Patient Information: Orthodontics


The four options to move your teeth:


1.  Conventional fixed appliance;

2.  Lingual fixed appliance;

3.  Removable appliances;

4.  Clear aligners

 Orthodontic treatment leaves the patient with a smile they are proud of. They can be reassured that when the camera man says calls for cheese they will have the perfect smile.  It’s a treatment options for all ages.  Although I am not on the specialist register I worked at specialist Orthodontic practice for over 5 years.   I was part of a team which would complete 350 braces a year. The majority of these treatment were completed using  conventional fixed and removable appliances on teenagers.  This has given me a a solid base of experience in orthodontics.  You should always keep in mind the teeth are surrounded by bone which will re-shape around teeth when the correct, type and direction of force is applied, but this process needs time.  Being patient and moving teeth gently, slowly and predictably gives greater long term stability and reduces the risk of side effects. Clear aligners can be used for small tooth movements of less than 3-4mm

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Conventional fixed appliance

A fixed appliance is the classic train track appliance.  Small blocks (brackets) are glued to the teeth at the front of your mouth. Sometimes teeth at the back have metal bands pushed over them to support the brace during chewing.  Once the top and bottom teeth have some sort of attachment it is time to time place a wire between the brackets and hold them in place with small elastic bands called ligatures.

Every 6 to 8 weeks the wire and ligatures are replaced.  Eventually the wire unravels the teeth, the brackets are removed and the teeth cleaned. Not all brackets are metal, white/clear brackets are more aesthetic and are available

How long does it take?

The period of time it takes a for this process differs with patients.  For a teenager with soft bone on average the process takes 18 months to three tears.  The harder bone of adults prolongs the treatment which can add an extra 12 months


Does it hurt?

Fitting the brace takes upto an hour and is painless.  Every time a new wire is fitted to the brace your teeth may be tender for 12 hours after the procedure.  Using the same painkiller you would use for a headache will help to overcome this discomfort.


Lingual Fixed Appliance

Lingual means tongue.  A fixed lingual appliance is similar to a conventional fixed appliance accept it sits on the surface of the tooth which is nearest to the tongue.  This means it can’t been seen. It takes a similar period of time to a conventional fixed brace. The bracktes can irritate your tongue initially.  The brackets and wires are custom made and as a result this increases the cost of the treatment.

Removable Appliances

A removable appliance is brace which can be taken out.  They can be used for many different tooth position problems from moving individual teeth with custom made springs to influencing the growth of a jaw in a adolescent.  They require fastidious wearing in order to be effective.  They can not be used for all teeth position problems and are sometimes used as an initial treatment prior to a conventional fixed appliance.

 Clear aligners

Clear aligners are the latest evolution in moving teeth.    From a mould of your teeth clear trays are made. The trays are made with a 3D scanner. A computer image is used to make small adjustments to the tray to move individual teeth.  Each trays is worn for a couple of weeks then the next trays is used until the teeth have moved.  They are not a direct replacement for a conventional fixed appliance and are suited for small movements of teeth of less then 4mm.

Further information:


http://www.bos.org.uk/Public-Patients/Orthodontics-for-Adults

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