Ortodontics - braces

Orthodontic Treatment (Orthodontics) - Braces

When teeth are misaligned, braces may sometimes be needed to straighten them. But when should you have braces, and are there cases where braces are not suitable?

In some cases where children have a malocclusion, this can be corrected with interceptive orthodontics – braces used during the mixed dentition to guide the growth of the jaw during the child's growth spurt. The growth spurt is individual, but it usually occurs at around eight to ten years of age for girls and ten to twelve years of age for boys.

In other cases that do not make use of the growth spurt, the body needs to have finished growing before teeth are moved. There is essentially no age limit for orthodontic treatment, but contact your dentist for a consultation for more detailed information.

There are three factors that can prevent the successful movement of a tooth/teeth.

Poor oral hygiene - It is extremely important to be able to keep your teeth clean, as the risk of caries is high if oral hygiene is poor. Good oral hygiene is therefore usually one of the requirements for receiving orthodontic treatment.

Something in the jawbone is preventing movement - This is why it is important to examine the jawbone before orthodontic treatment. The dentist does this most easily with a panoramic X-ray, supplemented with additional X-rays when needed.

Implants or ankylosed teeth - Implants and ankylosed teeth are “objects” that cannot be moved within the jawbone. If these objects can either stay in place or be removed entirely in the plan all the way through to the final result, the orthodontic treatment will be successful.

Frequently asked questions

• How long does it take to correct the position of the teeth with braces?

It can range from 6 months for milder cases to 2-3 years for more complex cases.

• How far can a tooth be moved?

Up to 8 mm in optimal cases, but in larger movements it can be up to 10-12 mm.

• What happens once the teeth have finished moving?

To keep the teeth in their new position, some form of retainer (something that holds the teeth in place) is needed. One option is a retainer made of metal wire that is bonded to the back of the teeth, usually in the front from canine to canine. Another option is an Essix retainer, a hard plastic splint that holds the teeth in place and is usually worn every night. In some cases, both a metal retainer and an Essix retainer are used, depending on the case.

• When are braces free of charge?

Children who meet the region's inclusion criteria for free orthodontic treatment can apply for it through a referral from their dentist. Many factors are taken into account in the decision.

What complications can occur?

Teeth normally need to be surrounded by bone at least 1.5 mm thick to maintain the bone level, and therefore the gum level, around the tooth. If a tooth has been moved too far outside the dental arch, the bone can sometimes become very thin (less than 1.5 mm), which can lead to the bone breaking down in that thin area. When the bone breaks down, the gums follow the bone, resulting in gum recession. The tooth root becomes exposed in that area, and the tooth may also become somewhat more sensitive to cold and sometimes heat. To avoid mishaps like this, careful planning by the dentist and good cooperation from the patient are required. If bone loss occurs and you still develop gingival recession despite good planning, there is a surgical solution in which the dentist builds up bone around the affected area to restore the height of both the bone and the gums.

Pressure-initiated tooth movement always carries a risk of damage to the tooth's root membrane. In rare cases, this can lead to root resorption, where part of the root gradually disappears. If this happens to too great an extent, the tooth can eventually become loose. It usually happens very slowly, which is why annual check-ups are important, so that these changes are detected in time and any tooth replacement can be planned, should the extent of the damage mean that the tooth needs to be removed.

Because of all the parts of the appliance, both food and plaque get stuck much more easily. It is therefore very important to clean the teeth extra thoroughly to prevent caries from forming.