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What is orthodontic Treatment?
Orthodontic treatment deals with the correction of irregularly arranged teeth. It involves the process of bringing the teeth into proper position and alignment with the help of braces(wires and brackets).

It is a scientific procedure which can also alter the position and orientation of the jaw structure supporting and housing the teeth and the surrounding periodontium.

Why should you consult an orthodontic specialist for this kind of treatment?
An Orthodontist specializes in the treatment of irregularly arranged teeth .Neither a simple B.D.S or a normal dentist is equavalant to an orthodontist and nor is every M.D.S an orthodontist.
After completing B.D.S one has to undergoe a comprehensive three year post graduate training program in orthodontia to become an orthodontic specialist. Obviously, there is quality and efficiency in the treatment given because of Orthodontist's specialized knowledge yielding to long term benefits.

Moresoever, because the procedure differs on various points from person's age to severity of the deformity, customized treatment planning has to be provided to the patient as each case is different and require expertise in the subject which only an orthodontist can give.

One should consult an orthodontist if-
- teeth are not in line and shape geometrically.
- there is difficulty in chewing food.
- child's milk teeth fall or shed before the normal schedule or if they do not shed naturally on due time.
- when the permanent teeth do not appear within three or four months of deciduous(milk teeth) shedding.
- the child does lip-biting, thumb-sucking or breathes through the mouth.
- there is a cross bite (the bottom teeth come or lie ahead of the upper teeth when the mouth is fully closed).
- the child has a habit of breathing through the mouth or has a open mouth while sleeping.
- there is continious and persistent cheek biting ( biting of the inner skin of the cheek) or if there is deep traumatic bite (the lower front teeth hit the upper palatal mucosa on closure).
- the jaw deviates OR there is a CLICK sound while closing or opening the mouth.
- there is pain in TMJ (area below and front of the ear ) during opening or closing movements of the mouth.
- there are congenital speech defects (as seen in cleft lip and palate cases) or there is a problem in speaking or pronouncing certain words correctly.

What is the right age to start the treatment?
Although the treatment can be started at almost any age, it primarily depends upon the nature of the problem and bone condition. Age group between 12 - 18 is the most ideal for orthodontic treatment, but in some deformities and certain developmental and functional aberrations the treatment is started between age 6 to 10.

What are the benefits of Orthodontic treatment?
Orthodontic treatment benefits in the following ways-
1. It adds to the overall looks and beauty of the face.
2. Helps in getting a wide, well structured beautiful smile.
3. Enhances the confidence levels of an individual.
4. Establishes a better co-ordination between upper and lower teeth which is important for correct execution of the chewing process and digestion henceforth.
5. It makes tooth brushing much easier and convenient.

What are braces?
Braces consist of brackets and wires. These brackets and wires are the main tools for the treatment. The brackets are stuck on the teeth and wire is attached over them.
Wire is the key element in bringing the change in the position of the teeth. Usually braces are made of steel, ceramic or plastic. Ceramic and plastic braces are less noticeable as compared to steel braces and hence are more aesthetic.

Is orthodontic procedure painful?
There is only mild pain during the initial phases of the treatment and sometimes during wire tightening. Otherwise there is no pain.

Does orthodontic treatment make the teeth loose?
No, this is just a myth and not a reality.

How much time does the whole treatment take?
The span of treatment usually varies between 1.5 - 2 years.
The time taken depends upon the patient's active participation and involvement. Complex procedures that deals with changing the jaw size- shape and orientation and certain deformities like cleft lip and palate etc. require a multidisciplinary approach, therefore requires more time than normal.

Is removal of some teeth necessary for orthodontic treatment?
Tooth removal is not required in every case. It becomes necessary when there is deficient space for all teeth to align themselves in correct order and inclination.The space created after removal of teeth gets filled up by other teeth during the course of treatment itself and by this way entire set of teeth is positioned in the most desired position. In certain conditions removal of teeth is required in upper or lower arch alone.

