Ortho­dontic Treat­ment

Orthodontics is the branch of dentistry that deals with the preven­tion, detec­tion and treat­ment of defor­mi­ties of the jaws and teeth.

Basically, any dentist may treat his patients ortho­donti­cally, but only an ortho­dontic specia­list has several years of training in this field, has passed a specialist exami­nation before the Chamber of Dentists and deals exclu­sively with ortho­dontics.

Your dentist in this practice, Dr. med. dent. Jost, is such an ortho­dontic specialist.

Diagnosis

Panoramic radiograph, photo: www.orto­doncia.ws

Before any ortho­dontic treat­ment, a detailed dia­gno­sis must be made. This con­sists of a medi­cal and den­tal health history (an­am­ne­sis), a physi­cal exami­na­tion, a func­tio­nal and model ana­ly­sis (by means of a mold of the teeth) and a radio­graphic exami­na­tion. With these findings the posi­tional relation­ship between the upper and lower jaw can be analyzed in detail. Simul­ta­neously, the peri­odontium is assessed and the dentition stage evalued.

At what age should one treat?

Girl with braces, photo: Zoe

The timely dia­gnosis enables an optimal start of treat­ment, which can often shorten the duration of treat­ment and reduce its amount. There­fore, children should be examined before the age of 10 in case of any suspicion of mis­aligned teeth. The treat­ment is pre­feren­tially carried out using the natural growth spurts from 9 to 14 years of age.

However - contrary to older opinions - an ortho­dontic treat­ment is possible at any age, even in adult patients. This applies in the event that an earlier treat­ment was missed or has failed, in case of patho­lo­gical tooth migration, and in the context of a disease of the gums. These treat­ments, however - apart from excep­tions - are not covered by public health insurance.

Treatment methods

Dental equipment for the correc­tion of mis­aligned jaws and teeth are collec­tively called braces. A typical treat­ment takes an average of 2-4 years, the dura­tion depends on the type and degree of the mis­align­ment, the braces used during therapy and the patient's cooperation.

Wired braces

Metal wired braces, photo: Monica Nguyen

Most common are fixed tradi­tional metal wired braces (in Germany called Brackets). They are attached to the tooth's surface by special bonding tech­niques and thus form an anchor point for the move­ment of the teeth.

Wired braces can be distin­guished according to where they are attached to the tooth. Mounted on the outer surface, i.e. directed to the cheek, they are called buccal braces (see image above). If they are attached to the inner surface of the teeth, facing the tongue, they are called lingual braces.

Lingual braces

In case of a lingual approach, a fixed brace is attached to the inside of the teeth, thus being virtually imper­ceptible from the out­side. Since the fine adjust­ment of the teeth is often more diffi­cult with this tech­nique than with buccal braces, the lingual tech­nique must often be combined with a final clear-aligner treat­ment (see below).

Thus, both the duration of treat­ment at each appoint­ment and the total treat­ment time are extended. There­fore, the costs are in general conside­rably higher compared to the conven­tional treat­ment with braces on the outer side of the teeth.

Clear-aligner treatment

Relatively new are correc­tion devices (aligners) made of trans­parent plastic. Unlike tradi­tional braces clear aligners have no adjustable elements. Instead, a mold of the patient's teeth is taken, which is used to create a digital tooth scan. Then a compu­te­rized model of the desired teeth positions is derived and stages between the current and the inten­ded teeth posi­tions are calculated and aligners are created accordingly.

Invisalign orthodontic aligner, photo: Smikey Io

Each aligner is worn conse­cu­tively for 2 weeks, about 20 hours per day. Up to 36 aligners are used over a period of 9-18 months. The aligners are more notice­able than lingual braces but less than buccal braces. They can easily be removed during meals and for cleaning of the teeth. Pronun­ciation can be affected at the beginning of the treat­ment, but usually improve with time.

Removable braces

Removable brace, photo: Metoc

Removable braces are used as active plates for upper and lower jaws and func­tional ortho­dontic devices. Active plates are parti­cu­larly suitable for children in the mixed denti­tion stage. In the perma­nent denti­tion active plates are used only for smaller tooth move­ments.

Temporo­mandibular joint dysfunction

Temporo­mandi­bular joint dys­function (TMD) is an umbrella term covering dys­regu­la­tions of muscle and joint func­tion of the jaw joints, which may be struc­tu­ral, func­tio­nal, bio­chemi­cal and psycho­lo­gi­cal in nature.

Find more on our dedicated page for TMD.