Braces, or dental appliances for malocclusion, cost quite a packet today. Are they cosmetic devices? What is the best age to start?

Dr Sridevi Padmanabhan answers frequently asked questions on braces.

What are braces?
Why do I need to move my teeth?
What is the right time to start braces?
Can adults be treated with braces?
Are extractions inevitable?
Are braces painful?
Do braces need special care?
How long will orthodontic treatment take?
Would surgery speed up treatment?
Can snoring be corrected by braces?

Orthodontic appliances are those used to move the teeth to optimal positions and may be removable or fixed appliances. The application of removable appliances is limited and thus most orthodontic patients are treated with fixed appliances or braces.

While these are most often made of stainless steel ,one has the option of less visible braces such as ceramic or lingual braces(placed on the inner surface of the teeth).

Why do I need to move my teeth. Is it primarily a cosmetic concern ?

No! Braces are not just Crowded teeth make it difficult to maintain oral hygiene and this could lead to tooth decay and gum problems.

Crowded teeth make it difficult to maintain oral hygiene and this could lead to tooth decay and gum problems.Mal alignment or protruding teeth could occasionally affect normal functions like speech, breathing ,chewing and could also lead to joint problems.

Before	After

Different problems need to be addressed at specific times. While simple derangements of the teeth can be corrected at practically any age after the full complement of teeth has erupted (10-12 yrs) problems affecting the jaws (skeletal malocclusions) need to be treated much earlier when the child is still in a growing phase and growth modification is possible.

Further, abnormal habits in growing children like thumb sucking, mouth breathing, lip biting etc. could affect growth of the jaws and cause malalignment of teeth.

Growing children who show abnormal facial form can benefit from early treatment with growth modification appliances.

Braces to straighten teeth are usually indicated when most of the permanent teeth have erupted into the mouth which is about 11-12 years though they may be exceptions.

Yes! Although the duration of treatment might take a little longer. Age is not a limitation provided the health of the gums and the tissues in the area is acceptable. In fact gum problems caused by faulty “bites” are benefited by orthodontic correction.

Adults can wear less conspicuous braces that would be more socially acceptable.

Sometimes adult patients who require artificial prostheses (dentures) for missing teeth might require and benefit from limited orthodontic treatment to align the remaining teeth, to enable a better prosthesis.

Are extractions inevitable?

In some cases, teeth might have to be extracted to create space for crowded or protruded teeth. Extraction spaces would be closed at the end of treatment.

 

Are braces painful?What are the otherproblems one can expect?

After the braces are fixed on, the teeth may become sore and may be tender to biting pressure for two to three days after each appointment although patients handle this better as treatment progresses.

Initial discomfort, difficulty in speech and eating hard foods is common although this settles down in a few weeks.

Do braces need special care?

Inadequate oral hygiene and maintenance could lead to white spot lesions, or even tooth decay. Gum enlargement in response to plaque accumulation is quite common too. Thus, scrupulous oral hygiene maintenance is necessary.

Patients must avoid hard and sticky foods to avoid damage to braces since this will prolong treatment time and will require extra appointments.

How long will orthodontic treatment take?

Most commonly 2-3 years. However this may vary depending on the nature and severity of the problem, the individual response to treatment and co-operation of the patient.

The retention phase involves maintaining the teeth in their new positions while they settle and this usually takes a year.

Would surgery speed up treatment?

Contrary to popular misconception, surgery is not a quick alternative to braces. It is indicated only when there is a jaw deformity that cannot be corrected by braces alone. Surgery needs to be coordinated with orthodontic treatment.

Can snoring be corrected by braces?

Snoring is a symptom that could be part of other problems such as sleep apnoea. While these require handling by a respiratory specialist, some patients might be benefited by wearing appliances that hold the jaw forward during sleep.

Dr Sridevi Padmanabhan completed her graduation at the College of Dental Surgery, Manipal. She was awarded the Colgate Palmolive Award and the International College of Dentists Award for academic excellence. A top ranker, she did her MDS at the Tamil Nadu Govt. Dental College, Chennai.She is also a Diplomate,Indian Board of Orthodontics.

Dr.Sridevi Padmanabhan is a Consultant Orthodontist at The Clinic, T.Nagar ,Chennai. She is also a Professor, Dept. of Orthodontics,Sri Ramachandra Dental College and Hospitals. She can be contacted at sridevipadu@gmail.com