BIDC ORTHODONTIC

Services : Orthodontics

Orthodontic Dentistry

Orthodontics is the branch of dentistry that specializes in the diagnosis, prevention and treatment of dental and facial irregularities. These includes treatment of different conditions: OverCrowding Deep overbite Open bite Overjet or upper protuding teeth Underbite or lower protuding jaw Crossbite Spaces in between teeth

Orthodontists requires professional skill in the design, application and control of corrective appliances, such as braces and retainers, to bring teeth, lips and jaws into proper alignment and to achieve facial balance.

The results of orthodontic treatment can be dramatic — beautiful smiles, improved dental health and an enhanced quality of life for many people of all ages. Outstanding results are also dependent on maximizing the coordination of care between you and our practice.

Services : Orthodontics : Orthodontic Treatment Types

Orthodontic Treatment Types

Crowding Teeth may be aligned poorly because the dental arch is small and/or the teeth are large. The bone and gums over the roots of extremely crowded teeth may become thin and recede as a result of severe crowding. Impacted teeth, poor biting relationships and undesirable appearance may all result from crowding.		Deep overbite A deep overbite or deep bite occurs when the lower incisor (front) teeth bite too close or into the gum tissue behind the upper teeth. When the lower front teeth bite into the palate or gum tissue behind the upper front teeth, significant bone damage and discomfort can occur. A deep bite can also contribute to excessive wear of the incisor teeth.		Open bite An open bite results when the upper and lower incisor teeth do not touch when biting down. This open space between the upper and lower front teeth causes all the chewing pressure to be placed on the back teeth. This excessive biting pressure and rubbing together of the back teeth makes chewing less efficient and may contribute to significant tooth wear.
Overjet Overjet or or upper protruding teeth is where the upper front teeth protrudes beyond normal contact with the lower front teeth. An overjet are prone to injury, often indicate a poor bite of the back teeth, and may indicate an unevenness in jaw growth. Commonly, protruded upper teeth are associated with a lower jaw that is short in proportion to the upper jaw.		Underbite About 3 to 5 percent of the population has a lower jaw that is to some degree longer than the upper jaw known as an underbite or lower jaw protrusion. This can cause the lower front teeth to protrude ahead of the upper front teeth creating a crossbite. Careful monitoring of jaw growth and tooth development is indicated for these patients.		Crossbite The most common type of a crossbite is when the upper teeth bite inside the lower teeth (toward the tongue). Crossbites of both back teeth and front teeth are commonly corrected early due to biting and chewing difficulties.
Spacing If teeth are missing or small, or the dental arch is very wide, space between the teeth can occur. The most common complaint from those with excessive space is poor appearance.

 

Types of Orthodontic Treatments

Metal Braces Conventional metal braces are now smaller, more efficient and comfortable In recent years following many advances in orthodontic materials such as metal wires and brackets.		Clear Braces The metal brackets on braces can now be done clear or colored, depending on the patient's preference. Clear braces makes wearing braces less noticeable.		Lingual or Internal Braces Lingual braces are attached to the inside or lingual side of the teeth which makes them completely non-visible. Lngual orthodontics particularly well-suited for adults whose professions keep them in the public eyes.
Invisalign Invisalign uses a series of clear removable aligners to straighten your teeth without metal wires or brackets. This is an invisible way to straighten your teeth without braces		Retainers A retainer is a custom-made, removable appliance that help teeth to maintain their new position after braces have been removed. Retainers can also be used to treat minor orthodontic problems

 

Signs for Early Orthodontic Examinations

• Early or late loss of baby teeth
• Difficulty in chewing or biting
• Mouth breathing
• Crowding, misplaced or blocked out teeth
• Jaws that shift or make sounds
• Biting the cheek or roof of the mouth
• Teeth that meet or bite abnormally or not at all
• Jaws and teeth that are out of proportion to the rest of the face

 

Benefits of Early Detection for Orthodontic Treatment

A check-up with an orthodontist no later than age 7 for children who enable the orthodontist to detect and evaluate problems (if any), advise if treatment will be necessary, and determine the best time for that patient to be treated. Patients who have clear indications for early orthodontic intervention, early treatment presents an opportunity to:

