Looking and Talking
Virtually all of our new patients experience one of the first tools of the trade on their initial visit—the orthodontic exam. This is an opportunity for both the doctor and the patient to begin to get to know each other, starting with an assessment of the dental and facial structures. A standardized examination is performed and careful notes are made regarding the patient’s presenting condition. The doctor and patient then have time for questions and answers, providing general explanation for the patient’s questions and a good sense of the patient’s desires for the doctor. Hopefully, the patient will be able to learn quite a bit about his or her own situation and will begin to understand what to expect during treatment.
Analysis: X-rays, Photos, Impressions
Once the need for treatment has been established, another appointment is made to gather diagnostic materials, also known as records. The x-rays that are taken allow a precise measurement of the jaws with regard to size and position. In addition, an evaluation of the positions of the teeth within their individual jaws can be made. Photographs allow a careful study of the patient’s facial appearance and presenting dental condition. Impressions are taken and are used to create models of the mouth which are measured and evaluated in great detail. All of these pieces of information are combined to create a total understanding of the patient’s needs and how any corrections are to be made. This summary is called a treatment plan.
The Patient, One Absolutely Necessary Resource
Once the treatment plan is known, treatment can commence. However, in a large way the plan will always include participation by the patient; participation being critical to the overall success of the treatment plan. Patients will be called upon to maintain excellent oral hygiene: a task which is usually quite familiar to most people and one that is hopefully already routine. Excellent oral hygiene is paramount in maintaining the overall health of the mouth, insuring the maximum response to orthodontic tooth movement in the shortest period of time. Avoidance of certain foods that could potentially damage orthodontic hardware will be outlined in detail. Obviously, damaged or broken hardware will not result in the expected tooth movement, possibly lengthening treatment time. Fortunately most healthy foods are quite compatible with orthodontic treatment. Many patients will be asked to help even further by wearing elastic bands that hook up to their braces, providing the gentle force needed to help the teeth move from one place to another. This force can be critical to the success of the treatment plan and without this form of participation completion of treatment may not even be possible. Everyone will be asked to participate in his or her treatment in some way. In most cases the “homework assignment” will just be a matter of following simple instructions. This day by day participation is essential and will lead to a beautiful result achieved in a reasonable amount of time.
Braces: Bands, Brackets and Other Fixed Hardware
Modern orthodontics often includes a hardware system that most people are familiar with: braces! In most cases braces consist of basic parts called bands, brackets and archwires. Bands are almost always made of stainless steel and are fitted to the back teeth, like a closefitting ring on a finger. They are then cemented in place using a fluoride-releasing glass ionomer cement, which seals off and protects the tooth surface under the band while adhering the band to the tooth. Brackets are usually manufactured in either stainless steel (silver colored) or ceramic (translucent). Nearly all brackets are attached to the tooth surface with a specially modified form of bonding material (the material used to repair broken front teeth). This material also seals and protects the tooth surface underneath the bracket. Archwires are seen connecting the teeth together from one side of the dental arch to the other. These wires are used to guide teeth up, down, in or out and are manufactured in a variety of special alloys including stainless steel, nickel-titanium, copper-nickel-titanium, betatitanium- molybdenum and other “space-age” metals. The doctor can vary the diameter and properties of the wire to produce the appropriate gentle force needed for optimum tooth movement in a variety of situations. Some modern wires are even heat sensitive and allow comfortable tooth movement in even the most extreme situations.
Removable Appliances, The Ins and Outs
Certain treatment situations may require removable appliances. These are devices that are removed by the patient for eating and tooth brushing. At times, these appliances may be used in conjunction with braces and can be very important in assuring that treatment will progress smoothly. Nearly everyone will be asked to wear removable appliances at the conclusion of wearing braces – we call the most common form of removable appliance a retainer. The amount of wear time needed will be determined by the doctors and the prescribed amount of wear should be followed closely. Just as with all other areas of treatment, patient compliance will assure the kind of result we are all looking to achieve! While there are many other tools that may be used in specific situations, we have covered most of the most commonly used choices here. Your specific treatment plan may vary based upon your individual requirements. No matter what you may need, there will always be someone else with the same appliance or at least something similar, so you should be able to find a friend with whom to share your experiences. Good luck!