Orthodontic Treatment Phases
Orthodontic treatment is highly predictable and immensely successful. Depending on the severity of the malocclusion (bad bite) or irregularity, orthodontic treatments may occur in either two or three distinct phases.
The benefits of correcting misaligned teeth are many. Straight teeth are pleasing to look at and greatly boost confidence and self esteem. More importantly, properly aligned teeth enhance the biting, chewing and speaking functions of the jaw. There are several types of irregularities, including:
Overbite – The upper teeth protrude further than or completely cover the lower teeth.
Underbite – The lower teeth protrude further than the upper teeth causing the chin to look prominent.
Crossbite – Some of the upper teeth may close inside the lower teeth rather than on the outside.
Overcrowding – Insufficient room on the arch causes some adult teeth to erupt incorrectly and become rotated.
The Phases of Orthodontic Treatment
Generally, orthodontic treatment takes between six and thirty months to complete. The treatment time will largely depend on the classification of the malocclusion, the type of dental devices used to correct it and the perseverance of the patient.
Here is a general overview of the three major stages of treatment:
Phase 1 – The Planning Stage
The orthodontist makes an exact diagnosis in order to realign the teeth in the most effective and expedient way. The first several visits may comprise of some of the following evaluations:
Medical and dental evaluations – Dental and physical problems tend to go hand in hand. Problems in the oral cavity can lead to (or be caused by) medical problems. The goal of this evaluation is to ensure that prior medical and dental issues are completely under control before treatment begins.
Study model (castings/bite impressions) – The patient is asked to bite down into a dental tray filled with a gel substance that hardens around the teeth. The trays are removed from the teeth and filled with plaster to create models of the patient’s teeth. Study models enable the orthodontist to scrutinize the position of each tooth, and how it relates to the other teeth.
Panoramic X-rays – X-rays are fantastic tools for viewing potential complications or pre-existing damage to the jaw joint. X-rays also allow the orthodontist to see the exact position of each tooth and its corresponding root(s).
Computer generated images – Such images allow the orthodontist to treatment plan and examine how specific treatments may affect the shape of the face and symmetry of the jaw.
Photographs – Many orthodontists like to take “before, during and after” photographs of the face and teeth to assess how treatment is progressing, and the impact the treatment is having on the patient’s face shape.
Phase 2 – The Active Phase
All of the above diagnostic tools will be used to diagnosis and develop a customized treatment plan for the patient. Next, the orthodontist will recommend custom orthodontic device(s) to gently move the teeth into proper alignment. This orthodontic appliance may be fixed or removable. Most commonly, traditional fixed braces are affixed, which utilizes individual dental brackets connected by an archwire. Lingual braces are also fixed, but fit on the inside (tongue side) of the teeth to make them less visible.
Removable devices are an alternative to fixed braces. Examples of removable devices include the Invisalign system, headgear and facemask. These devices are designed to be worn for a specified amount of hours each day to expedite treatment.
Whatever the orthodontic device, the orthodontist will regularly adjust it to ensure adequate and continual pressure is being applied to the teeth. It is essential to visit the orthodontist at the designated intervals and to call if part of the device breaks or becomes damaged.
Phase 3: The Retention Phase
When the teeth have been correctly aligned, fixed braces and removable devices will be removed and discontinued. The most cumbersome part of the orthodontic treatment is now over. The orthodontist will next create a custom retainer. The goal of the retainer is to ensure that the teeth do not begin to shift back to their original positions. Retainers need to be worn for a specified amount of time per day for a specified time period. During the retention phase, the jawbone will reform around the realigned teeth to fully stabilize them in the correct alignment.
If you have any questions about orthodontic treatments, please contact our office.
Early Orthodontic Treatment
Orthodontic treatment is primarily used to prevent and correct “bite” irregularities. Several factors may contribute to such irregularities, including genetic factors, the early loss of primary (baby) teeth, and damaging oral habits (such as thumb sucking and developmental problems).
Orthodontic irregularities may be present at birth or develop during toddlerhood or early childhood. Crooked teeth hamper self-esteem and make good oral homecare difficult, whereas straight teeth help minimize the risk of tooth decay and childhood periodontal disease.
During biannual preventative visits, your pediatric dentist is able to utilize many diagnostic tools to monitor orthodontic irregularities and, if necessary, implement early intervention strategies. Children should have an initial orthodontic evaluation before the age of eight.
Why does early orthodontic treatment make sense?
Some children display early signs of minor orthodontic irregularities. In such cases, your pediatric dentist might choose to monitor the situation over time without providing intervention. However, for children who display severe orthodontic irregularities, early orthodontic treatment can provide many benefits, including:
- Enhanced self-confidence and aesthetic appearance.
- Increased likelihood of proper jaw growth.
- Increased likelihood of properly aligned and spaced adult teeth.
- Reduced risk of bruxing (grinding of teeth).
- Reduced risk of childhood cavities, periodontal disease, and tooth decay.
- Reduced risk of impacted adult teeth.
- Reduced risk of protracted orthodontic treatments in later years.
- Reduced risk of speech problems.
- Reduced risk of tooth, gum, and jawbone injury.
When can my child begin early orthodontic treatment?
Pediatric dentists recognize three age-related stages of orthodontic treatment. These stages are described in detail below.
Stage 1: Early treatment (2-6 years old)
Early orthodontic treatment aims to guide and regulate the width of both dental arches. The main goal of early treatment is to provide enough space for the permanent teeth to erupt correctly. Good candidates for early treatment include: children who have difficulty biting properly, children who lose baby teeth early, children whose jaws click or grind during movement, bruxers, and children who use the mouth (as opposed to the nose AND mouth) to breathe.
During the early treatment phase, your pediatric dentist works with parents and children to eliminate orthodontically harmful habits, like excessive pacifier use and thumb sucking. The dentist may also provide one of a variety of dental appliances to promote jaw growth, hold space for adult teeth (space maintainers), or to prevent the teeth from “shifting” into undesired areas.
Stage 2: Middle dentition (6-12 years old)
The goals of middle dentition treatments are to realign wayward jaws, to start to correct crossbites, and to begin the process of gently straightening misaligned permanent teeth. Middle dentition marks a developmental period when the soft and hard tissues are extremely pliable. In some ways therefore, it marks an optimal time to begin to correct a severe malocclusion.
Again, the dentist may provide the child with a dental appliance. Some appliances (like braces) are fixed and others are removable. Regardless of the appliance, the child will still be able to speak, eat, and chew in a normal fashion. However, children who are fitted with fixed dental appliances should take extra care to clean the entire oral region each day in order to reduce the risk of staining, decay, and later cosmetic damage.
Stage 3: Adolescent dentition (13+ years old)
Adolescent dentition is what springs to most parents’ minds when they think of orthodontic treatment. Some of the main goals of adolescent dentition include straightening the permanent teeth and improving the aesthetic appearance of the smile.
Most commonly during this period, the dentist will provide fixed or removable “braces” to gradually straighten the teeth. Upon completion of the orthodontic treatment, the adolescent may be required to wear a retainer in order to prevent the regression of the teeth to their original alignment.