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Orthodontics / Braces
Many of us are blessed with well arranged teeth or so called ideal occlusion. We very often come across many children and adults having teeth that are protruded or crowded or (spaced) etc. These irregularities of teeth are called malocclusion and are an important factor in robbing one of a good smile.
Orthodontics is the specialization of dentistry, which deals with correcting the bite and arrangement of teeth, therefore improves the smile and/or function of the teeth.
Braces are appliances that the orthodontist uses to correct your bite. These braces are either fixed on to the teeth or rest against your teeth and bring about the desired movement of your teeth.
Braces aren’t just for children anymore. In fact, adults now comprise approximately 30 percent of patients who seek the help of an orthodontist to straighten teeth, close gaps or just improve their smiles by using various types of braces..

It has the advantage of  leaving the natural teeth intact and being closest to a permanent solution.
Why do we need braces?
Improves your smile

A good smile makes you attractive and also improves one's confidence levels.
Improves chewing

Having a good bite improves the function of the teeth.
Prevents other dental problems

Crooked teeth prevent maintenance of good oral hygiene. This can lead to other dental problems such as dental decay and gum diseases.
Psychological benefits

Not having a good smile can adversely affect the appearance and therefore the mental well being of an individual. It tends to make one an introvert and highly self-conscious.
Risk of trauma