• Guide the growth of the jaw
• Regulate the width of the upper and lower dental arches
• Guide incoming permanent teeth into desirable positions
• Lower risk of trauma (accidents) to protruded upper incisors (front teeth)
• Correct harmful oral habits
• Reduce or eliminate abnormal swallowing or speech problems
• Improve personal appearance and self-esteem
• Potentially simplify and/or shorten treatment time for later corrective orthodontics
• Reduce likelihood of impacted permanent teeth
• Preserve or gain space for permanent teeth that are coming in

Healthy teeth can be moved at almost any age. Many orthodontic problems can be corrected for adults as children. Orthodontic forces move the teeth in the same way for both a 75-year-old adult and a 12-year-old child. However for adults, complicating factors such as lack of jaw growth, may create special treatment planning needs.

Services : Orthodontics : Adult Orthodontics Treatment

Difference between Adult Orthodontics Treatment to that of Children and Adolescents

Adults are not growing and may have experienced some breakdown or loss of their teeth and bone that supports the teeth. Orthodontic treatment may then be only a part of the patient's overall treatment plan. Close coordination may be required between the orthodontist, oral surgeon, periodontist, endodontist and family dentist to assure that a complicated adult orthodontic problem is managed well and complements all other areas of the patient's treatment needs. Below are the most common characteristics that can cause adult treatment to differ from treatment for children.

No Jaw Growth Jaw problems can usually be managed well in a growing child with an orthopedic, growth-modifying appliance. However, the same problem for an adult may require jaw surgery. For example, if an adult's lower jaw is too short to match properly with the upper jaw, a severe bite problem may result. The limited amount that the teeth can be moved with braces alone may not correct this bite problem. Bringing the lower teeth forward into a proper bite relationship could require jaw surgery, which would lengthen the lower jaw and bring the lower teeth forward into the proper bite. Other jaw-width or jaw-length discrepancies between the upper and lower jaws might also require surgery for bite correction if tooth movement alone cannot correct the bite.

Gum or Bone Loss Periodontal Breakdown Adults are more likely to have experienced damage or loss of the gum and bone supporting their teeth (periodontal disease). Special treatment by the patient's dentist or a periodontist may be necessary before, during and/or after orthodontic treatment. Bone loss can also limit the amount and direction of tooth movement that is advisable

Worn, Damaged or Missing Teeth Worn, damaged or missing teeth can make orthodontic treatment more difficult, but more important for the patient to have. Teeth may gradually wear and move into positions where they can be restored only after precise orthodontic movement. Damaged or broken teeth may not look good or function well even after orthodontic treatment unless they are carefully restored by the patient's dentist. Missing teeth that are not replaced often cause progressive tipping and drifting of other teeth, which worsens the bite, increases the potential for periodontal problems and makes any treatment more difficult.

Services : Orthodontics : Clear and Metal Braces

Conventional Metal Braces

In recent years, many advances in orthodontic materials have taken place. Braces are smaller and more efficient. The wires now being used are no longer just stainless steel. They are made of alloys of nickel, titanium, copper and cobalt, and some of the wires are heat-activated. These new kinds of wires cause the teeth to continue to move during certain phases of treatment. In addition, braces on the front teeth typically have only the bracket bonded directly to the tooth, minimizing the "tin grin". These "space age" materials advancements exert a steady, gentle pressure on the teeth, so that the tooth-moving process may be faster and more comfortable for patients.

 

Colors on Metal Braces You can express your individuality. Part of the fun of having braces is choosing different-colored elastics at each appiontment. You can celebrate your school spirit, choose black and white for Halloween or select any number of fun colors that shows your style.

Clear Braces Brackets on braces can now be clear make treatment nearly invisible. The polymer-brace is translucent making it one of the most popular aesthetic choices in braces today.

 

Procedure of Dental Braces Treatment

1. First Evaluation and diagnosis
   • Medical records are made
   • An appropriate treatment plan is made based on analysis of the gathered information
   • An impression of your teeth and jaw is taken for the braces to be made
2. Fitting of braces
• Once ready the braces are placed on with bands that applies the forces required to align teeth
3. Checkup visits are made to adjust your braces on monthly basis
4. Retainers usually need to be worn during night time after braces are removed to prevent relapses

Successful orthodontic treatment is a "two-way street" that requires a consistent, cooperative effort by both the orthodontist and patient. To successfully complete the treatment plan, the patient must carefully clean his or her teeth, wear rubber bands, headgear or other appliances as prescibed by the orthodontist, and keep appointments as scheduled. Damaged appliances can lengthen the treatment time and may undesirably affect the outcome of treatment. The teeth and jaws can only move toward their desired positions if the patient consistently wears the forces to the teeth, such as rubber bands, as prescribed. Patients who do their part consistently make themselves look good and their orthodontist look smart.

