Braces treatment (Orthodontic treatment) is used to correct the teeth alignment prior to jaw surgery (Orthognathic surgery) for patients with discrepancy in his jaw relationship. This procedure requires close collaboration between orthodontist (dentist who does braces treatment) and maxillofacial surgeon (dentist who does jaw surgery). The objective of braces treatment before jaw surgery is to prepare the patient for surgery by placing the teeth in correct position in relative to their respective jaw bone without concern for the bite and aesthetic of patient. During this phase, patient might have compromised aesthetic and bitting ability until the jaw surgery is done. After jaw surgery, short duration of braces treatment is required to refine the final occlusion.
Reasons of braces treatment before jaw surgery
Facilitate the surgical procedures
Allow maximum surgical correction
Shorten and simplify braces treatment after the surgery
Allow production of stable bite during and after surgery
Dr. S. N. Ng is a general dental practitioner. She graduated from University of Malaya in 2003.
She is the founder and director of Prestige Dental Care Sdn. Bhd. She used to work in Prestige Dental Care, Bandar Puteri Branch before moving to Prestige Smile Bright, Bandar Puteri. Now she is in-charge and leading doctor in Prestige Smile Bright.
She mainly interest is braces and aesthetic dentistry which include teeth whitening, crowns and bridges. She attended many courses to improve her skills in denstistry field; and now she is one of the Invisalign Provider which provide clear aligner to align teeth.
Highly recommended by her patients for being gentle and caring, Dr. Ng always make sure the ultimate comfort of her patients while providing dental care.
A young lady came to our clinic complaint of her teeth were crooked and her front teeth were jerking out (below). She wanted to have them corrected.
We suggested to her that braces would be the best treatment option.
She went through orthodontic treatment for 1 years and finally, all her teeth were well aligned (below) and she has the confident to smile again!!
Read more on how we corrected her teeth…
A consultation for braces by dentist/orthodontist is a necessary to determine the need for braces, to size the braces and decide on various other factors concerning the impending braces. The consultation will last about a half an hour and cover various aspects of the braces as well as provide patients and their parents with all the necessary information.
During consultation, you will be asked questions such as:
What you don’t like about your teeth/face?
What do you want to achieve at the end of the treatment?
You expectation form the treatment
Examination
Next, the orthodontist will examine your face profile (such as skeletal pattern, facial height and symmetry) , position of you nose, upper and lower lips and position of you chin.
Then, he will looks into your mouth to see the position of the upper front teeth; how much the teeth inclined, whether they are in front or behind the lower front teeth. He will examine each segment of your teeth; whether the teeth overlap each other (insufficient space) or spacing, any tooth tilted, submerge
Finally, oral hygiene, any teeth need to be restored, decayed teeth or impacted wisdom teeth to be extracted.
Other Investigations
Photos of patient face for orthodontic assessment
To complete the assessment, photos of your face and teeth as well as X-rays of the mouth will be taken at the consultation, and a molding of the teeth may be taken.
Photos of patient’s teeth
Dental Panoramic Tomogram or OPG radiograph
Cephalometry Analysis done with computer software
Two radiographs that required you to have are the dental panoramic tomography (OPG) and lateral cephalometry radiograph. Dental panoramic tomography (OPG) allows orthodontist to examine the whole upper and lower jaw; to look of any missing teeth, impacted or embedded teeth. It is a good radiograph to look for any pathological lesion in the jaw bone. Lateral cephalometry radiograph is used to determine the upper and lower jaw relationship. Computer software is used to analyze the severity of jaws discrepancy and is it important for treatment planning.
Dental Model – Duplication of patient’s mouth
Diagnosis
The main focus at the braces consultation is determining the need for braces. This diagnosis is often obtained before the consultation appointment but will be discussed in reference to treatment plans for your orthodontic problems.
Treatment
Each specific treatment plan will be discussed and outlined at the braces consultation. Treatment plans may include wearing a retainer for a few weeks before having the braces placed. The amount of time the braces will need to remain in place will also be discussed at the consultation. It is during the discussion of treatment when the orthodontist will explain to you the necessary care for braces. At the consultation visit, you will be allowed to decide the types of braces (metal or crystal) and the colors of each brackets.
