Orthodontics
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Orthodontics in Tenafly
The word “orthodontics” is derived from the Greek words orthos, meaning proper or straight and odons meaning teeth.
Orthodontics is a branch of dentistry specializing in the diagnosis, prevention, and treatment of jaw, face and bite irregularities (malocclusions). Orthodontic treatment is provided by an oral health care provider known as an orthodontist, who has completed two to three years of additional training beyond dental school.
There are many advantages to well-aligned teeth, including easier cleaning, better oral hygiene, clearer speech and a more pleasant smile. Though orthodontic treatment can be effective at any age, the American Dental Association suggests that an orthodontic assessment should be performed around the age of seven. The earlier orthodontic treatment begins, the more quickly the problem can be successfully resolved.
Whether it’s traditional braces or custom-made removable appliances, orthodontics can help you have the healthy, straight, beautiful smile you’ve been waiting for! Give us a call today and schedule your orthodontic consultation.
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Orthodontic Procedures
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Orthodontic Treatment Phases
Generally, orthodontic treatment takes between six and thirty months to complete. The treatment time will largely depend on the classification of the malocclusion, the type of dental devices used to correct it and the perseverance of the patient. Here is a general overview of the three major stages of treatment:
01. The Planning Stage
The orthodontist makes an exact diagnosis in order to realign the teeth in the most effective and expedient way.
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The first several visits may comprise some of the following evaluations:
● Medical and dental evaluations – Dental and physical problems tend to go hand in hand. Problems in the oral cavity can lead to (or be caused by) medical problems. The goal of this evaluation is to ensure that prior medical and dental issues are completely under control before treatment begins.
● Study model (castings/bite impressions) – The patient is asked to bite down into a dental tray filled with a gel substance that hardens around the teeth. The trays are removed from the teeth and filled with plaster to create models of the patient’s teeth. Study models enable the orthodontist to scrutinize the position of each tooth and how it relates to the other teeth.
● Panoramic X-rays – X-rays are fantastic tools for viewing potential complications or pre-existing damage to the jaw joint. X-rays also allow the orthodontist to see the exact position of each tooth and its corresponding root(s).
● Computer-generated images – Such images allow the orthodontist to create a treatment plan and examine how specific treatments may affect the shape of the face and symmetry of the jaw.
● Photographs – Many orthodontists like to take “before, during, and after” photographs of the face and teeth to assess how the treatment is progressing and the impact the treatment is having on the patient’s face shape.
02. The Active Phase
The orthodontist will recommend custom orthodontic device(s) to gently move the teeth into proper alignment.
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All of the above diagnostic tools will be used to diagnose and develop a customized treatment plan for the patient. Next, the orthodontist will recommend custom orthodontic device(s) to gently move the teeth into proper alignment.
This orthodontic appliance may be fixed or removable. Most commonly, traditional fixed braces are affixed, which utilizes individual dental brackets connected by an archwire. Lingual braces are also fixed but fit on the inside (tongue side) of the teeth to make them less visible.
Removable devices are an alternative to fixed braces. Examples of removable devices include the Invisalign system, headgear, and facemask. These devices are designed to be worn for a specified amount of hours each day to expedite treatment.
Whatever the orthodontic device, the orthodontist will regularly adjust it to ensure adequate and continual pressure is being applied to the teeth. It is essential to visit the orthodontist at the designated intervals and to call if part of the device breaks or becomes damaged.
03. The Retention Phase
The orthodontist will next create a custom retainer. The goal of the retainer is to ensure that the teeth do not begin to shift back.
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When the teeth have been correctly aligned, fixed braces and removable devices will be removed and discontinued. The most cumbersome part of the orthodontic treatment is now over. The orthodontist will next create a custom retainer.
The goal of the retainer is to ensure that the teeth do not begin to shift back to their original positions. Retainers need to be worn for a specified amount of time per day for a specified time period.
During the retention phase, the jawbone will reform around the realigned teeth to fully stabilize them in the correct alignment.
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Frequently Asked Questions
What problems can be treated with orthodontics?
Orthodontics is a versatile branch of dentistry that can be used alone or in combination with maxillofacial or cosmetic dentistry.
