Ortho Info
The Orthodontic Specialty
Although “ortho” means straight and “dont” means tooth, orthodontics is more than just straight teeth. Traditionally people believe that orthodontic treatment is just for children. However, orthodontic treatment is also important for adults. Adult patients with concerns about crowded teeth, missing permanent teeth, fractured teeth, spaces or gaps between teeth, excessive wear of teeth or periodontally compromised teeth may benefit from orthodontic care. If the tooth’s supporting tissues (gums and bone) are healthy it is possible to move teeth at any time throughout life. Besides moving teeth into more functional and healthy relationships, orthodontic treatment improves one’s self-confidence and self worth.
Types of Appliances
Teeth are moved orthodontically by using fixed or removable appliances. Fixed appliances (braces) are able to move teeth in more directions with more precision than removable appliances (like Invisalign, Clear Correct, Orthotain and retainers). Braces are made of different materials (stainless steel, ceramic, composite, plastic, gold plate etc.) and may be placed on the cheek or tongue side of the teeth.
Around 1940, stainless steel became widely available. However it didn't replace gold and silver (brackets, bands and wires) for routine orthodontic treatment until the late 1950's. Originally the stainless steel bracket was soldered to stainless steel bands that went around a tooth. In the early 1970's the bracket was placed on a perforated pad that was bonded (cemented) to a tooth. This perforated pad was quickly replaced by a pad with wire mesh improving the strength of the bond. The stainless steel bracket has been used for more than 70 years and comes in many different styles or shapes.
Though the self-ligating bracket is presented as a recent modification of the stainless steel bracket, the concept was evolving about the same time as stainless steel was beginning to be used in orthodontics. The first commercially available self-ligating bracket appeared in the early 1970's. Design changes have been made over time and now there are a number of companies that offer self-ligating brackets.
Frequently changes in the orthodontic bracket or its placement were motivated by a patient's esthetic concerns. About 1975, lingual braces were developed. Though lingual braces bonded onto the tongue side of teeth are virtually invisible, they may interfere with the bite, irritate the tongue and/or adversely affect speech. Also, they are more challenging to clean. A ceramic (tooth colored) bracket is also used when esthetics is a concern. However, the ceramic bracket is brittle (may break), abrasive (slow tooth movement), and may be difficult to remove.
Computer-assisted technologies are being used with fixed orthodontic treatment (such as Sure Smile). A 3-D model of a patient's teeth is made before and after placing the braces to help determine necessary tooth movement and make all the arch wires needed for the patient's entire treatment. These systems claim to shorten treatment time: not by moving teeth faster, but by being more precise. This new concept is being refined and improved. At this time there appears to be no cost-benefit for a patient.
Removable appliances (as mentioned above) are used mainly when slight tooth movement is needed. Though removable, these appliances must be worn almost 24 hours a day to move teeth effectively and efficiently. Some removable appliances (Invisalign and Clear Correct) using computer-assisted technologies provide a series of clear-plastic templates that move teeth in small increments. Each set (upper and lower) of templates is worn for approximately two weeks. At the end of each two-week period, the next set of templates is worn. Depending upon the manufacturer, these templates may or may not be adjustable. In some instances, traditional braces may still be required for a few months to correct certain problems. Also treatment is reported to take longer than fixed appliances. Removable appliances made of wire and plastic, similar to retainers, offer a cost-effective alternative to treatment with clear templates.
Dr. Frank has selected a proven, versatile, esthetic, cost-effective stainless steel bracket that is bonded (cemented) onto the cheek side of the tooth for improved comfort and hygiene. When esthetics is a chief concern, a metal-reinforced ceramic bracket (Clarity) is used. This ceramic bracket is easy to remove and allows teeth to move like a metal bracket. The appropriate type of removable appliance is recommended in light of the patient's concerns and the type of tooth movement needed. Dr. Frank continually evaluates new orthodontic technologies as well as the accuracy of their marketing claims.