He will also discuss with you other dental treatments that you needed before orthodontic treatment such as scaling, restoration work and extraction. Sometime, you are required to undergo minor surgery to remove impacted or embedded tooth prior orthodontic treatment.
Other Options
Alternative treatments will also be discussed at the braces consultation. Alternative treatments may include only wearing a retainer or wearing a clear mouth guard apparatus.
Warnings
At the consultation appointment, the orthodontist will discuss the risks and complications associated with wearing braces. The orthodontist will then warn you about pain and discomfort associated with the braces and possible problems the braces can create, such as the removal of enamel from the teeth and gum soreness and bleeding. He will ask you to clean your teeth very well to prevent teeth decay during orthodontic treatment. You will have to wear a retainer at the end of the treatment to minimize relapse.
Financial Arrangements
Because braces are expensive, it is important that payment arrangements be discussed at the consultation appointment. At the consultation, the orthodontist may ask the patient and guardians if the patient has dental insurance. If the patient does not have dental insurance, the orthodontist may be able to set the patient up on a payment plant or may require the total cost of the braces be paid up front or by installment.
As a rule, positive orthodontic results can be achieved by informed and cooperative patients. Thus the following information is routinely supplied to all who consider orthodontic treatment. While recognizing the benefits of healthy teeth and a pleasing smile, you should also be aware that orthodontic treatment has limitations and potential risks. These are seldom enough to avoid treatment, but should be considered in making the decision to undergo orthodontic treatment. Orthodontic treatment usually proceeds as planned; however, like all areas of the healing arts, response to treatment and results cannot be guaranteed.
Benefits of Orthodontic Treatment
Orthodontics plays an important role in improving overall oral health. Orthodontics also helps create balance and harmony between the teeth and face for a beautiful, healthy smile. An attractive smile enhances one’s self esteem, which may actually improve the quality of life itself. Properly aligned teeth are easier to brush, and thereby may decrease the tendency to decay, or to develop diseases of the gum and supporting bone.
Nature & Purpose of Orthodontic Procedures
Orthodontics strives to improve the bite by helping to direct forces placed on the teeth. This protects the teeth from trauma during ordinary everyday activities, such as chewing and stress. Properly aligned teeth also help minimize excessive stress on bones, roots, gum tissues and the temporomandibular joints. Orthodontic treatment has the potential to eliminate future dental problems including the problem of abnormal wear. Treatment can facilitate good oral hygiene to minimize decay and future periodontal problems. In addition, orthodontics can provide a pleasant smile, which may enhance one’s self-image.
Orthodontic Treatment Risks
All forms of medical and dental treatment, including orthodontics, have some risks and limitations. Fortunately, in orthodontics complications are infrequent and when they do occur they are usually of minor consequence. Nevertheless, they should be considered when making the decision to undergo orthodontic treatment. The major risks involved in orthodontic treatment may include, but are not limited to: 1. DECALCIFICATION:(Permanent enamel markings) Tooth decay, gum disease, and permanent markings (decalcification) on the teeth can occur if orthodontic patients eat foods containing excessive sugar and/or do not brush their teeth frequently and property. These same problems can occur without orthodontic treatment, but the risk is greaterto an individual wearing braces. 2. ROOT SHORTENING: In some patients the length of the roots may be shortened during orthodontic treatment. Some patients are prone to this happening, some are not. Usually this does not have significant consequences, but on occasion it may become a threat to the longevity of the teeth involved. 3. GOOD ORAL HYGIENE: The health of the bone and gums which support the teeth may be affected by orthodontic tooth movement if a condition already exists, and in some rare cases where a condition does not appear to exist. In general, orthodontic treatment lessens the possibility of tooth loss or gum infection due to misalignment of the teeth or jaws. Inflammation of the gums and loss of supporting bone can occur if bacterial plaque is not removed daily with good oral hygiene. 