Here are some of the common conditions treated with orthodontics:
● Anteroposterior deviations – The discrepancy between a pair of closed jaws is known as an anteroposterior discrepancy or deviation. An example of such a discrepancy would be an overbite (where the upper teeth are further forward than the lower teeth) or an underbite (where the lower teeth are further forward than the upper teeth).
● Overcrowding – Overcrowding is a common orthodontic problem. It occurs when there is insufficient space for the normal growth and development of adult teeth.
● Overbite – An overbite refers to the protrusion of the maxilla (upper jaw) relative to the mandible (lower jaw). An overbite gives the smile a “toothy” appearance, and the chin looks like it has receded.
● Underbite – An underbite, also known as a negative underjet, refers to the protrusion of the mandible (lower jaw) in relation to the maxilla (upper jaw). An underbite makes the chin look overly prominent. Developmental delays and genetic factors generally cause underbites and overbites.
● Aesthetic problems – A beautiful straight smile may be marred by a single misaligned tooth. This tooth can be realigned with ease and accuracy by the orthodontist. Alternatively, orthodontists can also work to reshape and restructure the lips, jaw, or face.What are some of the orthodontic solutions?
Orthodontics is a technologically advanced field which offers many sophisticated solutions to malocclusions and other cosmetic problems. The orthodontist will generally perform a visual examination, panoramic X-rays, and study models (bite impressions) in order to assess the exact nature of the discrepancy.
When a diagnosis has been made, there are a variety of orthodontic treatment options available.
Here is an overview of some of the most common treatments:
● Fixed orthodontic braces – A metal or ceramic dental base is affixed to each tooth, and a dental wire is inserted through each base. The orthodontist is able to gradually train the teeth into proper alignment by regularly adjusting the wire. When the desired results are achieved, the fixed dental braces are completely removed.
● Removable appliances – There are a wide range of removable appliances commonly used in orthodontics, including headgear that correct overbites, Hawley retainers that improve the position of the teeth even as the jawbone reforms, and facemasks which are used to correct an underbite.
● Invisalign® – This is a newer, removable type of dental aligner that is completely transparent. Invisalign® does not interfere with eating because of its removable nature, and mechanically works in the same way as the traditional metal dental braces. Not all patients are candidates for Invisalign®.Who can benefit from orthodontics?
Orthodontics is a specialized branch of dentistry that is concerned with diagnosing, treating and preventing malocclusions (bad bites) and other irregularities in the jaw region and face. Orthodontists are specially trained to correct these problems and to restore health, functionality and a beautiful aesthetic appearance to the smile.
Though orthodontics was originally aimed at treating children and teenagers, almost one third of orthodontic patients are now adults. A person of any age can be successfully treated by an orthodontist.
A malocclusion (improper bite) can affect anyone at any age, and can significantly impact the individual’s clarity of speech, chewing ability and facial symmetry. In addition, a severe malocclusion can also contribute to several serious dental and physical conditions such as digestive difficulties, TMJ, periodontal disease and severe tooth decay. It is important to seek orthodontic treatment early to avoid expensive restorative procedures in the future.How can orthodontics help?
Orthodontic dentistry offers techniques that will realign the teeth and revitalize the smile. There are several treatments the orthodontist may use, depending on the results of panoramic X-rays, study models (bite impressions), and a thorough visual examination.
Fixed dental braces can be used to expediently correct even the most severe case of misalignment. These braces consist of metal or ceramic brackets, which are affixed to each tooth, and an archwire, which is used to gradually move the teeth through the duration of the treatment.
Removable appliances include headgear (which consists of a metal wire device attached to customized braces), retainers, Invisalign® aligners (which are almost invisible to the naked eye), palate expanders and tooth movers. Faceguards are generally used to correct developmental delays in both the upper and lower jaw and palate expanders are used to combat overcrowding.
Whatever the dental irregularity or the age of the individual, orthodontic appliances can properly realign the teeth and create a beautiful smile.Why straighten teeth?
Straighter teeth perform chewing, biting and speaking functions more effectively than crooked teeth. In addition, a straight smile boosts confidence, is aesthetically pleasing to look at, and can help stave off a wide variety of dental ailments.