To keep teeth and gums healthy, regular visits to the family dentist must continue during orthodontic treatment. Adults who have a history of or concerns about periodontal (gum) disease might also see a periodontist (specialist in treating diseases of the gums and bone) on a regular basis throughout orthodontic treatment.

 

Recovery Expectations

Most people have some discomfort after their braces are first put on or when adjusted during treatment. After the braces are on, teeth may become sore and may be tender to biting pressures for a few days. Patients can usually manage this discomfort well with whatever pain medication they might commonly take for a headache. The orthodontist will advise patients and/or their parents what, if any, pain relievers to take. The lips, cheeks and tongue may also become irritated for one to two weeks as they toughen and become accustomed to the surface of the braces.

 

Care of Dental Braces

1. Patients with braces must be careful to avoid hard and sticky foods
2. Patients must not chew on pens, pencils or fingernails because chewing on hard things can damage the braces. Damaged braces will almost always cause treatment to take longer.
3. Teeth and braces would need to be kept cleaned every day if the teeth and gums are to be healthy during and after orthodontic treatment
4. Follow your orthodontist directions on how often to brush, how often to floss and he use of other cleaning aids to help maintain good dental health

 

Services : Orthodontics : Invisalign

Invisalign Invisalign straightens your teeth with a series of clear, virtually invisible custom-molded aligners. The course of treatment involves changing aligners to moving your teeth into straighter position step by step until you have a more beautiful smile. And unlike braces, these clear aligners can be removed while you eat and brush your teeth as usual.

Benefits of Invisalign

Invisible thus no unwarranted attention to your mouth Removable thus easy to eat, brush and floss No brackets to catch food or plaque Healthier gums from properly aligned teeth that help gums to "fit" tighter around each tooth Easier cleanings in maintaining a good oral hygiene program that reduce chances of plaque buildup, tooth decay and periodontal disease

Invisalign, however, are not used to treat all all tooth-straightening cases. Also, being removable, patients' compliance is required. Do consult your orthodontist.

 

Procedure of Treatment

1. First Evaluation
   • An Invisalign Certified Orthodontist evaluates and creates a program of treatment
   • Records and impressions of your teeth are taken
2. Invisalign aligners made and delivered
   • A CT scan (Computed Tomography or CAT scan), is made from your dental impressions that produces an extremely accurate, 3D digital model of your teeth
   • CAD (Computer Aided Design) software is then used to simulate the movement of your teeth during treatment
   • The treatment plan are reviewed, modified, and approved the before the aligners are created
   • Invisalign then uses advanced stereolithography (SLA) technology to build precise molds of your teeth at each stage of your treatment
   • Individualized, custom-created clear aligners are made from these models and sent to your doctor's office
3. Wearing of Invisalign
   • Visits are made to your orthodontist for adjustments and to check progress on a monthly basis
   • At regular intervals, a new set of custom-molded clear aligners are received to continue the straightening process

The total number of clear aligners is specific to you, determined by your doctor for your course of treatment.

 

Recovery Expectations

Most people have some discomfort after aligners are first put on or when adjusted during treatment until your tongue, tooth and mouth becomes accustomed to the aligners. Overall, orthodontic discomfort is short-lived and easily managed.

 

Care of Teeth with Invisalign

1. Teeth and the aligners would need to be kept cleaned every day if the teeth and gums are to be healthy during and after orthodontic treatment
2. Follow your orthodontist directions on how often to brush, how often to floss and he use of other cleaning aids to help maintain good dental health

 

Services : Orthodontics : Frequently Asked Questions (FAQs) on Invisalign

• Does Invisalign really work?
• What are aligners made of?
• What do aligners look like?
• Do doctors need special training in order to use Invisalign?
• How does Invisalign effectively move teeth?

Does Invisalign really work?

Yes. In both clinical research and in orthodontic and dental practices nationwide, Invisalign has been proven effective at straightening teeth.

