FREQUENTLY ASKED QUESTIONS
Orthodontics is a special branch of dentistry, and focuses particularly on the diagnosis and treatment of dental and facial misalignments. The etymology of orthodontics comes from the Latin words "orthos" meaning flat and "dontos" meaning tooth.
An orthodontist is a dentist who specializes in the diagnosis and treatment of dental and facial misalignments. Orthodontists are required to graduate from a school of dentistry and then complete a residency or PhD program, which can take four or more years. During this education, the orthodontist acquires the knowledge needed to check the movement of teeth (these procedures are called orthodontics as a whole) and to provide guidance during facial development (this treatment approach can also be called maxillofacial orthopedics). Only the dentists that successfully complete this specialty or PHD program are granted the title of orthodontist.
- The patient may not have benefited from the opportunities that preventive medicine offers; for instance, cavities in milk teeth may have been left untreated with the thought that they will be replaced anyway, or some teeth may have been extracted prematurely, or fluoride and fissure prevention measures may have been ignored.
- Hereditary factors: Whether or not individuals, particularly those with skeletal defects, have a similar anomaly in the family history is an important factor. Hereditary missing teeth, narrow maxilla, and crowded teeth can be genetically passed down to children. In such cases, orthodontic problems will inevitably arise. What needs to be done is to ensure that the child is regularly seen by a general dentist starting from milk teeth dentition.
- Ear-nose-throat problems: Issues such as tonsillitis, presence of adenoids, and continuous mouth breathing, etc. can disrupt the shaping of the maxilla and mandible, and result in tooth eruption problems.
- Bad habits: Harmful habits such as thumb sucking, long-term pacifier or baby bottle use, tongue sucking, lip sucking, and pencil biting, etc. can also cause malocclusions in teeth and jaw formations.
- Some muscle disorders can also be another cause of orthodontic problems.
There is no age limit for orthodontic treatments. If there are skeletal problems, such defects can be corrected by means of orthopedic treatment approaches up to end of adolescence. On the other hand, in adulthood, such skeletal defects can be corrected by orthodontic treatment in conjunction with orthognathic surgery. Today, teeth can be corrected with aesthetic invisible wires (transparent brackets), wires attached to the back of teeth (Lingual technique) and transparent aligners (Invisalign).
Orthodontic treatment corrects crowded teeth and misalignments in bite, and not only aims to create an aesthetic look but also prevents potential gum diseases and mandibular joint problems as well as fixing the chewing function and speech impairment. Mostly used for correcting crowded teeth, orthodontics includes various treatment techniques in and of itself. Depending on the orthodontic problem, treatments can involve removable, functional or fixed appliances. Orthodontic problems that are less complex in nature can be solved with the use of plastic removable appliances that the patient can attach and remove. For under or overdevelopment of the maxilla and mandible, functional appliances that help the jaws develop in a specific direction are used during the growth-development period. The way the fixed appliances, which are seeing wider use in orthodontic treatment in recent years, work is based on the idea of moving the wires placed on the grooves of the brackets that are attached to the teeth. In addition to these basic appliances, there are many other appliances that assist in treatment. Once the active orthodontic treatments are completed, reinforcements also play an important role in preventing treatments from relapse and teeth from returning to their original positions. In this treatment period, a variety of appliances that work passively are used.
The main goals of orthodontic treatment include improving the chewing and speech functions, helping with better oral hygiene, creating an aesthetic look, and supporting the psychology of the patient by inspiring higher self-confidence.
Orthodontics, in collaboration with ear-nose-throat specialists, may also contribute to the patient's nose breathing. Plastic surgeons or maxillofacial surgeons can also be involved in the process to solve skeletal defects in adult patients, and treat infants and children with cleft lips-palates. Orthodontists also work with other dentistry branches.
It has been proven that cavities in milk teeth and premature extraction of milk teeth cause orthodontic anomalies, leading to permanent teeth remaining impacted in the jawbones.
Primary teeth (milk teeth) begin to erupt in a specific order from the sixth month, and by 2.5 years on averaged, they are fully formed in children. In total, 20 milk teeth on the maxilla and mandible remain until around 6 years of age. Starting from this age to 12, all the milk teeth are replaced by permanent teeth. The large cavities that occur in milk teeth during this change and early loss of milk teeth may lead to crowding due to the teeth toward the back moving to fill the voids and therefore permanent teeth not to erupt and remain impacted. This is why keeping the milk teeth healthy in the mouth is very important.
Issues during milk teeth dentition are not the only reason for the occurrence of orthodontic defects, which can be genetically passed from parents or older family members down to children. Malnutrition due to insufficient nursing in infancy, using baby bottles and pacifiers, bad habits such as thumb sucking, lip sucking, tongue pushing and mouth breathing in childhood can also result in orthodontic problems. In the case of mouth breathing, if there are problems that prevent nose breathing, these should be resolved by working with ear-nose-throat specialists.
The American Association of Orthodontics (AAO) recommends that children undergo orthodontic examination before the age of 7. An orthodontist will be able to recognize issues in in jaw and tooth development already when the child has milk teeth. Early detection of anomalies is important because some orthodontic problems are much easier to treat with early diagnosis, making complex and costly treatments less likely to occur in the future. For most patients, active orthodontic treatment begins around the ages of 9-14, and skeletal defects can be solved before the child's growth period ends.
In the first few days after the brackets are attached, eating can feel more difficult than usual, and chewing can be painful. When teeth are in such a sensitive state, soft foods that do not require much chewing should be preferred. Foods such as ice cream, yoghurt, pudding, soup, boiled potatoes, bananas, soft cheeses, soft cakes, and milk are recommended for easy chewing. The orthodontic patient should be careful about his/her diet, not only after the first session when the brackets are attached, but also during the entire time the brackets remain in the mouth. Otherwise, brackets may break, which will prolong the treatment period.
Foods to avoid during the treatment period:
- Crunchy and crispy food: Popcorn, ice, chips, etc.
- Sticky food: caramel, chewing gum, etc.
- Hard food: nuts, candies, etc.
- Food consumed by biting into: apples, plums, carrots, wraps, etc.
Teeth need extra care during orthodontic treatments. Food particles may build up on the brackets, wires, bands and other apparatuses, and therefore make it more difficult to clean. The only way of preventing cavities and gum diseases in this process is to brush teeth after each meal and snack.
Some recommendations for maintaining oral hygiene during orthodontic treatment:
- Brush your teeth after every meal and snack.
- Floss every day to remove food particles.
- Gargle with mouthwash after each meal to reduce bacteria formation.
- Used fluoride toothpaste and a soft-bristled toothbrush.
- Use interdental brush.
- Continue routine checks with a general dentist throughout treatment.