, it is a problem of mal-alignment of the teeth, the jaws or both. When you start to suspect that you have this kind of problem, it may be time to see an orthodontist. Your orthodontist may put you on treatment with braces or with an appliance.
How long does it take to wear an appliance or braces?
Orthodontic treatment comes in phases – preventive, interceptive and comprehensive. It depends on how early or how late you bring your child to the orthodontist.
Preventive orthodontic treatment is usually for young children, wherein we prevent any malocclusion from happening. This may involve the use of fillings or stainless steel crowns, wherein your dentist saves the baby teeth which serves as guide for the permanent teeth. It may also involve the use of appliances like space maintainers, when early extraction of baby teeth happens. Appliances installed at about 6 years old shall be in place for about 5 years, depending on which tooth is being monitored.
Interceptive orthodontics is for children in the early mixed dentition, meaning some of the permanent teeth have erupted and most of the baby teeth are still present. In this phase, your orthodontist has seen definite signs of a malocclusion and will intercept it from happening. Your orthodontist will utilize his knowledge of a child's growth patterns and usually involves the use of active appliances designed to move teeth – like space regainers, bite planes, and even a couple of brackets on specific teeth. These appliances are worn on a case-to-case basis, depending on how mild or severe the problem is. Or it can even entail serial extraction – the sequential extraction of certain baby teeth to make space for the erupting permanent teeth. In this stage, the child may or may not go on to a full blown malocclusion. But in some instances, interceptive orthodontics is carried out to simplify the child’s problem in preparation for comprehensive treatment.
A comprehensive orthodontic treatment is done when a full blown malocclusion has occurred. This is usually when all the permanent teeth have erupted and the child is expected not to grow anymore. This is what you see with other people weaing metal brackets on all of their teeth. This treatment usually takes an average of about 18 -24 months.
Why does it take so long?
Full comprehensive treatment with braces usually takes a minimum of 18 visits. More difficult cases that involve extractions to correct crowding and camouflage skeletal discrepancies usually take longer.
When is the right time to have orthodontic treatment?
The truth is orthodontic treatment can begin once the problem is diagnosed and a treatment plan is formulated. Full comprehensive work can begin during the late mixed dentition stage or when most of the permanent teeth have erupted into the arch. Once the premolars and permanent 2nd molars erupt, that is a perfect time to assemble the full appliance.
Are extractions really necessary ?
If the nature of the orthodontic problem has to do with severe crowding and bad profile, braces with extractions is still the recommended treatment approach. Ask your orthodontist for other options to help you choose the option which suits you best.
How often do I have to see my ortho?
Orthodontic adjustments are usually done every 4-6 weeks.
What does profile have to do with anything?
For Asians, profile is a big thing. Many of us have a common problem called Bimaxillary Protrusion - this means that the front teeth are both positioned too forward causing the lips to protrude. A bad profile can lead to poor appearance and low self-esteem. Sometimes teeth can be pushed so forward that they affect the speech of the person .
Will my teeth continue to move after my treatment with braces?
Definitely. Teeth will always try to go back to the original position they were in before the orthodontic treatment. That is why retainers are important. These retainers are designed to keep the moved teeth in place.
New studies show that you should wear your retainer for an extended period of time long after the braces are removed. Nighttime wear is recommended for an indefinite period of time if you want to keep your teeth straight.
What's an overbite?
An overbite is a general term for an excessive horizontal overlap of the upper teeth in relation with the lower teeth. When the overlap is vertical leading to an over-closure of the upper teeth in reference to the lower, this is called a deep bite.
How serious is an under-bite problem?
If the underbite is skeletal in nature (exhibiting a dished in appearance) that is a serious problem. You must see an orthodontist immediately while your child is still growing. Certain appliances can redirect the growth of your child and improve his facial appearance.
Underbites that are dental in nature that involve only a single tooth can be fixed more easily.
I hate metal braces. What other options do I have?
You can consider ceramic braces but using this type of braces requires a more meticulous oral hygiene regimen. The only advantage that ceramics have over the metal braces is that it looks a bit better.
I've heard about Invisalign treatment as an alternative to braces. Will it work for me?
Invisalign is a form of clear aligner therapy. Slowly, this relatively new form of treatment is gaining ground as an alternative for some malocclusion problems. Not all malocclusions can be fixed ideally with this mode of treatment. For more difficult cases, fixed braces is still the best option. You should ask your orthodontist if you are a good candidate for Invisalign.
What's the deal with the so called self-ligating braces? Are they effective?
Self-ligating prescription braces is a relatively newer design of braces specifically indicated for moderate to severe crowding. It is another option for the treatment of malocclusions. Patients claim they are less painful because of their frictionless mechanics.
Who adjusts the braces anyway? Can a regular dentist put on braces?
The professional tasked to put on and adjust the braces is an orthodontist. An orthodontist is a dentist who specializes in this field of dentistry. Normally, an orthodontic specialist would have to enroll in a 2-3 year full time graduate course to get his or her degree. In the Philippines, orthodontists recognized by the Board of Dentistry come from the Association of Philippine Orthodontists.
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