Teeth that are crooked, crowded or that protrude affect the way you look. The way your teeth fit together can affect your bite and be more difficult to clean. If you are not happy with the way your teeth look or work, orthodontic treatment may help.

» What is orthodontic treatment?
» How orthodontics is done
» Things to consider

What is Orthodontic Treatment?

Orthodontic treatment straightens your teeth so they look and work better. It may even make your face look better, and help your jaw muscles function properly. Orthodontic treatment uses braces or other appliances to put gentle pressure on your teeth and eventually move them into the right position.

Your dentist may do basic orthodontic treatment or refer you to an orthodontist - a dental specialist with two to three years of extra university training in this area.

Why you may need orthodontics

A number of factors may affect the size and position of your teeth and jaws. Problems like crooked teeth may "run in your family." You may have a habit that affected your teeth, such as thumb-sucking. You may have lost a tooth (or teeth), and the teeth that are left may have moved or shifted.

No matter what the cause, your dentist or orthodontist can treat:

• crowded teeth;
• crooked teeth;
• an overbite, an underbite and an overjet;
• an openbite;
• too much space between teeth;
• the results of extra or missing teeth.

It's important to treat these problems because teeth that are crowded, crooked or protruding can make you unhappy with your appearance. You may be shy and unwilling to smile because of your teeth.

Teeth that are misaligned affect your bite. This misalignment can make it hard to chew some foods and may cause some teeth to wear down. It can also cause muscle tension and pain.

Crowded and crooked teeth are harder to clean. Cavities and gum disease may develop as a result. Teeth that stick out are more easily chipped or broken.

Some orthodontic problems should start to be treated before all the adult (or permanent) teeth come in. Your dentist or orthodontist can do a screening to find out if your child will have any orthodontic problems.

An orthodontic screening by the age of seven can help your dentist or orthodontist treat (or intercept) a problem as it is developing. This type of screening is called interceptive orthodontics.

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How Orthodontics is Done

There are a number of methods for treating orthodontic problems. Your dentist or orthodontist will determine which method will work best for you.

1. Braces

The dentist or orthodontist will often use braces for orthodontic treatment. There are four parts to braces:

1. the bracket or band (the metal ring) that is attached to each tooth;
2. the cement or bonding material that attaches the bracket or band to each tooth;
3. the arch wire that fits into all the brackets;
4. elastics or wire ties that hold the wire into the bracket or band.

Most of the time, brackets, bands and arch wires are made of metal, but brackets and elastics can also be clear, tooth-coloured or multi-coloured.

Your dentist or orthodontist may suggest other treatments before, during or after braces are put on the teeth. Other ways to solve your orthodontic problem that do not include braces may be suggested.

2. Headgear

Headgear is used to guide the direction of tooth movement and/or jaw growth in someone who is still growing. Headgear may be worn before braces are applied, or during any part of orthodontic treatment. There are different types of headgear. The patient inserts the headgear and in most cases, wears it during the evening and at night. Your orthodontist or dentist will show you how to insert headgear, and tell you how long to wear it each day.

3. Removable appliances

Removable appliances are not as precise as braces, but they can move a tooth or a group of teeth and are fitted by a dentist or orthodontist. They can be worn:

• before braces are put on;
• while braces are worn; or
• on their own to treat specific orthodontic problems.

4. Retainers

Retainers keep teeth in the right place once braces have been removed. Retainers can be attached to the teeth or they may be removable. Your orthodontist or dentist will tell you if you have to wear your retainer all the time or for part of each day.

5. Oral surgery

Tooth removal may be needed if teeth are crowded, or if a tooth (or teeth) is badly out of position.

Jaw surgery (or orthognathic surgery) may be needed when there are major differences in the size or position of the upper and lower jaws. It helps the upper and lower jaws line up. If your orthodontist thinks you will need jaw surgery, he or she will refer you to an oral and maxillofacial surgeon.

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Things to Consider

If you require orthodontic treatment, discuss these important factors with your dentist or orthodontist.

1. Success

To help make sure your treatment is a success and lasts a lifetime, follow the advice of your dentist or orthodontist.

In some cases, minor treatment may be needed later to correct small changes in tooth position.

2. Discomfort

There are few risks or side effects to orthodontic treatment. The few problems that do occur are most often because the patient did not follow the advice of the dentist or orthodontist.

You may feel some discomfort for a while when your braces are first put on and when they are adjusted.

3. Time

Orthodontic treatment takes time. How much time depends on your age, the type of problem, how serious it is and what treatments are used. Treatment generally involves a visit every four to seven weeks over a period ranging from six months to two or three years.

4. Care

Brushing and flossing take longer, and are even more important for people with braces, because food gets stuck around the brackets. Your dentist or orthodontist will give you tips on how to brush and floss (using floss threaders).

If you have braces, do not bite on hard things such as ice cubes, nuts or pencils. Do not eat sticky foods like gum (sugar or sugar-free) or toffee. They can loosen brackets and pull them off your teeth. Your treatment will take longer as a result.

Parents should supervise their children to make sure they do a good job cleaning their teeth and braces, and that they follow their dentist's or orthodontist's advice.

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