Dental Braces

Dental Braces

Getting your teeth straightened with braces can make a big difference for many people. For many young people, orthodontic treatment often means a change in the way they see themselves and their appearance.

You may need braces when your teeth have grown crooked, are too crowded or something else in your bite needs to be improved. Such treatment is called orthodontic treatment. Braces are most common in young people, but can be used at any age.

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Orthodontics

The most common reason for orthodontic treatment is that the teeth are not in an even row. This can be bites where the teeth have twisted, teeth that are tilted in one direction or teeth that are crowded and on top of each other. It may also be that the jaws do not fit together and therefore the teeth do not fit together.

Why is orthodontic treatment performed?

There can be several reasons why you want to straighten your teeth. You may not be happy with your appearance and therefore want to straighten your teeth with braces even if there is nothing wrong with the bite.

The most common reason for getting braces is when you have something wrong with your bite. Usually it’s the upper and lower jaws that don’t meet properly when you bite together:

– With an overbite, the front teeth of the upper jaw protrude well ahead of the teeth in the lower jaw. This can make it difficult for the lips to meet. Teeth can be damaged more easily if you fall or play sports.

– In an underbite, the teeth in the lower jaw bite in front of the teeth in the upper jaw. Because the front teeth don’t meet properly, you may find it difficult to bite off and chew.

– In an open bite, the teeth in the front or sides of the mouth are not in contact with each other. It can be difficult to eat because you can’t bite or chew properly.

– In a deep bite, the front teeth of the lower jaw bite far up into the palate behind the front teeth of the upper jaw. Sometimes the front teeth of the lower jaw make small wounds in the palate.

Orthodontic treatment may also be needed to make it easier to insert dental restorations such as bridges or implants. Orthodontics is also used if you need to have jaw surgery.

How is a bite deviation detected?

Bite abnormalities are usually detected during regular dental check-ups.

In children, the dentist often finds that orthodontics are needed when a child has started to get permanent teeth but still has some baby teeth. In this case, the dentist may need to remove some of the baby teeth in order for the permanent teeth to emerge. Sometimes a removable brace or a simpler fixed brace is then needed for about 1-1.5 years.

You can contact a dentist or a specialist orthodontic clinic if you are concerned about the position of your teeth or if you have a bite defect. General dentists can usually perform some simple procedures, especially on young children.

Usually a specialist dentist will carry out the orthodontic treatment in a clinic with special equipment. A specialist dentist is also called an orthodontist. This is why you need a referral to a specialist dentist.

Sometimes a jaw operation is needed

Sometimes orthodontic treatment needs to be done together with an operation on the jaw. This may be necessary when the upper and lower jaws have grown differently and made the teeth not fit together at all when you bite. In this case, orthodontic treatment is needed both before and after the operation.

The jaw must have grown completely before both orthodontic treatment and jaw surgery are performed. It is up to the dentist to decide when the treatment can be done. You will be sedated during the operation, which is carried out in hospital by a dental surgeon.

Preparations

Before you have braces, the specialist will carry out a thorough examination of your bite, jaws and face. X-rays of your teeth and jaws will be taken.

An impression of your teeth is also taken with a soft tissue or the bite is scanned with a camera. This is then used to make a model of your teeth.

Your teeth and face will also be photographed.

You will be given a treatment proposal and an estimate of how long the treatment will take. You will be given information about what will be done, why and how the braces will be managed.

How the treatment works

There are two types of braces:

– One is removable, which you can put on and take off yourself.

– One that is glued to the front or back of your teeth.

Removable braces

Removable braces can be used when teeth only need to be moved a little, for example to tip a tooth into the right position. Sometimes you can adjust the braces yourself.

The dentist will then check and tighten the braces regularly.

Fixed braces most common

Fixed braces are most commonly used. Not all types of tooth movement can be done with a removable brace.

Braces consist of metal plates and a metal bar. The metal plates are also called brackets and the whole brace is sometimes called a rail. The dentist attaches small metal plates to the teeth with a special glue. The metal bracket that will move the teeth is then attached to the metal plates with small rubber bands or steel wires.

There is no sensation when the braces are attached and you do not need an anaesthetic.

The plates remain on the teeth for the duration of the treatment while the metal brackets are replaced. You start treatment with a very thin archwire, which is then changed to a slightly thicker archwire as your teeth become smoother.

Teeth are removed and others are moved

Sometimes it may be necessary to remove teeth, for example if the teeth are very crowded. The plug that is made is used to even out the teeth that are left.

If your teeth are spaced apart instead, the spaces between them can be pulled together with the braces. This can be done, for example, by using small rubber bands or metal springs attached to the braces.

You may have to visit your dentist regularly to tighten the metal braces. This can make your teeth feel a little sore.