4. RELAPSE TENDENCY: Teeth may have a tendency to change their positions after orthodontic treatment. This usually is only a minor change and faithful wearing of retainers as instructed should help reduce this tendency. Throughout life the bite can change adversely from various causes, such as: eruption of wisdom teeth, growth and/or maturational changes, mouth breathing, playing of musical instruments and other oral habits, all of which may be out of the control of the orthodontist. 5.JAW JOINT PROBLEMS: Occasionally problems may occur in the jaw joints, i.e., temporomandibular joints (TMJ), causing joint pain, headaches or ear problems. These problems may occur with or without orthodontic treatment. Any of the above-noted symptoms should be promptly reported to the orthodontist. 6.LOSS OF TOOTH VITALITY: Sometimes a tooth may have been traumatized by a previous accident or a tooth may have large fillings, which can cause damage to the nerve of the tooth. Orthodontic tooth movement may in some cases aggravate this condition and in rare instances may lead to root canal treatment. 7.POST-ADJUSTMENT PAIN: Sometimes orthodontic appliances may accidentally be swallowed or aspirated or may irritate or damage oral tissues. The gums, cheeks and lips may be scratched or irritated by loose or broken appliances or by traumatic blows to the mouth. Usual post adjustment tenderness should be expected, and the period of tenderness or sensitivity varies with each patient and the procedure performed. Typical post-adjustment tenderness may last 24 to 48 hours. You should inform our office of any unusual symptoms, broken or loose appliances, as soon as they are noted. 8. MINOR INJURIES: On rare occasions, when dental instruments are used in the mouth, the patient may inadvertently get scratched, enamel abrasions, poked or receive a blow to a tooth with potential damage to or soreness of affected oral structures. Abnormal wear of tooth structures is also possible if the patient grinds their teeth excessively. We will use extreme care to avoid minor injuries. 9. ADJUNCTIVE SURGERY: Sometimes oral surgery; tooth removal or orthodontic surgery, is necessary in conjunction with orthodontic treatment, especially to correct crowding or severe jaw imbalances. Risks involved with treatment and anesthesia should be discussed with your general dentist or oral surgeon before making your decision to proceed with this procedure. 11. UNFAVORABLE GROWTH: Atypical formation of teeth, or insufficient or abnormal changes in the growth of the jaws may limit our ability to achieve the desired result. If growth becomes disproportionate during or after treatment, or a tooth forms very late, the bite may change, requiring additional treatments or, in some cases, oral surgery. Growth disharmony and unusual tooth formations are biological processes beyond the orthodontist’s control. Growth changes that occur after orthodontic treatment may alter the quality of treatment results. 12. TREATMENT TlME: The total time required to complete treatment may exceed the original estimate. Excessive or deficient bone growth, poor cooperation in wearing the appliance(s) the required hours per day, poor oral hygiene, broken appliances and missed appointments can lengthen the treatment time and affect the quality of the end results. 13. CERAMIC BRACES: When clear and tooth colored brackets (ceramics) have been utilized, there have been some reported incidents of patients experiencing bracket breakage and/or damage to teeth, including attrition and enamel flaking or fracturing on debonding. Fractured brackets may result in ceramic remnants, which might be harmful to the patient especially if swallowed or aspirated. 14. ADJUNCTIVE DENTAL CARE: Due to the wide variation in the size and shape of teeth, achievement of the most ideal result (for example, complete closure of excessive space) may require restorative dental treatment (in addition to orthodontic care). The most common types of treatment are cosmetic bonding, crown and bridge restorative dental care and/or periodontal therapy. You are encouraged to ask questions regarding dental and medical care adjunctive to orthodontic treatment of those doctors who provide these services. (i.e. general dentist, periodontist, oral surgeon). 15. MEDICAL PROBLEMS: General medical problems can affect orthodontic treatment. You should keep your orthodontist informed of any changes in your medical health. 16. PERFECTION IS OUR GOAL: In dealing with human beings and problems of growth and development, genetics and patient cooperation, achieving perfection is not always possible. Orthodontics is an art, not an exact science; therefore, a functionally and esthetically adequate result, not 100% perfection, must be acceptable. Your comments in regard to your expectations prior to, during and after orthodontic treatment will help us understand your concerns. Please keep us regularly informed of your feelings, concerns and results that do not meet your expectations.
