What is an orthodontist? What problems can orthodontics solve?

Jack Lawrence

Written by Jack Lawrence DMD, Richard Hattaway DDS

An orthodontist is a doctor that deals with irregularities of the face and jaws. They use oral appliances that help put the teeth into the correct position for both function and esthetics. Each step of the treatment is monitored in case there is a need for a change.

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Orthodontist vs. other dental specialists

Orthodontists focus on dental movement as well as jaw and bite alignment. Some states in the US do not allow you to see an orthodontist without a direct referral from a primary dental care provider. Your teeth and mouth must be healthy enough for orthodontic treatment.

Orthodontist schooling involves 4 years of dental school followed by at least 3,700 hours of specialized training. This usually spans out over 2-3 additional years. According to the American Association of Orthodontists, 6% of dentists are orthodontists.

What makes up orthodontics?

Orthodontics is one of dental specialties. Its aim is to monitor tooth development and alignment. Even though orthodontics is mainly seen as part of pediatric dental care, more and more adults decide to undergo teeth straightening treatment. In fact, statistics show that 1 in 4 orthodontic patients is an adult.

The following are the most popular treatments conducted by orthodontists overall.

Braces

Metal braces

Picture by Authority Dental under CC 2.0 license

Braces are the most common fixed appliances used to straighten teeth. They are made from metal wires which are held together by brackets cemented onto the teeth. The wires are gradually tightened, which forces the dentition to align.

Patients with braces have to make a dentist appointment regularly, usually monthly. This visit consists of tightening the wires a little more each time. The whole process can even take a few years, but this is usually not more than 2. Many patients describe the experience as quite painful.

Invisible aligners

Full Invisalign treatment

Picture by Authority Dental under CC 2.0 license

Invisible aligners are an alternative to traditional braces. They are often used by adult patients. This is because they offer more flexibility and the process is covert, as the trays are harder to spot.

The most popular brand of clear aligners offered by professionals is Invisalign. Each tray is made one by one and the treatment can be moderated according to the effects achieved. Invisalign providers also include regular dentists who are specially trained.

Retainers

Invisible retainers

Picture by Authority Dental under CC 2.0 license

Retainers can be removable or fixed. The 2 types can be used at the same time for optimal results. They are used after orthodontic treatment to prevent teeth from reverting to their original position. Another application of theirs is to make thumb sucking impossible.

They are metal or clear plastic and custom-made. Patients usually have to wear them for the rest of their life, unless recommended otherwise by their orthodontist. Fixed ones are critiqued on the subject of their tendency to make cavities and gum disease more common. This is because they may make upkeeping proper hygiene difficult.

Fixed space maintainers

Fixed space maintainers are frequently taken advantage of with children. They are needed when a baby tooth falls out earlier than expected. This appliance keeps the space open for the permanent dentition. It prevents movement of other teeth into that area.

Space maintainers are made from metal. They hook onto neighboring teeth and have “loops” that prevent them from shifting closer together.

Palatal expander

When the upper arch is too narrow, teeth start to crowd and the bite may become misaligned. In order to aid this, palatal expanders are used. They do what the name suggests. They push away opposing teeth to make the palate wider.

The appliance consists of metal hoops that are attached to molars. A metal wire or plastic plate is placed between them to push them away from each other. A palatal expander may cover a significant area of the roof of the mouth.

Headgear

Orthodontic headgear is usually used when there is significant protrusion or retrusion of an arch. You may have heard of most common terms such as severe over- and underbites. This is when the teeth do not align properly at the front.

The fix is using a removable device that includes a strap. It is placed around the head to force teeth and jaws into position. Orthodontic headgear is more popular with children than adults and worn at night. Nonetheless, this treatment is becoming obsolete due to newer techniques.

Teeth straightening surgery

This solution is extreme and used in very complex cases only. The benefits include accelerated effects. Nonetheless, surgery is usually only a stage of orthodontic treatment. Patients normally wear braces as well, only for a shorter period of time.

Surgery is recommended for patients with over- or underbites as well as jaw misalignment. It is done under anesthesia. The teeth and gums are repositioned. There is a risk of complications, so it is usually not advised unless the problem is severe.

FAQ

They rarely do. General dentists pull teeth at times. If the situation is complex, you may be referred to an oral surgeon. This happens with impacted teeth.

The rule of thumb is to visit an orthodontist before your child turns 7 years old. If at any time before that a general dentist ascertains that an orthodontic visit is required, they will let you know.

Most orthodontic treatments last between a few months up to about 4 years. It really depends on your particular situation.

Yes. In fact, it is becoming more and more popular for adults to visit an orthodontist, especially for cosmetic reasons. It seems that a perfect, Hollywood smile is no longer a want, it is a need!

References

  1. 2017 Orthodontic Workforce Report - AAO
  2. Adult’s guide to orthodontics - AAO
  3. Simple Fixed Functional Space Maintainer - NCBI
  4. Palatal Expander - ScienceDirect
  5. reatment of dental and skeletal bimaxillary protrusion in patient with Angle Class I malocclusion - Scielo
  6. When Do Skeletal Class III Patients Wear Their Reverse Pull Headgears? - Hindawi