What are aligners made of?

Aligners are made of clear, strong medical grade plastic that is virtually invisible when worn.

What do aligners look like?

Aligners are clear and look similar to tooth-whitening trays, but are custom-made for a better fit to move teeth. Some orthodontists and dentists have referred to them as "contact lenses for teeth."

Do doctors need special training in order to use Invisalign?

While Invisalign can be used with virtually any treatment philosophy, specific training is needed. All orthodontists and dentists interested in treating patients with Invisalign must attend training before cases will be accepted from their office. Close to 30,000 orthodontists and dentists worldwide are certified to use Invisalign.

How does Invisalign effectively move teeth?

Like brackets and arch wires are to braces, Invisalign aligners move teeth through the appropriate placement of controlled force on the teeth. The principal difference is that Invisalign not only controls forces, but also controls the timing of the force application. At each stage, only certain teeth are allowed to move, and these movements are determined by the orthodontic treatment plan for that particular stage. This results in an efficient force delivery system.

Services : Orthodontics : Lingual Braces

Lingual Braces

Lingual braces are attached to the inside or lingual side of the teeth to allow tooth movements to be carried out while making them completely non-visible. This advanced method makes lingual orthodontics particularly well-suited for adults and especially appealing for adults whose professions keep them in the public eyes. No one can tell they are wearing these braces. Patients can enjoy the process of orthodontia while still retaining a natural smile.

Braces are made up of two main components: the small metal pieces (known as brackets) attached directly to the teeth, and the wire which connects them together (known as the arch wire). With standard braces, the brackets are cemented to the front of the teeth, which are quite uniform in their shape. However, lingual brackets are attached to the back side of the teeth.

The back side of each tooth has its own unique shape-unlike the front of each tooth. Each lingual bracket must be custom-formed to the unique shape of each individual tooth. Treatment for lingual braces are usually more difficult than that of standard braces, thus only orthodontists trained in lingual technique are able to offer this form of specialized treatment.

 

Benefits of Lingual Braces

• Hidden thus not visible that braces are being worn
• Bite opening and better anchorage control
• Less speech hindrance

Although the treatment is more difficult there are lots of techniques being used now which are allowing the lingual orthodontist to treat patients to the same standard as if labial appliances were being used.

 

Case of Lingual Braces

Lingual Braces Before

Lingual Braces During

Lingual Braces After

 

Procedure of Dental Braces Treatment

1. First Evaluation and diagnosis
   • Medical records are made
   • An appropriate treatment plan is made based on analysis of the gathered information
   • An impression of your teeth and jaw is taken for the braces to be made
2. Fitting of braces
3. Once ready the braces are placed on with bands that applies the forces required to align teeth
4. Checkup visits are made to adjust your braces on monthly basis
5. Retainers usually need to be worn during night time after braces are removed

 

Recovery Expectations

Most people have some discomfort after their braces are first put on or when adjusted during treatment. After the braces are on, teeth may become sore and may be tender to biting pressures for a few days. Patients can usually manage this discomfort well with whatever pain medication they might commonly take for a headache. The orthodontist will advise patients and/or their parents what, if any, pain relievers to take. The lips, cheeks and tongue may also become irritated for one to two weeks as they toughen and become accustomed to the surface of the braces.

 

Care of Lingual Braces

1. Patients with braces must be careful to avoid hard and sticky foods
2. Patients must not chew on pens, pencils or fingernails because chewing on hard things can damage the braces. Damaged braces will almost always cause treatment to take longer
3. Teeth and braces would need to be kept cleaned every day if the teeth and gums are to be healthy during and after orthodontic treatment
4. Follow your orthodontist directions on how often to brush, how often to floss and he use of other cleaning aids to help maintain good dental health

Services : Orthodontics : Frequently Asked Questions (FAQs) on Orthodontic Treatments

• At what age can people have orthodontic treatment?
• What causes orthodontic problems (malocclusions)?
• How long will orthodontic treatment take?
• Why does orthodontic treatment time sometimes last longer than anticipated?
• How do braces work?
• How Often Will I Need to See the Orthodontist During Treatment?
• Will Braces Cause Pain?
  Why do baby teeth sometimes need to be pulled?
• What Care Can I Expect After the Braces Come Off?
• What kinds of orthodontic appliances are typically used to correct jaw-growth problems?

