This section explains
the various stages of a normal course of orthodontic treatment.
The first consultation
During this visit the patient is examined clinically by
our Orthodontist, Dr. RAHUL PAUL.
This enables him to give advice on the treatment options available, when
treatment should commence, the duration of treatment, and the approximate
If the patient decides to proceed with treatment, an appointment is
made to collect records.
- Impressions from which plaster models of the teeth
- Photographs of the teeth and face.
- X-rays of the teeth and jaws.
Records allow the orthodontist to analyse each case accurately. They
are also used to record the existing malocclusion for future reference.
At this visit the orthodontist discusses the treatment
plan(s), which have been formulated using information obtained from the
first consultation and records.
Then, arrangements are made to commence treatment or, if it is too early,
to review the patient periodically until it is an appropriate time to
Extractions and other preliminary procedures
Sometimes it is necessary to remove teeth to gain sufficient
space to align the remaining teeth. Any decayed teeth should be filled
and the teeth sometimes need to be cleaned before orthodontic treatment
The patient is referred back to the family dentist to have these preliminary
procedures carried out. The cost of these procedures is not included in
the orthodontic fee.
Braces are the most efficient and accurate way of moving teeth.
Braces (bands, brackets and wires) are usually made of stainless steel
although clear brackets are available, usually at extra cost.
Fitting the braces usually involves two visits. Braces remain on the
teeth for the entire duration of treatment.
Patients then attend approximately every 4-8 weeks for adjustments, wire
Rubber Bands and Headgear
During treatment, patients may need to wear such items as rubber bands
and/or headgear with their braces. These items provide important extra
forces for the correction of the bite.
Orthodontic treatment usually takes 18 - 24 months. Some
cases may be finished earlier and others may take longer to complete.
The total treatment time depends on the severity of the original malocclusion,
the type of treatment carried out, and the co-operation of the patient.
Orthodontic patients should continue to attend their family
dentist for regular check-ups during the course of orthodontic treatment.
At the completion of the active part of orthodontic treatment,
the braces are removed and retaining appliances (retainers) are fitted
to hold the teeth steady in their new position. These appliances may be
removable plates or wires fitted behind the teeth.
Retainers play an important role in orthodontic treatment for, if they
are not worn according to instructions, the teeth may move back towards
their original position.
The retaining appliances are usually worn:
- Full-time for up to one year
- Just at night for a further year
- Phased out altogether over one more year
The corrected teeth are observed periodically for up to five years after
the retainers have been phased out. During retention and the subsequent
observation period, patients are expected to attend once or twice a year.
Orthodontics for children
what age should a child have an orthodontic examination?
A. Age 7, unless
you suspect a problem at an earlier age, because most facial asymmetries
are likely to be apparent by that time. A timely screening will lead to
extraordinary treatment benefits. For others, the principle benefit is
peace of mind.
are children being evaluated at such an early age?
A. Early diagnosis
and treatment can guide erupting teeth into a more favorable position,
preserve space for the permanent teeth and reduce the likelihood of fracturing
protruded front teeth. Also, early treatment may shorten treatment time,
make treatment easier and in some cases less expensive. It may even provide
advantages that are not available later.
Is orthodontic care expensive?
therapy may eliminate the need for other medical and dental treatment.
The physical and psychological benefits usually last a lifetime, which
makes orthodontics one of the best investments in healthcare and quality
What is the psychological impact of early treatment?
A. Appearance has
been related to popularity, social behaviors, self-expectation, personality
style, and self-esteem. Orthodontic therapy may lessen the likelihood
that a child will be picked on by other children. Treatment may reduce
appearance-consciousness and the emotional scarring that can occur during
critical developmental years. Also, as adolescents enter the sensitive
teenage years, they become far less receptive to orthodontic therapy.
addition to esthetic improvements, what are some other benefits of orthodontic
A. Additional benefits
may include better function, improved cleanability, more favorable wear
patterns and greater longevity of natural teeth.
is the growth spurt at puberty so important in orthodontics?
A. This is the
time when much of the development of the face occurs. Treatment during
this period allows the orthodontist to favorably influence the facial
profile in a growing child. Once growth of the facial bones is complete,
correction of skeletal discrepancies usually requires surgery.
I'm not sure about the need for orthodontics, how should the patient he
A. If in doubt,
refer. If you notice a problem and refer to a specialist, your legal and
professional responsibilities are fulfilled. Also, an early referral can
avoid more complex problems that may worsen with time.
the problem with waiting until the permanent teeth erupt to refer?
A. The problem
may be one of opportunities missed with respect to growth and development.
While patients can be treated at any age, those with available growth
may enjoy a substantial advantage. Timely treatment may prevent the need
for jaw surgery, extraction of permanent teeth, or fracture of protruded
incisors. Early treatment may also help the psychological development.
Patients also benefit from guidance of tooth eruption.
Orthodontics for Adults
what age is a patient too old for orthodontics?
A. Patients who
have teeth and healthy supporting structures are never too old for orthodontic
therapy. Age is not a factor.
How can I tactfully approach an adult patient who could benefit from orthodontics?
A. Ask the question:
"Are you happy with the appearance of your teeth?" The ill be
your guide to further answer will be your guide to further development
of the conversation.
Why are adults seeking orthodontics in increasing numbers?
A. Many adults
are receiving orthodontic care that was not available to them as children.
They realize that improving the health of their mouths and the attractiveness
of their smiles and facial appearances can result in changes for the better
in their personal, social, and professional lives. Technical advances
have also had an impact on adult therapy.
are some of those advances?
A. Advanced technology
has produced small tooth-colored brackets that are barely noticeable.
Specially alloyed wires are more comfortable, can speed up treatment,
and may decrease the number of necessary appointments. New retainers can
be placed where they do not show. Also, advanced surgical techniques now
allow treatment of many skeletal problems after growth is completed.