Braces are highly effective at correcting misaligned teeth and bite issues. A “crooked smile” generally refers to teeth that are not straight or jaws that do not align properly, impacting both appearance and oral function. Orthodontic treatment, primarily using braces, is a common and proven method to guide teeth into straighter positions and improve oral health.
Understanding Tooth Misalignment
Tooth misalignment, also known as malocclusion, describes conditions where teeth are improperly positioned or do not meet correctly. One common issue is crowding, which occurs when there is insufficient space in the jaw for all teeth to align smoothly. Conversely, spacing refers to gaps between teeth, which can result from missing teeth, small tooth size, or a jaw that is too large for the teeth.
Beyond spacing issues, bite discrepancies are also prevalent forms of misalignment. An overbite happens when the upper front teeth significantly overlap the lower front teeth. In contrast, an underbite involves the lower front teeth extending in front of the upper front teeth. A crossbite occurs when some upper teeth bite inside the lower teeth. These misalignments can contribute to various oral health problems, including jaw pain and chewing difficulties.
How Braces Achieve Correction
Braces facilitate tooth movement through bone remodeling. When consistent, gentle pressure is applied to a tooth by orthodontic appliances, it creates areas of compression and tension in the surrounding alveolar bone and periodontal ligament (PDL).
On the side of the tooth where pressure is exerted, specialized cells called osteoclasts become active. These osteoclasts are responsible for resorbing, or breaking down, the bone tissue, creating space for the tooth to move into. Simultaneously, on the opposite side of the tooth where tension is created, osteoblasts, which are cells responsible for forming new bone, are stimulated. This coordinated activity of bone resorption and formation allows the tooth to gradually shift through the bone into its desired position. The archwire, a thin metal wire threaded through brackets, applies precise forces to direct this movement.
Types of Orthodontic Appliances
Several types of orthodontic appliances can correct a crooked smile:
Traditional metal braces: These consist of high-grade stainless steel brackets bonded to the front surface of each tooth, connected by a thin archwire. Small elastic bands, called ligatures, hold the archwire in place, and these can be customized with various colors. Metal braces are known for their durability and effectiveness in addressing a wide range of complex orthodontic cases, including severe crowding and bite problems.
Ceramic braces: These function similarly to metal braces but use clear or tooth-colored brackets, making them less noticeable. While they offer a more discreet appearance, they can be more prone to staining and may be slightly more fragile than their metal counterparts.
Lingual braces: These are custom-made and placed on the inside surface of the teeth, making them virtually invisible from the outside. This placement can sometimes affect speech and requires specialized care.
Clear aligners (e.g., Invisalign): These represent a different approach to tooth straightening. They are sets of clear, thin, plastic trays custom-formed to fit the mouth. Each aligner tray is worn for about one to two weeks and is designed to move teeth a fraction of a millimeter at a time, applying gentle pressure. Aligners are removable for eating, drinking, brushing, and flossing, offering convenience and improved oral hygiene during treatment. They are often suitable for mild to moderate orthodontic problems.
The Orthodontic Treatment Process
The journey to a straighter smile typically begins with an initial consultation with an orthodontist. During this first visit, the orthodontist conducts a thorough examination of the teeth, jaws, and facial structure, often including X-rays and digital scans to assess the specific orthodontic issues. This assessment helps in developing a personalized treatment plan, outlining the recommended appliances and estimated timeline.
Once the treatment plan is established, the next step involves the placement of the orthodontic appliance, whether it be braces or aligners. For braces, brackets are bonded to the teeth, and archwires are then threaded through them. Patients receiving clear aligners will receive their first series of custom-made trays. The placement process for braces is relatively quick, often taking a few hours.
Throughout the active treatment phase, regular adjustments or check-ups are necessary to ensure progress. For braces, these appointments typically occur every four to eight weeks, during which the orthodontist will check for broken components, remove ties, and tighten or change the wires to continue guiding tooth movement. Patients using clear aligners will periodically receive new sets of trays, usually every one to two weeks, and have check-ups to monitor their progress. After the active treatment is complete and the braces are removed, the retention phase begins. This final stage involves wearing retainers, which are designed to hold the teeth in their new positions and prevent them from shifting back to their original alignment as the bone and tissues stabilize.