Othodontics- What are braces for?
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People often associate a perfect smile with good health. It’s true — your oral health plays an important role in your overall well-being. However, not everyone is born with straight teeth or completely aligned teeth. Although dental problems have surely been a problem for humanity before recorded history, the earliest evidence we have of practices resembling orthodontic work comes from ancient Egyptians, Etruscans, Greeks, and Romans.

The Greek philosopher Hippocrates authored some of the first categorisations of tooth ailments. It was not until hundreds of years later that orthodontic progress was made, when the Roman author Aulus Cornelius Celsus used his finger to apply pressure to reposition teeth over time. 

Orthodontics is usually one elective of oral therapy. However, when considering the significant effect on personality development that a beautiful smile with normally aligned teeth can have, and the increased self-esteem that this health service develops, it becomes less elective. Orthodontic therapy, usually delivered by orthodontic specialists, is readily available at a moderate cost and without any risks or complications. It should be accomplished when necessary to improve the appearance of your smile and improve chewing function, as well as to improve patient self-acceptance. If you have a bad bite or large spaces between your teeth, you may want to consult a dentist specialising in orthodontic care. 

Orthodontics is that branch of dentistry concerned with the prevention, interception and correction of malocclusion and other abnormalities of the dentofacial region. The word “orthodontics” is derived from the Greek word “orthos” meaning correct, and “odontos” which means teeth. Orthodontics, therefore, describes the practice of straightening misaligned/ malaligned teeth (referred to as malocclusion).

Benefits/aims of orthodontics

Orthodontics has the additional benefits of improving one’s appearance. The benefits of opting for straightening teeth include:

Improvement of self-esteem: By improving facial appearance in adults as well as in school-going students where due to compromised facial appearance, can lead to psychological disturbances. Improved function of teeth results in better chewing and clearer pronunciation and speech.

Reduced risk of dental caries: This occurs due to the collection of food particles between irregular teeth.

Reduced risk of gum injury and trauma: This is due to various types of malocclusions. Malocclusion is associated with poor oral hygiene and related periodontal diseases.

Temporomandibular Joint (TMJ) related problems: The TMJ acts like a sliding hinge, connecting your jawbone to your skull. In some cases where there are TMJ-associated problems, orthodontic treatment can act as a relief for the patient (a splint fabricated by an orthodontic can improve bite and relieve discomfort).

Some of the dental malocclusions that may be corrected by orthodontics include:

Crowded teeth: Crowding of teeth or poor alignment of teeth happens due to discrepancies in the tooth and jaw size ratio. Various teeth can be seen irregularly placed. This leads to a poor bite as well as an unsightly appearance.

Open bite: This occurs when there is a gap between the teeth of the upper and lower jaws during complete closure of the mouth. This gives an unaesthetic appearance as well as difficulty in pronouncing a few words.

Deep overbite: This is a condition which occurs when the upper front teeth completely overlap the lower front teeth. Exposure of lower front teeth is either minimum or completely invisible during the closure of the mouth. This may lead to gum damage, gum diseases, tooth wear and tear, and ultimately, tooth loss.

Increased overjet: This occurs when the upper front teeth are placed way forward about the lower front teeth.

Reverse overjet: This is a condition where the upper front teeth are placed backwards about the lower front teeth. The lower jaw is thus prominent in the overall facial structure. This condition is prevalent among the population of the northeast.

Spacing: Unnatural spacing between teeth may result from poorly developed, smaller or missing teeth.

What to expect at the orthodontist

Initially, it is the parent who notices the defect and they take an expert opinion from a general dentist. The dentist refers the case to an orthodontist. During the first orthodontic consultation, you’ll likely undergo an oral examination, photos of your face and smile, dental x-rays, and panoramic (360 degrees) x-rays of the face and head. Impressions will be taken to create replicas of your teeth. These tests will inform your orthodontist on how to proceed with your treatment.

How treatment is carried out 

Orthodontic treatment can be done with many kinds of tools. Braces or brackets can be metallic, ceramic, or plastic. These are attached to the teeth. A set of wires or springs apply force and move teeth into the desired position.

At what age should I have orthodontic treatment

The best time is generally during childhood because this is when growth modulation can be carried out and during this age, jaw bones are softer as compared to that in adults. However, adult orthodontics is also common these days. Age is no longer a restricting factor.

Will it hurt

All dental tools may feel strange at first and can cause discomfort. Teeth are usually uncomfortable immediately after a brace has been adjusted, but this will settle.

Risks of orthodontic treatment

Though orthodontic treatment is well managed with a very low level of force application, sometimes there might arise chances of complications which are very rarely seen. These include failure to achieve the desired outcome from the treatment, early tooth decay that may occur if the areas around the braces are not kept clean and plaque has accumulated around a fixed brace causing caries. Root resorption or dissolving of the roots of the teeth, and loss of gum support when braces in some individuals tend to aggravate gum inflammation and increase the risk of gum disease.

This article was authored by Dr Adarsh Deep Kharel, a senior resident of MDS (Orthodontics and Dentofacial Orthopedics) at the Sikkim Manipal Institute of Medical Sciences.

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