Posts for: February, 2019
Braces utilize the mouth’s existing teeth-moving mechanism by applying pressure in the direction of the desired movement. This is done with a wire laced through metal brackets affixed to the outside of the teeth that’s then usually anchored to brackets on the back teeth to maintain constant tension.
This anchorage set-up alone, however, may not work effectively with all bite situations, which might require other points of anchorage. That’s where these other tools in the orthodontist’s toolkit can come in handy.
Headgear. These appliances not only aid with moving teeth but they also help influence the proper growth of facial structures (as when one of the jaws is too far forward or too far back). Because of this influence on jaw growth you’ll only find them used with pre-teens. The most typical application is a strap running around the back of the head or neck (or sometimes over the chin or forehead) that attaches in the front to brackets usually bonded to the molars. In this case the back of the patient’s skull serves as the anchor point.
Temporary anchorage devices (TADs). Orthodontists sometimes wish to isolate the teeth to be moved from nearby teeth that shouldn’t be. For example, they may want to move front teeth back to close a space without the back teeth moving forward. In this case, it may be necessary to create a separate anchorage point in the jaw. This can be done with TADs, which are made of either biotolerant (stainless steel, chromiumâ??cobalt alloy), bioinert (titanium, carbon), or bioactive (hydroxyapatite, ceramic oxidized aluminum) materials and shaped like mini-screws. Orthodontists insert them into the bone and then attach them to the braces using elastics (rubber bands). After completing orthodontic treatment they’re easily removed.
Elastics. We’ve already mentioned them, but elastics deserve their own category because they can be used in various kinds of anchorage. They play an important role, for example, in cross-arch anchorage that maintains tension between the upper and lower jaws. They can also be used to help move one or more groups of teeth — or isolate certain teeth from moving. They truly are flexible (no pun intended) in their uses for fine-tuned tooth movement.
All these devices can be used in various combinations to match and correct whatever bite situation a patient may have. The end result is straighter and better-functioning teeth — and a more attractive smile.
If you would like more information on orthodontic treatment, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Orthodontic Headgear & Other Anchorage Appliances.”
If you or a family member has problems with teeth alignment or your bite, you may be considering braces. This tried and true method can straighten out most smiles — but there's more to braces than you may realize.
For one thing, orthodontic treatment wouldn't work if it weren't for the natural mechanism for tooth movement that already exists in the mouth. It may seem your teeth are rigidly set in the jawbone but that's not how they maintain their attachment: that's the job of an elastic connective tissue known as the periodontal ligament that lies between the tooth and the bone. The ligament has tiny fibers that attach to the tooth on one side and to the bone on the other to actually hold the teeth in place, much like a hammock secured between two posts.
The ligament attachment also allows the teeth to move incrementally in response to environmental factors or the aging process. We harness this natural movement ability with braces to move teeth to a more desirable position. We first attach small brackets to the front crowns of the teeth (the visible portion) and then string arch wires through them. We then attach the wires to anchor points where we can adjust the amount of tension they're exerting through the brackets against the teeth. By gradually increasing that tension, the teeth respond as they would when any force is applied against them and begin to move.
By precisely controlling that movement we can transform a patient's smile. But we believe the advantages are more than cosmetic: the teeth will function better and will be easier to care for and keep clean. These benefits, though, have to be balanced with heightened risks for root resorption (something that occurs only about 10% of the time) in which the ends of the roots can shrink, or loss of mineral content in teeth enamel where the hardware makes it more difficult to remove bacterial plaque. These risks can be reduced by closely monitoring dental health during the entire treatment process and through stepped up efforts in daily oral hygiene.
The starting point for deciding on an orthodontic treatment is a thorough dental examination with x-rays or CT scan imaging. Once we have a complete picture of your misalignment problems and any other extenuating circumstances, we can recommend a treatment plan just for you.
If you would like more information on orthodontic treatment, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Moving Teeth with Orthodontics.”
At any given time some 4 million teens and pre-teens are wearing braces or other orthodontic appliances to correct a malocclusion (poor bite). While most cases are straightforward, some have difficulties that increase treatment time and cost.
But what if you could reduce some of these difficulties before they fully develop? We often can through interceptive orthodontics.
This growing concept involves early orthodontic treatment around 6 to 10 years of age with the goal of guiding the development of a child’s jaws and other mouth structures in the right direction. These early years are often the only time of life when many of these treatments will work.
For example, widening the roof of the mouth (the palate) in an abnormally narrow upper jaw takes advantage of a gap in the bone in the center of the palate that doesn’t fuse until later in adolescence. A device called a palatal expander exerts outward pressure on the back teeth to influence the jawbone to grow out. New bone fills in the gap to permanently expand the jaw.
In cases with a developing overbite (the upper front teeth extending too far over the lower teeth when closed), we can install a hinged device called a Herbst appliance to the jaws in the back of the mouth. The hinge mechanism coaxes the lower jaw to develop further forward, which may help avoid more extensive and expensive jaw surgery later.
Interceptive treatments can also be fairly simple in design like a space retainer, but still have a tremendous impact on bite development. A space maintainer is often used when a primary (“baby”) tooth is lost prematurely, which allows other teeth to drift into the empty space and crowd out the incoming permanent tooth. The wire loop device is placed within the open space to prevent drift and preserve the space for the permanent tooth.
To take advantage of these treatments, it’s best to have your child’s bite evaluated early. Professional organizations like the American Association of Orthodontists (AAO) recommend a screening by age 7. While it may reveal no abnormalities at all, it could also provide the first signs of an emerging problem. With interceptive orthodontics we may be able to correct them now or make them less of a problem for the future.
If you would like more information on orthodontic treatments, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Interceptive Orthodontics.”