Orthodontics indications and treatments

The term orthodontics comes from the combination of two Greek terms, “Roth”, which means right or straight and “Oconto’s” which means tooth. The straightening of irregular teeth (orthodontic treatment) requires the use of fixed or temporary elements that move the teeth that are positioned incorrectly so that the dental arch reaches a normal socket or occlusion, which will result in better overall oral health. Besides improving the aesthetics.

What is orthodontics?

Orthodontics is a dental specialty that prevents and corrects alterations in the development and position of teeth and jaws. Its purpose is to restore the morphological and functional balance of the mouth and face, also affecting aesthetic factors. Thus, one of its main objectives is to alleviate the functional disorders of mastication, improving oral health in general.

Natural phases of teething

Temporary or “milk” dentition consists of 20 teeth. They begin to leave after 6 months and complete at 3 years.

The dental period between 6 and 12 years is known as ‘mixed dentition’ and is when the temporary pieces are gradually replaced by the definitive ones.

The final or permanent dentition is usually completed at 12-14 years, with the appearance of 28 permanent pieces, just waiting for the “wisdom teeth”, which may take a few more years to appear.

Development of the bite

The development and growth of teeth and jaws are governed essentially by genetic factors. During the configuration of the occlusion, or “fit” of the two jaws, there are external factors that may also have relevance. These include prolonged periods of suction of the finger by the child or use of the pacifier in late stages, which can lead to tooth displacement.

The appearance of malocclusions

In most cases, occlusal development develops satisfactorily without causing any functional setbacks. In some cases, however, problems can occur in the occlusion that can be corrected preventively when the final dentition has not yet made its appearance. If, on the other hand, malocclusions take place when the definitive denture is already present, then corrective treatments will be necessary.

At what age should orthodontic treatments be started?

There is no specific age to treat abnormal lacerations or malocclusions of teeth or other orthodontic problems. The right time will vary depending on the type of problem and its severity.

It would be advisable to consult the orthodontist as soon as an anomaly is known. In any case, a first revision is recommended at 6 years of age.

However, orthodontic treatments are becoming more common in adulthood. In this sense, there are few studies that indicate a better quality of life related to oral health derived from orthodontic treatment in the early stages of life.

Orthodontic treatments: appliances or brackets

Orthodontic treatments can be interceptive (if they try to avoid later alterations) or corrective (if they try to correct defects or problems that are already taking place).

In general, interceptive treatment begins and ends during the temporary or mixed dentition phase. It is usually used to correct habits or abnormal circumstances that may interfere with the normal development of the maxillary area.

If it has not been possible to prevent a problem through interceptive treatment, it must be resolved through corrective treatment.

For the corrective treatments, three types of devices are used: functional, removable and fixed.

Removable or removable appliances can be prescribed and supervised by a general dentist, while fixed appliances usually require the participation of an orthodontist. The latter are usually treatments of relatively long duration: from 1 to 2 years.

Fixed appliances or, as they are also commonly known, “brackets” are the most effective and versatile tools within orthodontic therapeutics.

Indications for brackets include dental malposition, in which the crown or root of a tooth is displaced from its correct position. In this sense, they allow carrying out movements of a very different nature, such as straightening, torsions, rotations and others. This allows to correct the spaces between teeth, the angle of the incisors or the multiple movements of teeth, which allow to correct at the same time the position of several teeth.

Once the treatment with the brackets is finished, it is necessary to consolidate the changes obtained during the “retention period”, in which, by means of temporary “retainers” , the teeth are kept in their correct position until the different tissues (bone and gums) adapt to the new positions.

Since corrective measures are frequent and are often expensive, it is important to assess whether your results will be stable in the long term. In this sense, there is no conclusive evidence on the stability of the oral structures after removing the retaining elements. There is also no conclusive evidence on long-term stability (more than 5 years) after the application of interceptive or corrective treatments.

Types of brackets

Nowadays you can find different types of fixed elements for orthodontics depending on the preferences and circumstances of each patient. In this way, you can find metallic, invisible or internal elements (located on the inside of the teeth), among others.

Risks and complications of orthodontic treatment

During the orthodontic treatment may appear certain adverse effects related to teeth and adjoining tissues. An example of this is the appearance of caries, periodontitis or sensitization reactions to the materials of the devices. Root desorption and temporomandibular problems are complications that can also occur.

Finally, the movement of the teeth can cause inflammation in the tissues around the tooth that can be associated with pain during different phases of the treatment.