Teeth that are protruding out increase the risk of trauma to them. This is more so in children during play or due to an accidental fall. Irregularly placed teeth can easily traumatise toung, lips or cheek mucosa while eating or while speaking.
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What is malocclusion?
Malocclusion can be said to be a deviation from the normal or abnormal arrangement of teeth.
Why do people have malocclusion?
Numerous are the causes of malocclusion. The following are some of the more common causes.
1. Heredity
The genes are probably the most important factors. Many disorders in the arrangement of the teeth are inherited.
Thumb sucking and other habits
Children at times tend to develop habits such as sucking of the thumb or fingers, lip sucking, lip biting,Toung thrusting etc. Presence of thumb sucking or finger sucking till 2-3 years age does not usually produce any ill effects on the teeth and the jaw bones. Continued sucking of the thumb beyond 4 years of age very often causes protrusion of the teeth and other abnormalities in the bite.
3. Use of pacifiers
Children who have used pacifiers for too long tend to develop some problems of the bite
4. Injuries
Injuries to the teeth or the bone during childhood may cause abnormalities of the bite.
5. Dental decay and diseases of the gums
If due to decay or accidental fall milk teeth have to be removed, adjacent teeth drift in to that empty space creating problem for permanant teeth to erupt.
Things that alert you to go to an Orthodontist
Parents are often worried about their children's teeth. It is a good idea to consult your dentist if you have any doubts about your child's bite. The presence of certain features should alert you to seek professional advice from a dentist.
1. If the milk teeth is shed off and the permanent teeth do not replace it.
2. Teeth that are erupting too close to one another or are crowded together.
3. Teeth that are too far apart or spaced teeth.
4. If the front teeth are too far forward and the lip does not cover the teeth.
5. Continued presence of habits such as finger sucking beyond 4 years of age often requires professional assistance to discontinue the habit and to rectify the damage done to the bite.
6. Normally the upper teeth are ahead of the lower teeth. In case the lower teeth are ahead of the upper it is called cross bite.
7. If a space exists between the upper and the lower teeth when the teeth are brought together. This is called open bite.
8. Presence of a space in the middle between the 2 incisors. This is called midline diastema.
9. Difficulty in chewing or biting
10. Difficulty in pronunciation of certain words or lisping.
11. In case your child is habituated to the use of pacifiers for too long.
12. In case one or both the parents have had orthodontic problems in the past.
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At what age should orthodontic treatment begin?
Although orthodontic treatment can be done at any age they are best carried out in young children of 8-15 years of age.
During this age it is possible for the orthodontist to foresee any dental problems that are likely to occur and can take preventive measures. This is called preventive orthodontics.
It is also possible to intercept disorders of the bite at an early stage so that it does not mature to a big dental problem. This is called interceptive orthodontics.
The jaws are actively growing by 8-10 years of age and therefore are the ideal time to mould the jaws.
The permanent teeth start erupting by 6-7 years of age and complete erupting by 12-14 years (all except the wisdom teeth). This would therefore be the ideal time to start Fixed orthodontic treatment.
What happens if the treatment is delayed?
At an early age the braces are less painful and the treatment duration is shorter. Advancing age makes the jaws harder and therefore makes it difficult to mold the jaws and to move the teeth.
As mentioned in the earlier section, in younger individuals it is possible to prevent and intercept the developing problems. But orthodontic treatment can be carried out at any age.
How long does orthodontic treatment take?
Most jaw molding and jaw corrections carried out during the growing age takes 1-11/2 years.
Do braces hurt and cause sores in the mouth
Initially for a few days after the braces are fixed, the mouth tends to be sore and some pain can be expected.
Much depends on the pain perception of the individual and his pain tolerance. However pain is expected for a few days after braces are fixed and every time your orthodontist tightens them.
Sores may develop on the cheeks or lips or the tongue after the braces are fixed. These often heal in a few days. You can use orthodontic wax to screen an area of the braces that are sharp and hurting.
In addition warm salt water rinsing of the mouth help heal the sores.
If the braces are damaged and therefore hurting the cheeks or lips you should immediately seek orthodontic consultation.
Are there any restrictions in eating when the braces are on?
Initially once the braces are fixed the mouth tends to be sore for a few days. During this period it is better to have soft food.
You should be careful in eating hard, crunchy and sticky food such as toffee, nuts, chocolates and gums as they may break the braces that are fixed to your teeth.
When you are eating fruits like apple make sure you cut them into pieces before you eat them.
What are the different kinds of braces?
Some braces that could mould the jaws
Braces that move the teeth - metallic and ceramic
kinds of braces
kinds of braces
Braces have evolved over the years. The modern day braces are smaller and have contours that are more comfortable for the tissues
Some braces move teeth while certain other appliances are used to mold the jaws during the growing period
The most common type of orthodontic braces is the metallic type.
However if you are bothered of the looks the orthodontist would fix you ceramic braces or plastic braces that are tooth colored and therefore not noticeable. These of course are more expensive and you have to shell out some more money.
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Does the orthodontist remove teeth as part of the treatment?
In case the teeth are too crowded or they are too far in front the orthodontist would advice you to remove some teeth. This depends from case to case and is decided after the final diagnosis once all the records are made.
It is not uncommon for the orthodontist to advice you to remove 2 or even 4 teeth. The teeth most often removed are the premolars that are present at the sides of the mouth.
Do I have to go back to the orthodontist after the fixation?
The orthodontist schedules an appointment after 4-6 weeks. The follow-up orthodontic appointment is every 4 weeks.
During these appointments the dentist may change the wires as the desired results are achieved and may even tighten the braces.
Teeth move very slowly (about 1mm /month). The force applied on the tooth by the braces should be tolerable by the teeth and the comfort of the patient. So the tightening is done gradually at regular appointments so that the teeth and the surrounding tissues are not hurt.
Any special oral hygiene procedures during the treatment ?
Regular brushing and flossing should be carried out. Try to brush your tooth after every meal and before sleeping.
The braces trap foodstuff under them and predispose to dental decay and gum problems. Thus good hygiene is a must when the braces are on.
The dentist may prescribe a special orthodontic toothbrush for you.
Fluorideted toothpaste may also be prescribed by your orthodontist to help prevent dental decay.
What are retainers?
Once the braces are removed the orthodontist will give you a retainer. A retainer is a removable type of braces that you can remove and replace in the mouth. These should be worn for a few months throughout the day and later for a few hours a day. The orthodontist would advice you on how long you have to wear them.
Why use retainers?
One of the greatest challenges faced by the orthodontists is the relapse of treatment. This means that the teeth tend to go back to the original position.
This occurs due to a number of factors. This is avoided by wearing the retainers that holds the teeth in the corrected position.
The retainers give time for the bone and other tissues around the teeth to adapt to the new position.
In case you are too absent minded and tend to loose your retainer or misplace them or forget to wear them you can ask the orthodontist to give you a fixed retainer that you cannot remove.
Some patients have to wear the retainer permanently.
Am I too old for orthodontic treatment?
Well to be honest you can have braces at any age provided of course that your gums and surrounding tissues are in a healthy state and you maintain good oral hygiene.
As you get older your tissues become less elastic and the bone gets harder. So the duration of the treatment is likely to be more and you tend to have more pain during the treatment.
Can the braces be fixed on the inner side of the teeth?
But I should tell you that these braces pose more discomfort to the tongue and are harder to fix and tighten for the dentist.
So the fees are naturally higher.     
braces be fixed
inner side of the teeth
Yes they are called lingual braces. The braces are fixed on the inner surface of the teeth so that they are not visible from the outside.
Not all orthodontists practice this type of treatment. So if you are interested in the lingual braces you should inform your orthodontist about your desire. Even if he does not practice lingual braces he may refer you to the right person.
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