Crooked teeth are straightened by the use of special devices and techniques [orthodontics]. An orthodontist is a dentist who has been specially trained to use a selection of braces (orthodontic appliances), both fixed and removable, to improve the appearance and health of the teeth and gums.
In general, orthodontic treatment is undertaken for two different groups: children, typically aged between 12 and 14 years old, or adults. The specific timing of treatment will, however, vary from patient to patient. A dentist is the first person to speak to. Based on the concerns, a decision will be made, if appropriate, to refer to an orthodontist.
The orthodontist will need to know what particular concerns there are about the teeth. He or she will undertake a detailed examination and possibly take x-rays and photographs of the face and teeth. Before deciding on the best course of treatment, the orthodontist will also take moulds of the teeth. The orthodontist will then explain the preferred course of treatment to obtain the best results. Options will be discussed as well as any potential problems and/or limitations with the proposed treatment.
The orthodontist may ask the dentist to remove one or more of either:
a) Baby teeth – Occasionally baby teeth stay in the mouth for longer than they should and delay the adult teeth coming through. In these cases, their removal will significantly help.
b) Adult (permanent) teeth – Many people have too many teeth for the size of their jaws and so the removal of some of the adult teeth may be needed to make space to straighten the crooked ones. The decision to remove teeth is never taken lightly and is based on careful consideration of the position of the teeth and how they bite together. If the teeth are not too crooked, it may be possible to have treatment without having any removed. In this case, it will usually involve the patient having to wear a night brace (head-gear) in order to make room to straighten the teeth.
The following factors could delay the start of treatment:
The number of adult teeth in the mouth.
Orthodontic treatment that involves the use of fixed braces usually starts when all the adult teeth have appeared in the mouth. However, a removable brace can be fitted at an earlier age if it is necessary.
The general condition of the teeth and gums.
If there is dental decay or gum disease, orthodontic treatment will need to be delayed until it is treated. If it is not, there is a real risk of both the decay and the gum disease getting worse when a brace is fitted.
The presence of a waiting list for treatment.
There is a great demand for orthodontic treatment and relatively few specialist orthodontists. As a consequence, there is often a delay in receiving treatment.
The time needed to effect the necessary corrections very much depends on:
How crooked the teeth are.
The more complicated the problem, the longer the treatment is likely to take; eg teeth that have failed to grow into the mouth properly can take up to two years to straighten.
The type of brace.
Once the brace (fixed or removable) has been fitted, visits to the orthodontist at 4-6 week intervals will be needed in order to monitor progress and have the brace adjusted. It is very important to continue with regular check-ups with a dentist to ensure that the teeth and gums remain in the very best condition possible throughout the treatment.
It is essential to ensure that both the teeth and the brace are kept as clean as possible. Any particles of food and plaque left around the brace means that you are more at risk of developing tooth decay or gum disease. The orthodontist, dentist or hygienist will advise about the use of any special toothpastes, brushes or mouth rinses to help keep your mouth as healthy as possible during your orthodontic treatment.