Stages of orthodontics
Orthodontic treatment usually begins with examining the patient's condition, studying the position of the teeth in the mouth, and determining the final change desired upon completion of the braces. The doctor uses X-rays for this purpose, the most common of which are panoramic X-rays, which help examine the position of the upper and lower teeth in both jaws and how they close. The doctor may also make plaster models that simulate the position of the teeth, determine their size, and how they close. In some cases, digital models of the teeth can be made by scanning on a computer, so the doctor can study the case more accurately and more easily. It may also be necessary to take a set of photographs of the position of the teeth, and then the doctor chooses the type of braces appropriate for the patient's condition. It is worth noting that the orthodontist does not begin the treatment phase unless the patient has clean teeth and good oral health; This is because braces increase the risk of tooth decay.
Orthodontic treatment involves a series of stages that begin with placing braces, whether fixed metal or clear aligners, followed by a stage of regular periodic adjustments that aim to rearrange the teeth, and then ends with the use of retainers after the braces are removed.
Calendar setting stage
Orthodontic appliances are divided into fixed and removable. The doctor determines the appropriate brace based on the initial examination of the patient mentioned above, where he develops a treatment plan specific to each case. The doctor often uses fixed braces that stick to the teeth temporarily until the end of treatment, but if the required modification to the teeth is minor, the doctor resorts to using the removable type or what is known as the transparent brace instead of fixed braces.
Fixed braces installation
The fixed calendar includes the following components:
- Brackets : Brackets are attached to the outer surfaces of the teeth, or they may be fixed to the back of the teeth to hide them. These brackets are made of materials such as stainless steel or ceramic, which are transparent or close to the color of the teeth, or other materials. With scientific and technological progress, modern metal brackets have become smaller in size and are not clearly noticeable in the mouth.
- Molar bands: These are metal rings made of either stainless steel or titanium that surround the upper and lower back molars. To facilitate their placement around the molars, the dentist creates a small space between the molars with rubber bands.
- Flexible wires: The wires connect all the brackets and metal bands together and are responsible for the movement of the teeth.
- Small rubber or metal bands: to ensure the wires are connected to the brackets. Other larger bands may also be used to help move the teeth, so that they are connected between the upper and lower jaws with a specific mechanism depending on the case to generate a certain pressure on the teeth and move them in the desired direction.
- Headgear: The headgear is connected to the braces via tubes inside the mouth to create additional pressure on the teeth so that they move as they should. The headgear is usually used in complex cases, and is often worn only at night.
- Temporary Anchorage Devices (TADs) are sometimes used as an alternative to rubber bands and headgear. They are small screws that are inserted into the jawbone through the gums to increase the pressure on the teeth so that they move.
Transparent movable aligner
The patient wears the removable clear braces in both jaws daily, for a period ranging from one to three weeks, for as long as possible during the day, except for mealtimes or brushing teeth, until it is replaced with a new brace; to repeat the process again for a period that may reach nine months or more to achieve satisfactory results. It is worth noting that drinking beverages is also prohibited while wearing the braces, except for water, with emphasis on the need to clean the teeth after eating each time before wearing it again. It is also recommended to use dental floss at least once a day.
Periodic amendments
After placing the braces, the patient needs to visit the doctor periodically and regularly to make the necessary adjustments and examine the braces, at a number of times determined by the orthodontist usually according to the patient's need, and the visit is usually every four to six weeks. These adjustments include tightening the rubber bands used to fix the wires; as they weaken over time, which makes them lose the ability to generate the required pressure on the teeth to move them to the desired place. During the adjustment sessions, the doctor also monitors how the teeth move and the mechanism of the treatment process to do what is necessary in order to obtain the best possible result. During the adjustment session, the rubber bands and wires connecting the metal supports may also be removed, which allows the patient the opportunity to clean the teeth properly, before re-installing new wires and rubber bands to complete the treatment and move the teeth. The doctor may also find during the adjustment sessions that the patient's condition requires alternative treatment options, so he discusses them with the patient to achieve the best possible results.
It is also worth noting that these modifications may cause toothache due to the increased pressure generated on them from the tension of the ligaments, which usually goes away after 4-6 hours from the end of the session. The patient is advised to take over-the-counter pain relievers to relieve the pain, such as those taken after installing the braces for the first time.
To learn more about how to install braces, you can read the following article: (How to install braces) .
Remove the calendar
The specialist removes the braces when the treatment is finished. The procedure of removing the braces is simple, easy, and painless. The doctor presses on the base of the brackets and removes the adhesive to pull the brackets and lift them. He also cuts the ligaments connecting the brackets to the teeth in a way that ensures the safety of the latter and does not scratch them. It is worth noting that when removing the brackets, the doctor ensures that the adhesive is not removed from the teeth in the meantime to prevent damage to the enamel and other parts of the tooth. Then, he cleans the teeth of the adhesive immediately after removing the brackets completely with the same air drilling hand piece that the doctor uses to drill the teeth and clean the cavities, but with less pain because what is removed here is only the adhesive without any damage to the surface of the tooth. As for the gum inflammation accompanying the removal of the braces, it is slight and disappears after a few days by cleaning the teeth and taking care to use dental floss.
To learn more about how to remove braces, you can read the following article: (How to remove braces) .
Installer mode
A retainer is a removable or fixed mold made to fit the patient's teeth. The retainer is placed no more than two weeks after the braces are removed to prevent the teeth from returning to their old position and to hold the teeth in their new position. This is because teeth that have been repositioned due to braces require the bone, gums, and surrounding muscles to adapt to the new tooth positions. A retainer can also be used to treat minor dental problems instead of braces.
The length of time a patient needs to wear a retainer varies from person to person, but usually the patient wears the retainer, whether made of rubber, clear plastic, or metal wires, for a period of six months throughout the day, and then it is only worn during sleep. It is worth noting that the growth process affects the change in the position and movement of the teeth; therefore, using a retainer is necessary to maintain the straightness of the teeth after the end of treatment.
Surgery and tooth extraction
Some severe cases require surgery in addition to the use of fixed braces to move the entire jaw. This surgery is known as orthognathic surgery. This surgery is usually performed in the hospital and is only resorted to if the differences between the size and position of the jaws are so great that braces alone are not sufficient to fix them. Some cases also require the extraction of some of the patient's teeth before installing the braces, especially when there is no room in the jaw for all the teeth or in cases where it is difficult to adjust the position of the tooth. It is worth noting that it is preferable to extract wisdom teeth if they begin to appear after removing the braces for fear of their effect on the new straightness of the teeth.
Results after the end of the evaluation
The success of orthodontics depends on the skill of the orthodontist and the patient's patience and commitment to following the instructions accurately and the periodic visits recommended by the specialist, especially in the final stages of orthodontics and when starting to use the retainer. In general, orthodontics is an effective treatment for rearranging the teeth and helping to correct the position of the jaws to obtain a beautiful smile and maintain oral health. It is worth noting that if the patient is a child, the success of the orthodontics requires the cooperation of both the guardian and the child together.
The time required for orthodontics
The period of time required for orthodontics is determined based on the patient's age, the severity of the condition, and the treatment technique used. As mentioned above, the treatment phase includes a series of periodic and regular visits to the dentist or specialist for a period that may extend from several months to years. In general, the treatment period lasts longer for adults compared to children and adolescents. As for wearing fixed braces, most people wear them for 1-3 years, i.e. an average of two years, followed by a period of commitment to wearing the retainer to maintain the shape of the teeth after braces.
