Orthodontics (Braces)

By Joseph Preziosi Jr., DMD

Orthodontics is the art of moving, repositioning or maintaining the position of teeth. This can be done by removable appliances, such as retainers or mouth guards, fixed orthodontic appliances, such as thumb sucking or thumb thrusting appliances or by brackets or bands that are usually referred to as braces. The treatment option of choice is related to the specific needs of each specific patient.

Generally, the more teeth that are involved and the more their position needs to be altered the more likely that braces will be needed and the longer the treatment time to achieve the desired result. Conversely, the fewer teeth that need to be repositioned and the less they need to be moved the more likely a removable appliance can be employed and the shorter the treatment time required to achieve the desired result. After successful repositioning of the teeth the patient will often have to have an appliance made that maintains the new position of the teeth and helps prevent relapse, or the unwanted movement of the teeth out of their newly established ideal position towards their original misalignment.

The consequence of not completing this last stabilizing step can often times result in teeth that are in no better position than they originally were prior to treatment. Thus rendering the time and expense, including the physical, psychological and monetary components, of the initial tooth movement and repositioning phase of treatment a complete waste.

As with all quality dental care the first and foremost aspect of braces or any tooth movement therapy is proper diagnoses and treatment planning. This initial step in braces will always include, but is not limited to, radiographs (X-rays) and diagnostic models of the patient’s moth as they first present prior to any orthodontic treatment. The radiographs (X-rays) will usually consist of a panoramic film and a cephalometric series to evaluate the pretreatment tooth position and the bony architecture of the upper and lower jawbones. Sometimes malpositioned teeth are not due to the teeth being in the wrong position in the jawbone but the jawbones being in the wrong position. This can be caused by the inadequate growth of one or both of the jawbones, the excessive growth of one or both of the jawbones or the misorientation of one or both jawbones relative to the rest of the skull. It is critical to determine what is causing the malposition of the teeth prior to any treatment because some of the aforementioned conditions lend themselves to treatment with braces, while other conditions require oral surgery, and still others will require a multidisciplinary approach that will incorporate braces and oral surgery. Models also assist in the planning of treatment and allow for proper band size selection prior to the patient’s banding visit when bands are needed.

Today most orthodontic cases do not use full bands that encircle the teeth. Instead brackets are bonded on the facial side of the teeth, that’s the side that faces out towards the lips and cheeks. The brackets come in a variety of colors and in clear that makes their detection much more difficult, especially from a distance.

For some cases a series of clear removable appliances may be applicable that are sold under the trademark of Invisolign. For the cases that can be treated by this method braces may be avoided altogether, thus eliminating what most patients perceive as the most unsightly aspect of braces and tooth movement.

However, it is important to realize that only a small percentage of patients will have the type of orthodontic cases that will lend itself to this particular type of treatment.

About the Author:

Joseph Preziosi Jr., DMD
New Jersey Cosmetic Dentist
phone. (908) 654-7100
fax 908-654-8764
email: Drpreziosi@aol.com
url: http://www.preziosidentistry.com/