Assessment
In the first stage of orthodontic treatment, an assessment of the current state of the patient's teeth and their likely development is made. This usually involves taking X-rays and making plaster models of the teeth.
After completing the assessment, the orthodontist will be able to provide more information about the type of treatment that is needed, and the likely results.
Orthodontic appliances
Orthodontic treatment uses appliances to correct the position of the teeth. The four main types of appliance are:
- removable appliances - which are usually plastic plates that cover the roof of the mouth and clip on to some teeth; they can be taken out and cleaned
- functional appliances - a pair of removable plastic braces that are joined together or are designed to interact together and clip on to the upper and lower teeth
- fixed appliances - a non-removable brace that is fixed to each tooth with a metal or ceramic bracket or attachment
- headgear - this is not an orthodontic appliance itself, but it is used with other appliances to add a certain type and direction of pressure
The four types of orthodontic appliances are discussed in more detail below.
Removable appliances
Removable appliances can be used to correct minor problems, such as slightly crooked teeth. They can also be used to discourage children from sucking their thumb.
Although the appliance is easily removable, it should only be taken out of the mouth for cleaning. However, removing the appliance may also sometimes be recommended as a precaution during certain activities, such as cycling or playing a wind instrument. Your orthodontist can advise you about this.
Functional appliances
Functional appliances can be used to treat problems with the relative position of the upper jaw and teeth and the lower jaw and teeth, such as a retruded lower jaw and teeth (backward movement of the lower jaw).
Most people who use functional appliances will need to wear them all of the time. It is very important to follow your orthodontist’s instructions about how and when to wear the appliance because if it is not worn correctly, the treatment will be unsuccessful.
It may be necessary to remove your functional appliance while you are eating.
Fixed appliances
Fixed appliances are the most common type of orthodontic appliance. They can be used to treat cases where a number of teeth need to be corrected, or where a high degree of precision is required to guide the development of the teeth and prevent problems in the future.
You will be able to eat normally while wearing a fixed appliance. However, certain foods and drinks, such as toffee, hard sweets and fizzy drinks, must be avoided because they can damage the appliance and teeth. Your orthodontist will be able to give you further dietary advice.
If you are using a fixed appliance and you play a contact sport, such as rugby, you should wear a gum shield to protect both your mouth and the appliance.
NHS braces are usually made out of metal, so they will be noticeable on the front of your teeth. Many private orthodontists now offer ceramic or clear plastic braces that are much less noticeable. However, these types of braces are usually more expensive than the metal variety.
Headgear
Headgear is used to correct the position of the back teeth or to keep them in position while the front teeth are being treated. Most people only need to wear headgear for a few hours during the evening or when they are sleeping. You will not be able to eat or drink while you are wearing headgear.
It is important that you follow all of your orthodontist’s instructions relating to the use of your headgear, such as how to put it on and take it off, and how to use it at night. Failure to use headgear correctly could lead to a facial injury or, more seriously, an eye injury.
Your orthodontist will be able to train you to use your headgear correctly and safely.
Other treatments
Retainers
Retainers are often used near the end of a course of orthodontic treatment. Retainers are dental devices that hold newly fixed teeth in place while the surrounding gum and bone adjusts to the new position of the teeth. Retainers can be either removable or fixed.
Tooth removal
In some cases, it may be necessary to remove a tooth to correct the position and appearance of nearby teeth. However, as a result of recent advances in orthodontic treatment, the need to remove a tooth has become much less common.
