Orthodontists do far more than simply apply traditional metal braces. Orthodontics is a specialized field of dentistry focused on diagnosing, preventing, and treating irregularities of the teeth and jaws. Their practice extends beyond straightening misaligned teeth to include managing facial growth and correcting functional bite problems. This specialty utilizes a wide range of sophisticated devices and treatment strategies tailored to a patient’s unique dental and skeletal structure. The goal is to achieve an aligned, functional, and healthy bite.
Orthodontic Specialization Versus General Dentistry
The distinction between a general dentist and an orthodontist lies primarily in the depth and focus of their education. Both professionals complete a four-year dental school program, earning a DDS or DMD degree. This initial training qualifies them to handle routine care, such as cleanings and fillings, which is the primary focus of general dentistry.
An aspiring orthodontist must then complete an additional two to three years of full-time, accredited residency training. This intensive, post-doctoral program is dedicated exclusively to the study of dentofacial orthopedics, which involves the movement of teeth and the modification of jaw growth. This rigorous specialization equips orthodontists with the expertise to plan complex tooth movements and manage the development of the jaw and facial structures.
While some general dentists may offer limited orthodontic services, such as simple clear aligner treatments, they lack the extensive training required for complex malocclusions. Orthodontists possess a deeper understanding of biomechanics, growth patterns, and the long-term stability of corrections. Complex cases involving significant jaw discrepancies require the specialized knowledge that only a certified orthodontist can provide.
Auxiliary Appliances and Devices
An orthodontist’s toolkit includes numerous appliances designed to achieve specific corrective movements. Clear aligner systems utilize a series of custom-made plastic trays to gradually shift teeth without fixed brackets or wires. Each aligner is worn sequentially, delivering precise forces until the desired position is reached.
Specialized Orthodontic Devices
Orthodontists utilize several specialized devices in addition to braces and aligners:
- Palatal expanders are fixed devices used to widen a narrow upper jaw, often in growing patients, to correct crossbites and create space for crowded teeth.
- Functional appliances, such as the Herbst appliance, modify the growth of the jawbones, particularly the lower jaw, to correct large overbites in adolescents.
- Temporary Anchorage Devices (TADs) are small titanium mini-screws placed into the jawbone. These provide a stable anchor point for applying force, allowing for highly controlled tooth movements.
- Space maintainers are used in young children to hold the position of a prematurely lost baby tooth, preventing adjacent teeth from drifting.
- Retainers, which can be fixed wires or removable appliances, are used at the end of treatment to hold the teeth in their corrected positions and prevent shifting.
- Habit breakers, such as tongue cribs, discourage damaging oral habits like thumb sucking or tongue thrusting that interfere with alignment.
Correcting Bite Issues and Jaw Alignment
The primary focus of orthodontic treatment is to correct malocclusion, the technical term for a “bad bite” or misalignment of the teeth and jaws. Treatment goals extend beyond aesthetics to ensure optimal function for chewing, speaking, and maintaining oral health. Orthodontists categorize these alignment problems into distinct types, each requiring a specific treatment strategy.
One common issue is the overbite (Class II malocclusion), where the upper front teeth significantly overlap the lower front teeth. Conversely, an underbite (Class III malocclusion) occurs when the lower jaw protrudes, causing the lower front teeth to sit in front of the upper teeth. Correcting these discrepancies often involves utilizing functional appliances in children or a combination of braces and elastics in adults.
Other malocclusions include the crossbite, where some upper teeth bite inside the lower teeth, and the open bite, where the upper and lower front teeth do not touch when the mouth is closed. These conditions can lead to uneven tooth wear, speech difficulties, and jaw joint discomfort if not addressed. Severe crowding and spacing are also major treatment areas, where the orthodontist plans precise movements to fit all teeth into the dental arch or close unsightly gaps.
For patients with severe skeletal discrepancies, the orthodontist works closely with an oral surgeon. Orthodontics prepares the teeth for orthognathic surgery, which repositions the jaw structure. The comprehensive treatment plan aims to harmonize the alignment of the teeth with the underlying skeletal structure, optimizing the bite and enhancing the overall facial profile.