Orthodontics—What Is Involved?

YOUR teeth are important! You need them for eating and for speaking, and they are also an important part of a pleasant smile or laugh.

Crooked teeth can make it difficult to chew food, can contribute to gum disease, and can be responsible for speech defects. Experts have also noted that crooked teeth can be a social handicap for some, as they may have difficulty in expressing themselves freely because they believe that their smile is marred by their teeth.

What can be done if your teeth are not straight? Who can help you? At what age? What kind of treatment can be used? Will it be painful? Is it always necessary?

A Branch of Dentistry

The branch of dentistry that deals with such problems is called orthodontics. It is concerned with the correction of dental irregularities.

What are the main functions of orthodontics? It has to do with the diagnosis and prevention of problems as well as the construction of corrective appliances.

Crowded, irregular, and protruding teeth were a problem for people even in ancient times, and attempts at therapy date back to at least the eighth century B.C.E. Surprisingly well-designed early orthodontic braces have been brought to light in Greek and Etruscan archaeological finds.

Today, in most parts of the world, specialized dentists called orthodontists treat the problems associated with crooked teeth. They have to have a good knowledge of the growth and development of teeth and jaws and the surrounding muscles and tissues.

What Orthodontics Does

Orthodontics may be defined as “the area of dentistry concerned with the supervision, guidance and correction of the growing and mature dentofacial structures.” It includes “the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of the functional forces within the craniofacial complex.” Yes, a technical definition, but accurate.

So in orthodontics, forces are exerted on the teeth or on the structures that surround them. This is done by means of made-to-order appliances that correct the particular problems of each patient, pushing teeth and even bones into the correct position.

In the bone around the teeth, there are cells called osteoclasts and other cells called osteoblasts. As a result of the forces generated by braces, the osteoclasts are put to work where there is pressure, so that bony tissue is absorbed. In the areas where there is traction, the void is bridged by new bone formed by the osteoblasts. In this way the teeth slowly move.

Is it not uncomfortable to wear a foreign body made of wire, resin, and perhaps even elastic in the mouth for months? When appliances are fitted or adjusted, they can initially cause some discomfort; but after a while, one gets used to it. In theory, anyone can get used to wearing braces.

When Should a Person Be Treated?

Not all situations that seem to present bite abnormalities, or malocclusions, in children will persist into adulthood. Some types of tooth malposition tend to correct themselves. In fact, during the transition from deciduous, or milk, teeth to permanent teeth, the permanent teeth toward the front of the mouth often tend to crowd, since these are larger than the teeth they replace.

However, with the shedding of the deciduous molars, which are replaced by the permanent bicuspids, there is a change in the relative position of the teeth. With use and under the influence of the muscular structure, the teeth may straighten themselves out. So if you are a parent, do not be alarmed if you notice that your child’s permanent teeth initially seem to be growing in crooked. An orthodontist should be able to determine if anything needs to be done.

Orthodontists do not agree on when to treat young patients. Some say at a very young age (4-6 years). Others say later, toward the end of growth during puberty (12-15 years). Still others adopt a position somewhere in the middle.

Not Just for Children

Orthodontics is not just for children though. Crooked teeth cause many problems, even in adulthood. The state of your smile can be corrected without any limits on age if the teeth and tooth-bearing structures are sound.

What problems do crooked teeth cause? At least three kinds: (1) problems related to appearance; (2) functional problems, including difficulties in jaw movement (pain and lack of muscle coordination), problems in chewing, and problems in articulation and the production of speech; (3) greater risk of trauma due to protruding teeth and also greater risk of periodontal disease (gum disease) and tooth decay as well as dental deterioration and wear caused by malocclusion.

In addition, some experts associate malocclusions with problems in the position of the spinal column (particularly in the neck area) and problems of muscle function in other parts of the body. But how is treatment given? And how long does it last?

Duration and Methods of Treatment

If you feel that either you or one of your children needs an orthodontist, you should choose one whom you can trust. The duration of treatment will vary according to the gravity of the problem and the technique employed, but it will probably last several months, perhaps years.

For simplicity, we can divide treatment appliances into two groups: removable appliances and fixed appliances. Whereas removable appliances can be taken out and reinserted by the patient, fixed appliances are literally cemented to the teeth and perform more complex tooth movements.

Research has made great progress in the field of aesthetics, so that today there are many “naturalized” appliances. Some are unseen because they are the same color as the teeth, and others, which are fitted internally in what is known as the lingual position, adjacent to the tongue, remain out of sight. Such techniques are called invisible orthodontics.

In the most difficult cases, when the orthodontist is unable to attain the desired result with braces, he may even seek the help of a surgeon who specializes in problems of the mouth and face. He can perform an operation that literally moves the bones that form the face.

Today, orthodontics can satisfy many of the needs of those who have tooth and jaw problems, including those who desire to smile without being self-conscious about their teeth. Of course, whether a person decides to make use of orthodontics or not is a personal decision.

For the time being, mankind has to reckon with physical imperfections, some of which may be alleviated by corrective measures. Nevertheless, we can look forward to the time in God’s new world when he will eliminate completely and permanently all the effects of imperfection, including those of the mouth. Then, in that new system of perfect health, each of us will be able to offer with confidence a warm, friendly smile to everyone we meet.

Regarding that time, the Bible foretells: “The whole earth has come to rest, has become free of disturbance. People have become cheerful with joyful cries.” (Isaiah 14:7) Surely, such cheer and joy will be accompanied by beautiful smiles!

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Displays of braces designed to (1) move the molars backward and (2) stimulate jaw growth

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Braces designed to close the bite