Orthodontics cannot be rushed

Straightening your teeth cannot be rushed by tightening your braces more or more often. Instead, the tooth may move more slowly. In addition, there is a high risk of damaging the root of the tooth, making it shorter.

Braces are removed once the teeth have moved

The braces are removed when the dentist agrees with you that the treatment is complete. This means that each metal plate is lifted away from the tooth with a special instrument. Removing the plates usually takes a few minutes. Then all the glue that attaches the plates to the teeth must be polished off with a special drill so as not to damage the tooth surface.

Usually you do not need an anaesthetic when braces are removed.

It can be uncomfortable in the mouth when the metal plates are removed and the glue is ground away from the teeth. If you are very worried that removing your braces will hurt, you can take painkillers before you go to the dentist.

After the braces have been removed, your teeth may feel loose, but this will disappear after a week or so.

Plastic braces or wires hold the teeth in place

Once the braces are removed, the teeth should be held in their new position. This can be done with a removable plastic splint used at night.  The teeth can also be held in place with a thin wire that is glued directly to the back of the front teeth. You cannot remove the wire yourself.

The method chosen depends on how the teeth were originally positioned and how likely they are to move back. In total, it takes one to two hours to remove the braces and put in the wire that will hold the teeth in place.

After the braces are removed, it takes one to two years for the teeth to grow into their new position. As the teeth and bite change with age, you will need to wear the plastic splint or wire for a long time so that age changes do not affect orthodontics. Sometimes you may need the splint or wire for life.

Wearing braces

Five to seven days after braces are put in place, your teeth may be very sore. It may also feel sore after adjustments, but this will pass after a few days.

At first, you may find that your braces feel very large and clumsy. Your lips and cheeks may be itchy. Putting a little wax on the areas of the braces where it chafes can make it feel better. The dentist will take the wax home with you and you can put it on yourself.

During the first few days, it is a good idea to eat foods that are easy to chew. In the first week after your braces are fitted, you may need to take over-the-counter painkillers containing paracetamol or ibuprofen.

Drinking cold water or keeping ice cubes in your mouth may help if you have problems with your braces. This is because the force of the wires pulling on your teeth is reduced when it is cold.

Checking and adjustment needed

The braces can be chewed as usual, but if you eat too hard or very hard things, the metal plates can come loose. If your braces come loose or break, you need to contact your dentist as soon as possible, preferably within a few days. Otherwise, there is a risk that the teeth will be moved back and the treatment time will be longer.

You need to check your braces regularly to make sure they are working properly. It will be adjusted every four to eight weeks throughout treatment.

Side effects or complications

The roots of the teeth will be slightly shorter than they were before treatment as the teeth move through the bone. Root shortening is checked by X-rays during treatment. If the root shortening becomes too great, it may be necessary to discontinue treatment.

While you are in braces, avoid biting your nails or pencils. It is also a good idea to avoid hard foods such as raw carrots and apples.

It is rare that a tooth does not move well enough to need filling.

Brush your teeth thoroughly

It’s important to be extra careful when brushing your teeth when you have braces. Food debris and plaque can easily stick, especially around the arches and attachments of braces. If you take care of your teeth, there is no risk of tooth decay because you have braces.

White spots on the teeth around the area where the metal plates have been can be the first sign of tooth decay, the beginning of a cavity. Poor tooth brushing can also cause the gums around your teeth to become inflamed, tender and bleed when you brush.

To reduce the risk of tooth decay, it’s a good idea to avoid sweets and cut down on snacks and sugary drinks between meals. Brush your teeth at least twice a day and also rinse your mouth regularly with fluoride.

Nickel is rarely a problem

Most metals used in braces contain nickel. Even if you have a nickel allergy, it is very rare for braces containing nickel to cause problems.

You can have your braces replaced with a nickel-free one if you get a small rash or itch.

You are not at risk of developing a nickel allergy from braces. Studies have shown that you are less sensitive to nickel after treatment with braces.

Teeth may change position after treatment

There is no guarantee that your teeth will not change position after orthodontic treatment.

Teeth change slightly with age. To keep them as unchanged as possible, you may need to keep the wires on the back of your teeth or your plastic braces for the rest of your life.

You can always ask what the risk is of your teeth moving backwards. The dentist can tell you about your circumstances even before the orthodontic treatment.

How treatment affects your life

Wearing braces can be inconvenient and sometimes they have to be worn for years.

Braces can reduce the risk of developing dental problems later in life.

For those who need fixed dentures, combined treatment with orthodontics often improves quality of life. It becomes easier to chew with the teeth in the right place in the mouth and the bite becomes more durable.

Getting your teeth straightened with braces can make a big difference for many people. For many young people, orthodontic treatment often means a change in the way they see themselves and their appearance.

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