About Orthodontics

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Do I need braces?

Only your dentist or orthodontist can determine whether you can benefit from orthodontics. Based on diagnostic tools that include a full medical and dental health history, a clinical exam, plaster models of your teeth, and special X-rays and photographs, an orthodontist or dentist can decide whether orthodontics are recommended, and develop a treatment plan that’s right for you.

If you have any of the following, you may be a candidate for orthodontic treatment:

  • Overbite, sometimes called “buck teeth” – where the upper front teeth lie too far forward (stick out) over the lower teeth
  • Underbite – a “bulldog” appearance where the lower teeth are too far forward or the upper teeth too far back
  • Crossbite – when the upper teeth do not come down slightly in front of the lower teeth when biting together normally
  • Openbite – space between the biting surfaces of the front and/or side teeth when the back teeth bite together
  • Misplaced midline – when the center of your upper front teeth does not line up with the center of your lower front teeth
  • Spacing – gaps, or spaces, between the teeth as a result of missing teeth or teeth that do not “fill up” the mouth
  • Crowding – when there are too many teeth for the dental ridge to accommodate

Types of bites requiring braces

An improper bite doesn’t look good. That is the usual reason people seek treatment from an orthodontist. In addition, an improper bite causes difficulty in chewing. In people with crowded teeth, it can lead to more cavities or gum disease. Treatment of an irregular bite can improve your overall oral health and stabilize your bite.

Incorrect bites are grouped into categories. Common bite problems include:

  • Crossbite – Here, the upper teeth rest significantly inside or outside the lower teeth. A crossbite often can make it difficult to bite or chew. It also may cause the jaw to shift to one side as it grows.
  • Crowding – Permanent teeth may not have room to move into the right position:
    – If there is not enough room for the teeth
    – If the teeth are unusually large compared with the size of the dental arch
    – If the jaw is narrower than it should be
  • Deep overbite – This occurs when the upper front teeth (incisors) overlap too far over the lower teeth. In some cases, the biting edges of the upper teeth touch the lower front gum tissue and the lower front teeth may bite into the roof of the mouth.
  • Underbite – A crossbite of the front teeth is commonly referred to as an underbite if the lower teeth are ahead of the upper teeth. This may also be a sign that the jaws are not in the correct position. Sometimes surgery is needed.
  • Openbite – If your upper and lower front teeth don’t meet when you bite down, this is called an openbite. This may make it impossible to bite off food with the front teeth. It also can affect speech. Because the front teeth don’t share equally in the biting force, the back teeth may receive too much pressure. This makes chewing less efficient. It can lead to premature wear of the back teeth.
  • Spacing problems – Some people have missing teeth or unusually small teeth in a normal sized jaw. This can result in large spaces between the teeth. People who have lost one or multiple teeth may have uneven spacing because adjacent teeth may drift into the unoccupied areas. Braces can be used to shift the position of these teeth so the missing tooth or teeth can be replaced.

How Does Orthodontic Treatment Work?

Many different types of appliances, both fixed and removable, are used to help move teeth, retrain muscles and affect the growth of the jaws. These appliances work by placing gentle pressure on the teeth and jaws. The severity of your problem will determine which orthodontic approach is likely to be the most effective.

  • Sleep Apnea – Sleep apnea is typically indicated by snoring and often awakening during sleep gasping for breath. Sleep apnea causes restless nights and drowsiness during the daytime hours. Sleep apnea can also lead to more serious health issues including increased blood pressure and the restriction of oxygen to the brain and blood stream.
  • Braces – the most common fixed appliances, braces consist of bands, wires and/or brackets. Bands are fixed around the teeth or tooth and used as anchors for the appliance, while brackets are most often bonded to the front of the tooth. Arch wires are passed through the brackets and attached to the bands. Tightening the arch wire puts tension on the teeth, gradually moving them to their proper position. Today’s braces are smaller, lighter and show far less metal than in the past.
  • Space Maintainers – if a baby tooth is lost prematurely, a space maintainer is used to keep the space open until the permanent tooth erupts. A band is attached to the tooth next to the empty space, and a wire is extended to the tooth on the other side of the space.
  • Palatal expander – a device used to widen the arch of the upper jaw. It is a plastic plate that fits over the roof of the mouth. Outward pressure applied to the plate by screws force the joints in the bones of the palate to open lengthwise, widening the palatal area.
  • Special fixed appliances – used to control thumb sucking or tongue thrusting, these appliances are attached to the teeth by bands.
  • Removable retainers – worn on the roof of the mouth, these devices prevent shifting of the teeth to their previous position.
  • Headgear – with this device, a strap is placed around the back of the head and attached to a metal wire in front, or face bow. Headgear slows the growth of the upper jaw, and holds the back teeth where they are while the front teeth are pulled back.

Parts of Braces

  • Archwire: The metal wire that acts as a track to guide your teeth along as they move. It is changed periodically throughout treatment as your teeth move to their new positions.
    Band: A metal ring that is cemented to your tooth, going completely around it. Bands provide a way to attach brackets to your teeth.
  • Bond: The seal created by orthodontic cement that holds your appliances in place.
    Bracket: A metal or ceramic part cemented (“bonded”) to your tooth that holds your archwire in place.
  • Coil Spring: A spring that fits between your brackets and over your archwire to open space between your teeth.
  • Elastic (Rubber Band): A small rubber band that is hooked between different points on your appliance to provide pressure to move your teeth to their new position.
  • Ligatures: The tiny rubber band that fits around your bracket to hold the archwire in place. They come in a variety of colors.
  • Headgear Tube: A round, hollow attachment on your back bands. The inner bow of your headgear fits into it.
  • Hook: A welded or removable arm to which elastics are attached.
  • Ligature: A thin wire that holds your archwire into your bracket.
  • Lip Bumper: A lip bumper is an archwire attached to a molded piece of plastic. The lip bumper holds back the molars on your lower jaw to provide more space for your other teeth.
  • Palatal Expander: A device that makes your upper jaw wider.
  • Retainer: An appliance that is worn after your braces are removed.
    Separator or Spacer: A small rubber ring that creates space between your teeth before the bands are attached.
  • Tie Wire: A fine wire that is twisted around your bracket to hold the archwire in place.
  • Wax: Wax is used to stop your braces from irritating your lips.

Orthodontic Procedures

  • Branding: The process of fitting and cementing orthodontic bands to your teeth.
  • Bonding: The process of attaching brackets to your teeth using special orthodontic cement.
  • Cephalometric X-ray: An X-ray of your head which shows the relative positions and growth of the face, jaws, and teeth.
  • Impressions: The process of making a model of your teeth by biting into a soft material that hardens into a mold of your teeth. Your orthodontist will use these impressions to prepare your treatment plan.
  • Ligation: The process of attaching an archwire to the brackets on your teeth.
  • Panoramic X-ray: An X-ray that rotates around your head to take pictures of your teeth, jaw and other facial areas.
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