Updated: 10th May 2008

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Orthodontics

Orthodontic treatment is the straightening of teeth using fixed bonds or removable appliances. This practice refers patients for expert orthodontic opinion when required. Timely orthodontic intervention can ensure that patients benefit by improving facial and dental aesthetics, dental health and function, with a resulting increase in self-esteem.

Patients and parents must be aware of the difficulties encountered during treatment prior to starting what is often a long course of treatment (2 years or more and sometimes long periods of retention after this). Failure to complete a course of orthodontic treatment is frustratingly common (nearly 25%).

Orthodontic patients have twice the enamel deminaralization of untreated patients, even after 5 years. Demineralization is the first stage in the dental decay process. Oral hygiene is therefore paramount. Patients with poor oral hygiene compliance are unsuitable for orthodontic treatment. Even patients with good oral hygiene must take extra care with brushing and must use a fluoride mouthrinse.

Other problems which may be unavoidable sequelae to treatment include:

• Enamel fractures.
• Inflammation of the gum - usually of short duration.
• Root and pulp damage.
• Soft tissue damage - irritation from a new appliance which can be protected using vegetable wax.
• Allergy.
• Relapse - even with orthodontic treatment of a high standard teeth will still move. Teeth move throughout life; this is physiological not necessarily due to relapse. Closing a space between the two front teeth is particularly prone to relapse.

Many of the above problems of treatment are rare but must be borne in mind. With good oral hygiene and compliance the results are usually excellent.