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Why do some people have nicely arranged teeth while others do not?

Just as with the colour of our skin, eyes or hair, the arrangement of our teeth is also largely influenced by hereditary factors. Heredity will influence the size, shape and relationship of the jaw bones supporting the teeth. For example, this would determine whether one has a prominent upper jaw with correspondingly prominent upper front teeth.

Other factors would also influence the final appearance or arrangement of the teeth. For example,

  • A. The size of the teeth (whether large or small)
  • B. The number of teeth (missing or extra teeth)
  • C. Presence of habits (thumb sucking)
  • D. Early extraction of the deciduous teeth

However as the saying goes, ‘Beauty is in the eyes of the beholder’ and this is particularly true in this context. In some societies, having a space between the upper two front is considered attractive, while in others it is not. In some communities, having a space between the two upper front teeth is a sign of luck or beauty, while in others, the converse holds.

Thus if an individual is happy with her appearance, there is no need to wear ‘braces’ – unless the proper function of her teeth is affected.

Why are teeth straightened?

As you know, teeth may be straightened to improve the appearance. It is sometimes necessary to realign them in order to improve health and function of other tissues in the mouth. For example, poor positioning of teeth could result in mandibular joint pain, injury to the gum tissues or even result in a person being more prone to dental decay or gum disease.

It may also be necessary to reposition teeth to allow other forms of dental treatment like the construction of crowns, bridges and dentures to be carried out satisfactorily.

Is it essential that poorly positioned or malaligned teeth be orthodontically corrected?

In so far as correction of teeth to improve appearance, the decision is up to you. If you are happy with your appearance, then there is absolutely to necessity to have orthodontic correction.

However, you may be advised by your dentist to do so for the sake of better dental health, or , to enable other proposed dental treatment (for example, crowns) to be carried out satisfactorily. In these situations, it is best you follow his advise.

Why are some braces removable while others are not?

Orthodontic treatment can be carried out either using appliances which can be removed ( Removable appliance therapy ) or, using ‘bands’ which are cemented on to the teeth. The latter are not removed until treatment is complete. This form of treatment is called ‘Fixed therapy’.

The orthodontist would evaluate each case and decide which form of treatment would be best for the particular individual.

Is it all right to wear a removable appliance only at night?

No! The appliance must be worn constantly. Otherwise, any movement of the teeth which is achieved during the night will be reversed during the day – and the teeth will go back to their original position. Thus, the appliance may be as well not be worn at all!

The principle, is that once the teeth have been moved, they must be allowed to establish themselves in their new position. It takes time for the adjacent tissues to adjust to a newly positioned tooth.
This is precisely why, after the teeth have been moved to a suitable position, the orthodontist will ask you to continue wearing an appliance. This ‘retaining appliance’ will be worn until the orthodontist feels the teeth are stable in their new position.

Is wearing braces painful?

Different people have different pain thresholds. In other words, their level of tolerance differ. Most individuals adjust to the presence of ‘braces’ or ‘bands’ within a few days. A certain degree of discomfort is expected soon after insertion of braces and following their tightening or adjustment. This usually last 2 to 3 days.

How long does it take for orthodontic treatment to be completed?

This would depend on:

  • A. The type of problem that exists
  • B. The type of appliance used ( removable appliance therapy would usually take a little longer)
  • C. The age at which treatment is commenced (it generally takes a little longer in adults)

It would take, on average, about two years for orthodontic treatment to be completed.

For treatment to be effective, the co-operation of the patient is essential. Monthly visits to the dentist must be made to enable adjustment of the braces.

Is extraction required before orthodontic treatment?

This depends on the severity of the problem. In cases of mild crowding, treatment can often be carried out without extraction.

The teeth usually appear ‘crooked’ because they cannot be accommodated by the jaw. By extracting certain teeth, space is created, to enable those which are retained, to be rearranged such that they are aligned properly.

What is the best age to start orthodontic treatment?

The best time is just before, or immediately after, all the permanent teeth ( excluding the third molars ) erupts, as this would coincide with maximum growth activity of the child. Maximum orthodontic response is seen at this stage. This is generally between the ages of 10 and 14 years. Sometimes treatment is started as early as 7 or 8 years, especially when the child needs what is known as ‘functional therapy’. When in doubt, seek your dentist’s advice.

Is it true that braces cause the gums to bleed and the teeth to decay?

The wearing of orthodontic bands or braces, will not in itself cause the gums to bleed or the teeth to decay. But, as you can imagine, it is far more difficult to clean your teeth when you do wear them. Therefore, it calls for a greater effort on your part to ensure cleanliness of your mouth.

Should you fail in this respect, then plaque and food debris will accumulate around your teeth and appliance. The action of plaque bacteria will result in decay and gingivitis.

Orthodontic treatment carried out in a mouth with poor oral hygiene would result in the patient having straight, well aligned – but carious – teeth, with poor supporting tissues.

If you are wearing braces, be sure to ask your dentist for special aids to clean your teeth. It is unlikely the orthodontist will embark on any treatment unless you clean your teeth well and your gums and supporting tissues are healthy.