There are several types of malocclusion, including overbite, underbite, crossbite, and overcrowding. Each of these alignment problems negatively impacts the functionality and cosmetic appearance of the teeth.
Here is a brief overview of some of the main disorders associated with crooked teeth:
● Periodontitis – Periodontitis or gum disease begins with a bacterial infection. The bacterial infection is caused by inadequate oral hygiene. Crooked teeth are hard to clean effectively, which means that debris, plaque and bacteria can build up in hard-to-reach areas. Straight teeth are much easier to clean and are at less risk of contracting gum disease.
● Temporomandibular Disorder (TMJ) - Crooked teeth can lead to improper jaw alignment, which in turn causes a painful condition known as TMJ. Severe headaches, jaw pain, lockjaw and the grinding of teeth characterize this debilitating disorder.
● Tooth injury – Straight teeth create a strong wall, which means injuries are less likely to occur. Crooked teeth are weaker and often protrude, making them far more vulnerable to external injury.
● Uneven wear – Crooked teeth cause some of the teeth to work harder than others when biting and chewing. Straight teeth share the workload evenly, meaning less risk of injury and better aesthetics.
Teeth can be straightened using either orthodontic braces or customized aligning trays. Orthodontic braces are usually affixed to the teeth for a set duration. The brackets and archwires are tightened regularly by the orthodontist and removed when treatment is complete. Fixed braces can be placed on the front side or back side of the teeth and are effective for most types of malocclusion.
Aligning trays are fully removable and are used where the malocclusion is less severe and the teeth need to move a shorter distance. These trays are replaced every few weeks for the duration of the treatment and have proven to be equally effective for straightening teeth.What is a malocclusion?
A malocclusion is an incorrect relationship between the maxilla (upper arch) and the mandible (lower arch), or a general misalignment of the teeth. Malocclusions are so common that most individuals experience one, to some degree. The poor alignment of the teeth is thought to be a result of genetic factors combined with poor oral habits, or other factors in the early years.
Moderate malocclusion commonly requires treatment by an orthodontist. Orthodontists are dentists who specialize in the treatment of malocclusions and other facial irregularities.
The following are three main classifications of malocclusion:
● Class I – The occlusion is typical, but there are spacing or overcrowding problems with the other teeth.
● Class II – The malocclusion is an overbite (the upper teeth are positioned further forward than the lower teeth). This can be caused by the protrusion of anterior teeth or the overlapping of the central teeth by the lateral teeth.
● Class III – Prognathism (also known as “underbite”) is a malocclusion caused by the lower teeth being positioned further forward than the upper teeth. An underbite usually occurs when the jawbone is large or the maxillary bone is short.
Why is it important to treat a malocclusion?
A severe malocclusion may lead to skeletal disharmony of the lower face. In a more extreme case, the orthodontist may work in combination with a maxillofacial dentist to reconstruct the jaw. It is never too late to seek treatment for malocclusion. Children and adults alike have completed orthodontic realignment procedures and have been delighted with the resulting even, straight smile.
Here are some of the main reasons to seek orthodontic treatment for malocclusion:
● Reduced risk of tooth decay – A malocclusion often causes an uneven wear pattern on the teeth. The constant wearing of the same teeth can lead to tooth erosion and decay.
● Better oral hygiene – Malocclusion can be caused by overcrowding. When too many teeth are competing for too little space, it can be difficult to clean the teeth and gums effectively. It is much easier to clean straight teeth that are properly aligned.
● Reduced risk of TMJ – Temporomandibular jaw syndrome (TMJ) is thought to be caused by malocclusion. Headaches, facial pains, and grinding teeth during sleep all result from the excessive pressure on the temporomandibular joint. Realigning the teeth reduces pressure and eliminates these symptoms.How is malocclusion treated?
A malocclusion is usually treated with dental braces. The orthodontist takes panoramic X-rays, conducts visual examinations, and takes bite impressions of the whole mouth before deciding on the best course of treatment.