At what age can people have orthodontic treatment?

Children and adults can both benefit from orthodontics, because healthy teeth can be moved at almost any age. Because monitoring growth and development is crucial to managing some orthodontic problems well, it is recommended that children have an orthodontic screening before the age of 7. Some orthodontic problems may be easier to correct if treated early. Waiting until all the permanent teeth have come in, or until facial growth is nearly complete, may make correction of some problems more difficult.

An orthodontic evaluation at any age is advisable if a parent, family dentist or the patient's physician has noted a problem.

What causes orthodontic problems (malocclusions)

Most malocclusions are inherited, but some are acquired. Inherited problems include crowding of teeth, too much space between teeth, extra or missing teeth, and a wide variety of other irregularities of the jaws, teeth and face.

Acquired malocclusions can be caused by trauma (accidents), thumb, finger or dummy (pacifier) sucking, airway obstruction by tonsils and adenoids, dental disease or premature loss of primary (baby) or permanent teeth. Whether inherited or acquired, many of these problems affect not only alignment of the teeth but also facial development and appearance as well.

How long will orthodontic treatment take?

In general, active treatment time with orthodontic appliances (braces) ranges from one to three years. Interceptive, or early treatment procedures, may take only a few months. The actual time depends on the growth of the patient's mouth and face, the cooperation of the patient and the severity of the problem. Mild problems usually require less time, and some individuals respond faster to treatment than others. Use of rubber bands and/or headgear, if prescribed by the orthodontist, contributes to completing treatment as scheduled.

While orthodontic treatment requires a time commitment, patients are rewarded with healthy teeth, proper jaw alignment and a beautiful smile that lasts a lifetime. Teeth and jaws in proper alignment look better, work better, contribute to general physical health and can improve self-confidence.

Why does orthodontic treatment time sometimes last longer than anticipated?

Estimates of treatment time can only be that - estimates. Patients grow at different rates and will respond in their own ways to orthodontic treatment. The orthodontist has specific treatment goals in mind, and will usually continue treatment until these goals are achieved. Patient cooperation, however, is the single best predictor of staying on time with treatment. Patients who cooperate by wearing rubber bands, headgear or other needed appliances as directed, while taking care not to damage appliances, will most often lead to on-time and excellent treatment results.

How do braces work?

In their entirety, braces work by applying continuous pressure over a period of time to slowly move teeth in a specific direction. As the teeth move, the bony tooth socket reabsorbs and changes shape as pressure is applied.

Braces are made up of the following components:

• Brackets are the small squares that are bonded directly to each tooth with a special dental bonding agent or are attached to orthodontic bands. Brackets act like handles, holding the arch wires that move the teeth.
• Orthodontic bands are stainless steel, clear or tooth-colored materials that are cemented with dental bonding agents or cement to teeth. They wrap around each tooth to provide an anchor for the brackets. The clear or tooth-colored bands are more cosmetically appealing options but are more expensive than stainless steel. They are not used in all patients. Some people have only brackets and no bands.
• Spacers are separators that fit between teeth to create a small space prior to placement of orthodontic bands.
  Arch wires attach to the brackets and act as tracks to guide the movement of the teeth. Arch wires can be made of metal or be clear or tooth-colored.
• Ties are small rubber rings or fine wires that fasten the arch wire to the brackets. They can be clear, metal or colored.
  A buccal tube on the band of the last molar holds the end of the arch wire securely in place.
• Tiny elastic rubber bands, called ligatures, hold the arch wires to the brackets.
• Springs may be placed on the arch wires between brackets to push, pull, open or close the spaces between teeth.
• Two bands on the upper teeth may have headgear tubes on them to hold the facebow of the headgear in place. (A headgear is another tool used by orthodontists to aid in correcting irregularities of the teeth; see below)
• Elastics or rubber bands attach to hooks on brackets and are worn between the upper and lower teeth in various ways. They apply pressure to move the upper teeth against the lower teeth to achieve a perfect fit of individual teeth.
• Facebow headgear is the wire gadget that is used to move the upper molars back in the mouth to correct bite discrepancies and also to create room for crowded anterior teeth. The facebow consists of an inner metal part shaped like a horseshoe that goes in the mouth, attaching to buccal tubes, and an outer part that goes around the outside of the face and is connected to a headgear strap.
  

