Types of Orthodontic Care

Before orthodontic treatment can begin, pre-treatment records are gathered (this is the key to successful diagnosis of orthodontic problems). Those records include medical/dental history, clinical examination, plaster study models of your teeth, photos of your face and teeth and x-rays of your head. This information will be used to decide on the best treatment for you.

Orthodontic treatment usually consists of applying braces to the teeth or using other appliances which gradually move the teeth or jaws into their correct position. Many of today’s braces are far less noticeable than those of the past. Braces consist primarily of brackets and interconnecting wires. Brackets (the part of the braces that hold the wires) are bonded to the teeth. Often, clear or tooth colored brackets are used for esthetics. These braces may not be suitable for all types of orthodontic problems and, because they are more difficult to place and control and require frequent adjustments, they tend to be more costly. New white-colored elastics blend with the teeth. For the younger crowd, colored elastics are available.

When braces are removed, it is usually necessary to wear a retainer for a period of time. A retainer keeps the teeth in their new, correct position until the tissues surrounding them stabilize.

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Removable Dental Appliances

At the other end of orthodontic treatment, a special appliance is fabricated to hold the teeth in their new positions. This is called a “retainer”. Some retainers are cemented over teeth to hold the position and others that are removable.

Other removable appliances are very similar to the removable “retainer” in looks but provide a very different function. These can, in fact, create pressures on teeth in a specific way so as to cause the appropriate teeth to come into the correct position. This appliance can be used for active treatment as well as for post treatment retention.

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Types of Braces

Braces come in a variety of shapes, sizes, and colors. Some are the more traditional looking metal brackets that have been greatly reduced in size. Other brackets are clear plastic types and still other are made of ceramic materials. These last two types have been developed to aid in creating a greater cosmetic acceptance by patients in treatment.

Sometimes these brackets can be placed on the inside of the teeth. Brackets positioned in this way cannot be detected by others.

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Malocclusions

Class 1 - Unilateral posterior cross bit, on the right side, slight anterior open bite.

Before	After

Class 1 - crowding, deep bite

Before	After

Class 2 division 1 - Crowding, deep bite, adult surgical case

Before	After

Class 2 division 2 - Deep bite, severe crowding

Before	After

Class 2 division 2 - Mandibular asymmetry, lateral open bite, posterior cross bite, crowding

Before	After

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Cleansing

You would probably never dream of not bathing your body but give less thought to not brushing or flossing your teeth. When you have braces, it is incredibly important that you give as much attention to cleaning the braces as you do to cleaning the rest of your body.

The bands or bonded brackets on braces create small nooks and crannies where food and plaque (an invisible file of bacteria) can hide. If plaque is allowed to remain on the teeth for a long time, it can increase the likelihood of tooth decay. This same process can also cause permanent white lines and spots as enamel is dissolved by the acids.

Because of these problems, it is essential to brush after every meal and snack. You should also clean between your teeth and around each bracket daily. Brushing removes the food and plaque that forms on your teeth. When you brush, use a brush with soft and rounded bristles or a special orthodontic brush and also, use fluoride toothpaste. Look for the American Dental Association’s Seal of Acceptance. The Seal is awarded to products that have proven to be effective.

How should I brush?

A number of different tooth brushing methods are acceptable. Whichever method you use, take the time to brush thoroughly. Here’s an example of a method:

- Place a soft-bristled brush at a 45-degree angle against the gums.

- Move the brush back and forth in short strokes with a gentle scrubbing motion.

- Brush the inner, then outer, and finally the chewing surfaces of the teeth.

- Use the “toe” of the brush to reach the inner front tooth surfaces.

- Brush your tongue to help freshen your breath.

After brushing, rinse well. Then closely inspect your teeth and braces in a well-lighted mirror. You may have to brush and rinse several times before your teeth are clean.

Is flossing possible with braces?

Yes! But it can be a little tricky while wearing braces. A floss threader can help you slip the flow between the braces or under the arch-wire.

- Once the floss is in place, hold it between your forefingers, about an inch apart.

- Using a gentle sawing motion, guide the floss between your teeth. Do not snap it in place.

- When the floss reaches the gum-line, cure it against the tooth and gently slide it into the space between the gum and tooth.

- When you feel resistance, gently rub the side of the tooth moving the floss away from the gum.

- Rinse your teeth to wash away food or other particles that you removed with the floss.

Are there other products that can help me clean my mouth?

There are several dental aids that can be helpful. Specially shaped brushes, the other interdental cleaners and oral irrigating devices can often help clean some of those hard-to-reach areas. After brushing prior to bedtime, an ADA accepted fluoride mouth-rinse should be used for added protection of the enamel surfaces of the teeth.

Interdental Cleaners

Interdental cleaning devices with the ADA Seal of Acceptance are specially shaped brushes or other implements that help remove plaque. They are usually made of wood, plastic or rubber and shaped to help clean between the teeth. They can be particularly useful for people who wear braces or who have trouble handling floss. Discuss the proper use of these devices with your dentist to avoid injuring your gums.

Oral Irrigators

These devices create a focused stream of water to remove particles of food from the surfaces around and between the teeth. They are useful for cleaning hard-to-reach areas and may reduce gingivitis. They are especially helpful for people who have braces. Your dentist will tell you if you can benefit from using this device and provide instruction on proper use. Look for devices bearing the ADA Seal of Acceptance.

Fluoride Mouth Rinse

Fluoride with the ADA Seal of Acceptance provides extra protection for your teeth. Is an element that combines with tooth enamel, strengthening it against decay. Fluoride can even repair microscopic cavities by helping mineral incorporate into the teeth. You may want to discuss with your dentist the need for additional fluoride products such as non-prescription mouth rinses for children in your family over the age of 6.

Dental aids can play an important role in cleaning those hard-to-reach areas, but your diligence in daily cleaning is really the key to good oral health. By watching your diet, practicing good oral hygiene and following your dentist instructions, you can be assured that your orthodontic treatment will be a success. Remember, it is even more important that you visit your general dentist every six months for routine cleanings and examination while you have braces.

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