Braces are one way orthodontists treat a "malocclusion," which literally means a "bad bite." A perfect bite is one in which the teeth are straight with just enough space in between, the back molars meet in such a way to permit thorough chewing and the top teeth slightly overlap the bottom teeth. Very few mouths meet this ideal and require correction. Misaligned teeth can be unattractive, physically and emotionally painful and keep a person from being able to bite, chew and speak well. The appearance of teeth may be what prompts people to have their teeth straightened, but orthodontists treat poorly aligned teeth and jaws to improve dental health. A beautiful smile is a nice side effect of orthodontic treatment.
Bad bites have a variety of causes. Most are inherited. Some are brought on by actions such as sucking the thumb or fingers. Whatever the cause, no two bad bites are exactly alike. The American Association of Orthodontists (AAO) recommends that children have their first checkup with an orthodontist no later than age seven. At this age, enough permanent teeth have come in for an orthodontist to detect any current problems, or alert parents to problems that are developing.
Some children may be candidates for early treatment. Others may need to wait until they have all of their permanent teeth. It's best to consult an orthodontist, someone who has two to three years of specialized education in orthodontics after dental school, about whether orthodontic treatment will be needed. If it is, an early checkup will let the orthodontist recommend the right time to take action.
Braces are the treatment of choice for many patients. They are made up of tiny brackets glued to teeth and thin wires, called archwires, which sit in slots of brackets. It's the wires that actually move the teeth. Archwires are adjusted periodically to help guide teeth and jaws into ideal positions. The brackets act as handles to hold the wires in place. Metal brackets are used most often. Some older teens or adults may want a less noticeable option and may select ceramic brackets, if the orthodontist feels these will get the patient to the desired final results.
Braces are just one type of orthodontic "appliance." Depending on the problem needing correction, the orthodontist may suggest other appliances to move teeth and align jaws. Headgear, which attaches to braces and wraps around the neck or the head, can help line up jaws. Rubber bands may be recommended to move teeth in directions that braces alone cannot. Appliances that patients put on and remove can only work when worn. So be sure to follow the orthodontist's prescription for wear.
Orthodontic treatment requires two main components: pressure and time. Braces or other appliances apply pressure to teeth and jaws over a period of time. Most treatment lasts between one and three years. Two years is the average length of treatment.
Improvements in wires have sped up treatment time over the years. And because today's wires stay strong longer than old wires did, patients may only need to see the orthodontist every six or eight weeks, so they miss less school or work.
There can be some discomfort associated with braces or other appliances. Especially after braces are first placed, teeth may feel sore. There may be some irritation of the cheeks as the patient adjusts to hardware in the mouth. This is usually temporary. Discomfort can usually be managed well with over-the-counter pain relievers and softer foods. Orthodontic wax can cover a bracket or wire causing irritation. The mouth adjusts relatively quickly. There might be some temporary soreness after an adjustment of wires. Soreness is a good sign. It means teeth are moving.
After active orthodontic treatment ends, many patients get retainers. Often, they will wear them full time for the first several months after braces are removed. The orthodontist might suggest that the patient wear retainers nightly after that. Retainers are as an important part of orthodontic treatment as braces. They help hold teeth in their new positions while new bone forms around the teeth. Follow the orthodontist's instructions on retainer wear. It's the best way to keep teeth where the orthodontist and patient have moved them.
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