This is a field of dentistry that specializes in the diagnosis, prevention and treatment of dento-facial irregularities. The practice of orthodontics requires professional skill in design, application and control of a host of corrective appliances (braces) to bring the teeth, lips and jaw into proper alignment and relationship.

If your teeth are irregular, do not bite right and you feel conscious about it, an orthodontist can help. Such problems are called malocclusion. Orthodontists are dentists who are specially trained to straighten teeth (orthodontics) and intercept certain types of developing malocclusion in a growing child by modifying bone growth in the jaws (dento-facial orthopedics).

                                        

                                          Before Orthodontics                                     After Othodontics

What Causes Malocclusion?

Malocclusions occur when the jaws and teeth do not meet right.

• Skeletal malocclusion occurs when one jaw does not line up with the other, or when the jaw is too big or too small for the teeth.
• Dental malocclusion occurs when the teeth are out of line, crowded, turned or spread out. This can happen with or without a jaw problem.

• Inherited malocclusion
  A child may inherit jaw from one parent and teeth from the other parent. This may lead to crowding, spacing or extra or missing teeth.
• Acquired malocclusion
  Such condition may be due to poor dental care leading to early loss of deciduous (milk) teeth, traumatic injuries, habits such as thumb sucking and chronic airway obstruction such as enlarged adenoids.
• Other types of malocclusion may be congential in nature such as cleft lip and palate deformity and other syndromes.

• Tooth decay and tooth loss as misaligned teeth are difficult to clean and maintain.
• Gum diseases.
• Abnormal wear of tooth surfaces.
• Excess stress on supporting bone and gum tissues.
• Misalignment of the jaw joints, resulting in chronic headaches or pain in the face or neck.
• Lower self esteem as the facial appearance is affected.

• Phase 1
  If the child's jaws are not aligned right or too small, the orthodontist may start treatment while the jaws are growing. This is called growth modification and is usually carried out between ages 7 to 12 and takes about 1 year. Subsequently, the orthodontist will review the child 6-monthly or yearly to monitor the development of the permanent teeth.
  
  
• Phase 2
  If the child's adult or permanent teeth are not properly aligned when they erupt (usually between ages 11 to 13), they will need to be straightened and this is called Phase 2. Most children who have undergone Phase 1 treatment also need Phase 2.

• Metal Braces
  The most efficient type of braces. Instead of winking metal, colours may be added to make your braces more attractive and they can be changed upon monthly adjustment visits. Self-ligating braces such as Damon 3, Smart Clip, Inovation etc are also available.
• Plastic or Ceramic Braces
  Made with translucent brackets, these tooth-coloured braces will not attract as much attention as metal braces.
• Lingual Braces
  Also know as invisible braces, the lingual brackets are attached to inner surface of the teeth, rendering them invisible from the outside.

1. When is the best age for orthodontic treatment?
   
   Although adolescents (11-15 years of age) are most responsive to orthodontics, treatment is sometimes provided for younger patients to intercept a developing malocclusion. Orthodontic treatment can also be done on adults and there is no age limit.



2. How long must I wear braces?
   
   Usually 1-2.5 years but some cases may need shorter or longer duration. If you always fail or cancel your appointments, it may take even longer. Retainers will be fitted to hold your teeth in their new positions after your brace is removed. If these are not worn, your teeth may slip back.



3. Is orthodontic treatment painful?
   
   During the first few days your teeth may be a little tender. This will soon pass off as you get used to your brace. If necessary, take a mild painkiller e.g. Paracetamol. The brace may rub your lips, cheeks or tongue and cause ulcers initially. Your orthodontist can give you some wax and a mouth ulcer gel.



4. How do I care for my brace / teeth?
   
   Brush your teeth well using a small head orthodontic toothbrush. Use a mouthwash at night. It is very important to maintain good oral hygiene as teeth may discolor and/or decay and gum disease may develop. Regular 6 monthly cleaning are required during treatment. More frequent cleaning may be required depending on patient’s overall oral hygiene.



5. What food or drinks should I avoid?
   
   Avoid sticky or hard food e.g. chewing gums, toffees, apples, carrots or crusty bread as these may break and bend the wires. Avoid sweets, mints and sugary or fizzy drinks since these may dissolve the enamel.
   
   
6. How will brace affect my lifestyle?
   
   You may lisp for the first few days. Only by wearing your brace full-time will your speech return to normal. If you play contact sports or a musical instrument, let your orthodontist know.
   
   
7. What to do If I notice broken braces or wires?
   
   Braces and wires should be checked daily after cleaning. If you find something loose or broken, please call the clinic immediately to fix an appointment. Do not wait until your next appointment. Broken wire or braces can cause teeth to move in the wrong direction and hence prolong the treatment time unnecessarily.