If malocclusion is obviously caused by overcrowding, the orthodontist may decide an extraction is the only way to create enough space for the realignment. However, in the case of an underbite, crossbite, or overbite, there are several different orthodontic appliances available, such as:
● Fixed multibracket braces – This type of dental braces consists of brackets cemented to each tooth and an archwire that connects each one. The orthodontist adjusts or changes the wire on a regular basis to train the teeth into proper alignment.
● Removable devices – There are many non-fixed dental braces available to treat malocclusion. Retainers, headgear, and palate expanders are among the most common. Retainers are generally used to hold the teeth in the correct position while the jawbone grows properly around them.
● Invisalign® – These dental aligners are removable and invisible to the naked eye. Invisalign® works similarly to fixed dental braces but does not impact the aesthetics of the smile.What is a retainer?
When braces are finally removed, the “retention” phase begins for most individuals. The objective of this phase is to ensure the teeth do not regress back to their previous position. A retainer will be used to maintain the improved position of the teeth.
A retainer is a fixed or removable dental appliance that has been custom-made by the orthodontist to fit the teeth. Retainers are generally made from transparent plastic and thin wires to optimize the comfort of the patient.
Retainers are worn for varying amounts of time, depending on the type of orthodontic treatment and the age of the patient. Perseverance and commitment are required to make this final stage of treatment successful. If the retainer is not worn as directed, treatment can fail or take much longer than anticipated.What types of retainer are available?
There are a variety of retainers available, each one geared towards treating a different kind of dental problem. The orthodontist will make a retainer recommendation depending on the nature of the original diagnosis and the orthodontic treatment plan.
The following are some of the most common types of retainers:
● Hawley retainer – The Hawley retainer consists of a metal wire on an acrylic arch. The metal wire may be periodically adjusted by the orthodontist to ensure the teeth stay in the desired position. The acrylic arch is designed to fit comfortably on the lingual walls or palate of the mouth. ● Essix – The Essix retainer is the most commonly used vacuum formed retainer (VFR). A mold is initially made of the teeth in their new alignment, and then clear PVC trays are created to fit over the arch in its entirety. VFR’s are much cheaper than many other types of retainers and also do not affect the aesthetic appearance of the smile in the same way as the Hawley retainer. The disadvantage of VFR’s is that they break and scratch more easily than other types of retainers. ● Fixed retainers – A fixed retainer is somewhat similar to a lingual brace in that it is affixed to the tongue side of a few teeth. Usually, a fixed retainer is used in cases where there has been either rapid or substantial movement of the teeth. It usually consists of a single wire. The inclination of the teeth to move rapidly means they are also more likely to regress back to their previous position if a fixed retainer is not placed.What do I need to consider when using a retainer?
There are a few basic things to consider for proper use and maintenance of your retainer.
● Don’t lose the appliance – Removable retainers are very easy to lose. It is advisable to place your retainer in the case it came in while eating, drinking, and brushing. Leaving a retainer folded in a napkin at a restaurant or in a public restroom can be very costly if lost because a replacement must be created. A brightly colored case serves as a great reminder. ● Don’t drink while wearing a retainer – It is tempting to drink while wearing a retainer because of the unobtrusive nature of the device. However, excess liquid trapped under the trays can vastly intensify acid exposure to teeth, increasing the probability of tooth decay. ● Don’t eat while wearing a retainer – It can be difficult and awkward to eat while wearing a removable retainer and it can also damage the device. Food can get trapped around a Hawley retainer wire or underneath the palate, causing bad breath. When worn on the upper and lower arches simultaneously, VFR retainers do not allow the teeth to meet. This means that chewing is almost impossible. ● Clean the retainer properly – Removable retainers can become breeding grounds for calculus and bacteria. It is essential to clean the inside and outside thoroughly as often as possible. Hawley retainers can be cleaned with a toothbrush. Because harsh bristles can damage the PVC surface of a VFR, denture cleaner or a specialized retainer cleaner is recommended for this type of device. ● Wear the retainer as directed – This phase of treatment is critical. The hard work has been done; the braces are off, and now it is tempting not to wear the retainer as often as the orthodontist recommends. Retainers are needed to give the muscles, tissues, and bones time to stabilize the teeth in their new alignment. Failure to wear the retainer as directed can have regrettable consequences, such as teeth returning to their original position, added expense, and lost time.