How Often Will I Need to See the Orthodontist During Treatment?

Your orthodontist will want to see you about every month to 6 weeks or so in order to make sure that the braces are exerting steady pressure on your teeth. To create more tension and pressure on your teeth, your orthodontist will make adjustments in the wires, springs, or rubber bands of your braces. In some cases, braces alone aren't enough to straighten the teeth or shift the jaw. In these situations, an external appliance, such as a headgear may need to be worn at home in the evening or through the night.

Will Braces Cause Pain?

Some of the adjustments your orthodontist may make to your braces may make your mouth feel sore or uncomfortable. When needed, over-the-counter pain relievers like Motrin or Tylenol can help relieve the pain. If you always experience a lot of pain after your braces are adjusted, talk to your orthodontist about it; he or she may be able to make the adjustments a bit differently.

Why do baby teeth sometimes need to be pulled?

Pulling baby teeth may be necessary to allow severely crowded permanent teeth to come in at a normal time in a reasonably normal location. If the teeth are severely crowded, it may be clear that some unerupted permanent teeth (usually the canine teeth) will either remain impacted (teeth that should have come in, but have not), or come in to a highly undesirable position. To allow severely crowded teeth to move on their own into much more desirable positions, sequential removal of baby teeth and permanent teeth (usually first premolars) can dramatically improve a severe crowding problem. This sequential extraction of teeth, called serial extraction, is typically followed by comprehensive orthodontic treatment after tooth eruption has improved as much as it can on its own.

After all the permanent teeth have come in, the pulling of permanent teeth may be necessary to correct crowding or to make space for necessary tooth movement to correct a bite problem. Proper extraction of teeth during orthodontic treatment should leave the patient with both excellent function and a pleasing look.

What Care Can I Expect After the Braces Come Off?

After your braces are taken off, your teeth will be thoroughly cleaned. Your orthodontist may want to take another set of x-rays and bite impressions to check how well the braces straightened your teeth and to see if any wisdom teeth have developed. If wisdom teeth are beginning to come in after your braces have been removed, your orthodontist may recommend the wisdom teeth be pulled to prevent your newly straightened teeth from shifting position in your mouth.

Your orthodontist will also fit you with a retainer. A retainer is a custom-made, removable appliance that help teeth to maintain their new position after braces have been removed. Retainers can also be used to treat minor orthodontic problems. The use of a retainer is a very important part of post-braces care. Retainers, which are typically made of rubber or clear plastic and metal wires that cover the outside surface of the teeth, need to be worn all the time for the first 6 months and then usually only during sleep. The time frame for wearing a retainer will vary from patient to patient. The reason why a retainer is needed is that even though braces may have successfully straightened your teeth, they are not completely settled in their new position until the bones, gums, and muscles adapt to the change. Also, after long periods of time, teeth tend to shift.

What kinds of orthodontic appliances are typically used to correct jaw-growth problems?

Correcting jaw-growth problems is done by the process of dentofacial orthopedics. Some of the more common orthopedic appliances used by orthodontists today that help the length of the upper and lower jaws become more compatible include:

Headgear: This appliance applies pressure to the upper teeth and upper jaw to guide the rate and direction of upper jaw growth and upper tooth eruption. The headgear may be removed by the patient and is usually worn 10 to 12 hours per day.

Herbst: The Herbst appliance is usually fixed to the upper and lower molar teeth and may not be removed by the patient. By holding the lower jaw forward and influencing jaw growth and tooth positions, the Herbst appliance can help correct severe protrusion of the upper teeth.

Bionator: This removable appliance holds the lower jaw forward and guides eruption of the teeth into a more desirable bite while helping the upper and lower jaws to grow in proportion with each other. Patient compliance in wearing this appliance is essential for successful improvement.

Palatal Expansion Appliance: A child's upper jaw may also be too narrow for the upper teeth to fit properly with the lower teeth (a crossbite). When this occurs, a palatal expansion appliance can be fixed to the upper back teeth. This appliance can markedly expand the width of the upper jaw.

The decision about when and which of these or other appliances to use for orthopedic correction is based on each individual patient's problem. Usually one of several appliances can be used effectively to treat a given problem. Patient cooperation and the experience of the treating orthodontist are critical elements in success of dentofacial orthopedic treatment.