How many times and how often one has to visit the orthodontist for treatment?
Initially 2-3 times and thereafter once in a month is normally what is required. But if due to negligence or any other reason there is breakage of brackets then repair should be done immediately or else the progress of the treatment is stalled there itself and total treatment duration increases. if an appointment needs to be changed, the orthodontist should be informed in advance and a fresh appointment should be taken such that the interval between 2 appointments is not long or else treatment is unnecessarily delayed.

Why orthodontic treatment seems to be expensive?
There are two main reasons for this:
1. The instruments and materials used in orthodontic treatment are mostly imported from outside and are of high quality. Lot of precision is involved in manufacturing these products.
2. The duration of the treatment is long (1-2yrs),thus the treatment is really not expensive.

Implants


What is dental implant?
A dental implant is a small screw shaped attachment, usually made from titanium. It is inserted into the jawbone to replace back a missing tooth. Once it gets fused with the jaw bone an artificial tooth is made upon it so that the entire load of chewing food is borne by the implant.

Can one have new teeth fixed immediately?
Although some implants can be loaded into function immediately yet it is often suggested that a period of 3 months or more be allowed for the implant to integrate or fuse with the bone. A temporary bridge or removable partial denture can be worn during this period.

Is the procedure painful?
Placing the implants requires a small operation.. This can be done under local anaesthesia. There is no pain at the time of insertion. There is only slight discomfort during the week following the placement.

How long does the treatment take?
Normally, it takes about 3 months from the initial assessment to the time when the artificial teeth or denture are finally attached to the implants.
A lot depends on individual treatment plan. The doctor is the best judge for each case. Complicated cases may require more healing time and a different time table.

Are Implants safe. How long will they last?
Implants are a well established, tried and tested treatment. Majority of the implants last for ever.

Can a single tooth be replaced by an implant?
Yes, a person can have a single tooth replaced by an implant. For badly damaged single tooth, implant can be placed immediately after extraction or removal of the tooth.

If more than one teeth are missing?
If only a few teeth are missing, two to three implants may be used. If all the teeth are missing usually 4 to 5 implants are used in each jaw. Normally each implant can be used to support at least two teeth.

What are the advantages of implant over Bridges and Dentures?
Implant supported teeth are more comfortable than conventional dentures (C.D. or RPD) because there is no slipping movement.
They are a better alternative to bridge work,in which to replace back one missing tooth or multiple teeth at least two or more healthy adjacent teeth are grinded in order to give support. This grinding is absolutely not required when implants are used.

Other benefits of implants are-
  • Dental implants can help to maintain the shape and structure of the jaw bone which otherwise undergoes shrinkage by denture or bridge wear.
  • Implants once fused (osseointegrated) with bone has the maximum load bearing capacity when compared to bridges, RPD, complete dentures and even the natrual teeth.
  • With dentures patients may not eat or speak well because of poor stability and continuous movement, but teeth attached to an implant do not cause this problem.


What can one can eat with implants?
Once the teeth are fixed over the implant patients are able to eat a normal healthy diet with little or no difficulty.

Can implant always be used to replace missing teeth?
This depends on the state or condition of the bone within the jaws. The doctor carries out various tests to assess the amount of bone present in concerned area of the jaw or the entire ridge in a patient with no remaining teeth at all.
If there is not enough bone, it may not be possible to place implants without bone grafting into the area.

What happens if the implant does not fuse (osseointegrate) with the bone?
This happens very rarely. If the implant becomes loose during the healing period or just after it, then it is easily removed and healing takes place the normal way. Once the jaw has healed, another implant can be placed there.

Who is not a suitable candidate for implant?
It is often difficult to get good bone support in people who have active periodontists (gum disease or pyorrhea) due to underlying uncontrolled diabetes. In such patients proper treatment planning is required. Also patient suffering from osteoporosis and other bone diseases are poor candidates for implant placement.

Is the treatment expensive?
Unfortunately yes, however in many situations, the cost of the treatment is a little more than the cost of more conventional treatment with crowns, bridges and dentures but considering the advantages of implants they are not really expensive.