Possible Alternative Treatments
For the vast majority of patients, orthodontic treatment is an elective procedure. One possible alternative to orthodontic treatment is no treatment at all. You could choose to accept your present oral condition. The specific alternative to the orthodontic treatment of any particular patient depends on the nature of the individual’s teeth, supporting structures and appearance. Alternatives could include:
1. Extraction versus treatment without extraction(s);2. Orthodontic surgery versus treatment without orthodontic surgery;
3. Possible prosthetic solutions (bridges, implants, partials, replacement teeth); and
4. Possible compromised approaches (To be discussed with you, if applicable)
Orthodontics is the art of repositioning the teeth in the mouth, and is traditionally thought of as something only buck-toothed children go through. In fact, orthodontics helps a host of positional problems in the mouth, in both children and adults.
Take for example, some one with a large gap between his front teeth. There are several ways to close that gap, depending on what caused it, where it is, and the state of health of the surrounding teeth. You could restore the teeth through the use of a crown, or you could remove the affected teeth and replace them with a bridge or implants, which is clearly the least desirable option. Alternatively, you could reposition the teeth using orthodontics: the ideal treatment when your teeth are healthy and look attractive, because you don’t lose some of the healthy parts of your teeth as you would during crowding. You simply move the teeth in the gums and put them in a more attractive position.
Orthodontics is mostly used for cosmetic reasons such as straightening teeth or closing gaps. You might have buck teeth, or you might have very skew teeth. Perhaps you have a gap that has bothered you all your life. If your teeth are healthy, but your simle needs improvement, orthodontics may be the way to go.
Orthodontic treatment does take a long time, there’s no getting away from it. You’re looking at six months to three years, depending, of course on what your particular problem is, and you will require regular checkups and adjustments to ensure the desired result is achieved. However, modern braces are far less visible (as compared to the traditional full-sized braces), and treatment may be as simple as a retainer plate for a couple of months.
Traditional Braces
Traditional full-sized braces
Mini Braces
Mini braces are the most popular braces people wear today.
Lingual Braces
These days, some problems may be corrected with lingual braces. These are mounted on the back surface of the teeth, and are virtually invisible. If those are not an option for your problem, you can also have clear plastic/crystal brackets fitted to your teeth instead of traditional metal ones, which also reduces their visibility to others.
Lingual braces
Crystal Braces
Unlike ceramic brackets that are opaque and colored to mimic a particular tooth shade, clear brackets are crystal clear and virtually disappear regardless of tooth shade. For more info, click here
Crystal brackets
Of course, there are possible complications, of which you should be aware. In some cases, the teeth move back to their original positions. This is the reason you are required to wear a retainer plate that ensures the teeth stay put after the actual treatment. In additional, loose bands on the teeth can create decalcified areas where decay can begin. However, this is not common, and modern bonding methods ensure the brackets are fixed to the teeth in such a way that the risk of decay is greatly reduced.
Colour on braces
Invisalign Aligner
Invisalign
Invisalign is a well known clear aligner used to correct misaligned teeth with ease and comfort from the US.
Mbrace Aligner
MBrace
MBrace is a clear aligner used to correct misaligned teeth with ease and comfort. It is clear and removable which makes it almost unnoticeable by others and convenient to use. The aligners are custom-made digitally and fabricated individually to ensure a perfect and accurate fit for your teeth.
Treatment can be performed by a general dental practitioner who has sufficient training in orthodontic field or by an orthodontist who specializes in this field. Generally, your dentist refers you to an orthodontist, with whom you make an initial appointment, so that he can assess the state of your teeth and propose a treatment plan. It is good idea, at this stage, to discuss cost implications, as orthodontic treatment can be very costly, and you need to know what you are letting yourself in for.
Your treatment plan may consist purely of braces and retainers, just retainers, or may even require that two or more teeth are removed to make space in your mouth. For example, you may have buck teeth in your mouth because there simply wasn’t enough space for all your adult teeth in your gums when they erupted. To correct this, the orthodontist may have to extract the back molar on each side of the top set of teeth to make extra room in your mouth. This then allows him to move the remaining teeth into a more favorable position.
Also don’t forget to ask the orthodontist how long the treatment is likely to take. It’s a lot easier to put up with braces if you know when they’re likely to come out. All in all, however, orthodontics is a painless procedure; there is some initial discomfort from braces or even from a retainer, but this generally disappears after a few weeks. It’s more a case of getting used to the foreign objects in your mouth than them causing discomfort.
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If you have any question, don’t hesitate to contact us, we are more than glad to provide you with the information you need!
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