Orthodontic treatment procedure at Udental Clinic

Orthodontics is a technologically advanced field which offers many sophisticated solutions to malocclusions and other cosmetic problems. 

Step 1: Examination and treatment plan

The orthodontist will generally perform a visual examination, panoramic x-rays and study models (bite impressions) in order to assess the exact nature of the discrepancy.

Preparation for braces generally involves:

• Oral exam – the orthodontist conducts a full exam of teeth, jaws and mouth.
• X-rays – a series of X-rays will be taken to determine the position of teeth. The most common is the panoramic X-ray, which shows all the upper and lower teeth and any teeth still developing within the jaws. Special head X-rays also may help determine the size, position and relationship of jaws to teeth.
• Plaster models – from impression, a plaster model of all teeth (dental cast) is created and the orthodontist evaluates the occlusion. In some cases, this dental cast may be scanned into a digital format for further evaluation or treatment decisions.
• Potential tooth extraction – in case of very overcrowding, there may be limited or no room in the jaw for all the existing teeth. The orthodontist may recommend removing one or more permanent teeth to allow room for the remaining teeth to fit comfortably. This allows the teeth to fit together better and also allows for adequate space for cleaning.
• Other procedures – in severe cases, where tooth movement alone will not correct a bite that’s significantly out of alignment, jaw repositioning surgery is required in combination with orthodontics.

When a diagnosis has been made, there are a variety of orthodontic treatment options available.

Here is an overview of some of the most common treatments:

• Fixed orthodontic braces – A metal or ceramic dental base is affixed to each tooth, and a dental wire is inserted through each base.  The orthodontist is able to gradually train the teeth into proper alignment by regularly adjusting the wire. The length of treatment varies between several months and several years, depending on the original status of the discrepancy and patient’s age.
• Removable appliances – There are a wide range of removable appliances commonly used in orthodontics, including headgear that correct overbites, Hawley retainers that improve the position of the teeth even as the jawbone reforms, and face-masks which are used to correct an underbite. Removable appliances can be used alone or be accompanied with fix orthodontic braces.
• Invisible orthodontic treatment: For minor corrections, an option is a series of customized, removable appliances called clear aligners or “invisible braces.” These may have a more acceptable appearance to some adults. Udental Clinic uses the invisible orthodontic systems of 2 brand names: Invisalign^®(USA) and Giko Aligner^® (Japan). They both are the most famous systems in the major. Clear aligners are not only totally esthetic but also do not interfere with eating, because of their removable nature, and mechanically work in the same way as the traditional metal dental braces. However, not all patients are candidates for invisible orthodontic treatment. Our specialists will examine and give consultation for each particular case, to ensure the best result of treatment with the most reasonable cost and the shortest length of treatment time.

Step 2: Treatment process

Treatment is done in three phases: the initial placement of the braces (or clear aligners), periodic adjustments and use of a retainer after the braces are removed.

Phase 1: Placement of braces (for fixed dental braces)

Fixed dental braces typically consist of these components:

• Brackets attached to the outside surfaces of the teeth. Or they can be attached to the backside of teeth, hiding them from view, but this makes them a bit harder to access. Brackets can be made of stainless steel, ceramic (clear or tooth-colored) or other materials. Modern metal brackets are smaller and less noticeable than they used to be.
• Ring-like bands that encircle the molar teeth. Before bands are applied, space is created by placing very small rubber bands (spacers) between the molar teeth. These bands are made of stainless steel or titanium. A buccal tube attached to the band of the last molar holds the end of the connecting wire in place.
• A flexible wire (arch-wire) that connects all of the brackets and bands. The arch-wire controls movement of the teeth.
• Small rubber bands (elastic ties) or metal ties to secure the wire to the brackets (though some braces have a sliding mechanism instead of ties to secure the wire). Larger rubber bands also may be used to help move teeth. Stretching elastics between the upper and lower jaws is an option to produce more corrective pressure.
• Headgear attached to the braces. Headgear is usually only worn at night, and it is just indicated in more-complex cases. Headgear is attached to headgear tubes in the mouth to produce additional pressure and to help hold or move teeth into the correct position.
• Temporary anchorage devices (TADs) – Instead of headgear or rubber bands, TADs may be an option for some patients. Tiny screws are placed through the gums into the jawbone, and can then be used as anchors to apply continuous pressure to move the teeth.

Removable clear aligners (“Invisible braces”)

Instead of using fixed braces, certain people who need only minor corrections may benefit from a series of customized, removable appliances called clear aligners. Typically, each set of aligners is worn for one to three weeks, as close to 24 hours a day as possible – except when eating, brushing or flossing — until it’s replaced by the next set. The entire series of aligners may take up to nine months or longer, allowing better alignment.

Only plain water is OK to drink when wearing aligners. After taking the aligners out to eat or drink any other food or beverage, be sure to brush your teeth before putting the aligners back in. Floss as often as directed — at least daily.

Phase 2: Periodic adjustments

After fixed braces are placed on teeth, the orthodontist adjusts them periodically by tightening or bending the interconnecting wires. This puts mild pressure on the teeth and gradually shifts them into new positions. The jaw responds to the pressure by dissolving bone in the path of the moving tooth and laying down new bone behind it.

Occasionally, the orthodontist may use tension between the upper and lower jaws to help correct alignment. This is often done with elastic bands stretched between opposing teeth.

Teeth and jaws may feel slightly sore for the first few days after an adjustment. This discomfort can usually be eased with an over-the-counter pain reliever.

Phase 3: Retainers

After dental braces are removed, the newly straightened teeth need to be stabilized for a period of time (retention period) to prevent them from shifting back to their original position. This is accomplished with the use of a custom-made appliance typically made of plastic, or plastic and metal wires, that help teeth stay in place (retainer).

Retainers are usually removable, but may be fixed. Or a combination of fixed and removable may be used.

Braces are generally very effective in re-aligning crooked teeth and helping correct improperly positioned jaws to create a nice smile and a healthy mouth.

On average, most people wear full braces for one to three years. Retainers may be worn indefinitely to ensure that the final results remain stable.

The person wearing the braces has an important role to play in the success of the treatment. Follow the orthodontist’s instructions precisely, especially during the retention period. When it comes to this final phase, it’s important to wear the retainer as directed or risk losing the benefits gained while wearing braces.

Orthodontic treatment cases were made at Udental Clinic