What is Orthodontics?
Orthodontics is the speciality in Dentistry dedicated to correcting the malpositions of the teeth and jaws. This way, it ensures the correct teeth alignment and contributes towards a harmonious and functional smile, stabilising the temporomandibular articulation. Correct dental occlusion also enhances general well-being since there is an improvement in posture.
Orthodontics is therefore directed towards diagnosing, preventing and treating problems caused by teeth that do not articulate functionally and harmoniously, whether due to the poor position of the teeth themselves and/or the position of the jaws.
The causes of orthodontic problems
The main causes for having misaligned teeth are diverse, such as:
- For example, in the case of direct relatives, having a very prominent chin or overly protruding upper teeth.
Habits and behaviour;
- Sucking on dummies or the thumb;
- Mouth breathing;
- Premature loss of baby teeth.
A combination of genetic and behavioural factors can also occur.
The 1st Orthodontic consultation
As orthodontic issues are intimately linked to dental development and skeletal growth (dental bones), these can lead to disturbances in the temporomandibular joint and influence function and aesthetics by developing facial and body asymmetries. For this reason, we recommend a preventive Orthodontic evaluation at the age of 5-6 years and another during the final phase of the transition from deciduous to permanent dentition at 10-12 years.
During this appointment, an orthodontic study will be carried out to evaluate the need to use an orthodontic appliance and the most suitable one for each situation – fixed or removable orthodontic appliances, myofunctional removable appliances, “invisible” removable appliances (aligners) or conventional fixed brackets.
Step-by-step orthodontic assessment
- Orthodontic appointment
This consultation is carried out by the medical team responsible for diagnostic appointments for planning. Photographs are taken, x-rays are taken, a clinical assessment is made, and a treatment plan is drawn up.
- Oral Hygiene Appointment
Oral hygiene and any Oral Health treatments that may be necessary are carried out.
- Orthodontic study
An intraoral scan is carried out using the iTero® digital scanner, new photographs are taken, new X-rays are taken, and a new clinical examination is carried out.
- Digital planning
At this stage, it is possible to provide a diagnosis. Then, the patient’s smile is studied and drawn in order to plan the treatment as accurately as possible. Even before treatment begins, the patient is given a concrete idea of the final result of their smile, conceived digitally in 3D.
- Beginning treatment
Approximately one month after the study, orthodontic treatment begins. On this day, the patient receives their first set of aligners if the treatment was performed with Invisalign®. If they have chosen fixed orthodontics, the braces are applied.
This consultation lasts approximately one hour and is dedicated to advice and clarifications regarding the use and care to be taken during treatment.
- Follow-up appointments
For Invisalign® treatments, follow-up appointments are held every 8 to 10 weeks throughout the treatment Using the ClinCheck® software is the best way to assess whether treatment is progressing as planned.
At these appointments, the patient is also given the necessary aligners until their next appointment. If patients live abroad, check-ups can be carried out up to 12 weeks apart, depending on the case’s complexity.
If the treatment is performed with a fixed orthodontic appliance, consultations are held every 4 to 5 weeks.
More than just a check-up, each visit to the clinic is an appointment with the entire orthodontic team. Throughout the treatment, each team member accompanies the patient to meet the needs that arise at any moment.
At the end of the treatment, the patient returns every 6 months to have a check-up on the retainer – an appliance used to maintain the results obtained during treatment – and an oral hygiene appointment.
Dental correction can be carried out using a fixed orthodontic appliance. In this type of appliance, dental movement is achieved by placing brackets and metal arches.
The decision regarding the type of appliance to be used should consider the dentist’s diagnosis and the patient’s objectives and expectations.
Sometimes the conditions are not only dental but also skeletal (bone). Surgery to correct the relationship between the jaws may be indicated in these cases.
Orthognathic surgery is an intervention that is combined with orthodontic treatment when dentofacial discrepancies are found. Dentofacial deformities affect functions such as chewing, speaking and breathing Consequently, they interfere with the patient’s quality of life and psychosocial interaction.
Combined with orthodontic treatment, orthognathic surgery can restore the correct function and stability of the jaws, as well as smile harmony and aesthetics.
Functional Maxillary Orthopedics
Functional Maxillary Orthopedics is the area that diagnoses, prevents, controls and treats growth and development problems that affect the dental arches and their bone bases.
It aims to remove interferences that affect oral structure’s physiological growth and development. And its action on the neuromuscular system makes it possible to alter the bone development of the jaws, which, consequently, can lead to the teeth occupying more correct functional and aesthetic positions. This will create new postural reflexes, harmonious mandibular dynamics and better masticatory efficiency.
The treatment in Functional Maxillary Orthopedics may resort to using specific appliances or other types of resources.
Orthodontics with invisible aligners
Invisalign® is a transparent aligner that enables a more discreet and comfortable orthodontic treatment. The treatment is planned digitally, and the dental correction is achieved through the daily use of invisible aligners. Every 1 or 2 weeks, the patient switches from one aligner to the next until the correct position of the smile initially planned is achieved.
The aligners allow the treatment to be carried out without restrictions since they are removed for eating and daily oral hygiene.
- Joffe, 2003, Rahman et al, 2018, Lagravere et al, 2005, Pacheco-Pereira et al, 2018, Flores-Mir et al, 2017, Gu et al, 2017.
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- Rosvall et al, 2008 Wiechmann et al, 2003, Gu et al, 2017.
- Ribeiro-Neto, Ferreira et al 2018, Hunt et al, 2001.
- Ribeiro-Neto et al 2018, Mendes de Paula Gomes et al, 2019.
- Hunt et al, 2001.