Orthodontic Treatment

Table of Contents
  1. Orthodontic Treatment

What is Orthodontic Treatment?

Orthodontics, the oldest specialty of dentistry, is a branch of dentistry that focuses on diagnosing, preventing and treating dental irregularities and facial anomalies. Since its early days, orthodontics has played an important role in beautifying the smiles and improving oral function for millions of people. As the science of dentistry has advanced, so have orthodontic techniques and tools.

The main goal of orthodontics is to achieve ideal alignment of the teeth and jaws and to improve the symmetry of the facial structure. Modern orthodontics combines traditional practices with innovative technology to provide more efficient, less painful and more aesthetically pleasing treatments.

To summarize briefly, orthodontics is a branch of dentistry that corrects teeth and jaws in the wrong position. It is also called braces treatment, braces, bracket treatment. Orthodontic specialists receive four years of specialty training in addition to five years of dentistry education.

Click here to access the American Orthodontic Association articles on orthodontic treatments.

If we consider the problems caused by crooked and incorrectly positioned teeth:

  • teeth are difficult to brush and clean
  • high likelihood of caries and gum disease
  • teeth can be lost prematurely due to caries and gum disease
  • crowded teeth can cause head, jaw joint, shoulder and back pain because they put too much stress on the chewing muscles
  • they pose serious aesthetic problems.

Crooked teeth negatively affect the aesthetic appearance of the individual and cause problems in social life.

In the light of this information, we can say that orthodontic treatment means a healthier mouth, a more beautiful appearance and longer-lasting teeth.

Do I Need Orthodontic Treatment?

Your dentist or orthodontist will decide whether you really need orthodontic treatment. Your doctor will evaluate your need for orthodontic treatment by using different diagnostic tools (photographs, x-rays, etc.).

If you have one or more of the following conditions, you may be a candidate for orthodontic treatment:

  • Your upper teeth are protruded (Figure 1) – there are two different reasons for this: 1) your upper teeth are in front, 2) your lower jaw or teeth are in the back. The orthodontic term for this condition is Class II malocclusion.
Class two malocclusion. The lower jaw is positioned behind the upper jaw. Orthodontic treatment
Figure 1. Lower teeth positioned backward
  • Underbite (Figure 2 and Figure 3) – in this case the lower front teeth are positioned in front of the upper front teeth when they should be behind them. The name of this condition in orthodontics is Class III malocclusion.
Class three malocclusion. The lower teeth are positioned in front of the upper teeth.
Figure 2. The lower teeth are positioned in front of the upper teeth.
The lower teeth are positioned in front of the upper teeth. There is an anterior crossbite.
Figure 3. The lower teeth are positioned in front of the upper teeth. There is an anterior crossbite.
  • Crossbite (Figure 4) – normally the upper teeth should cover the lower teeth like a box lid. In other words, the upper jaw is wider than the lower jaw. When the upper jaw is narrower than the lower jaw, this is called a crossbite. Crossbite should be treated as early as possible.
Normally, the upper jaw should cover the lower jaw like a box lid. In the image, it is seen that the upper jaw is narrow at the back.
Figure 4. On the posterior side, the upper jaw is narrower than the lower jaw. So there is a crossbite.
  • Open bite (Figures 5 and 6) – a gap between the upper and lower front teeth when the mouth is closed. In some cases, there may also be an open bite between the back teeth.
Although the back teeth make contact when the mouth is closed, the front teeth do not close.
Figure 5. The anterior teeth do not close. There is an open bite between the teeth.
Although the back teeth make contact when the mouth is closed, the front teeth do not close.
Figure 6. The front teeth do not occlude. There is an open bite between the teeth.
  • Misalignment of the midline of the teeth (Figure 7) – the middle of the upper two central incisors does not coincide with the middle of the lower two central incisors.
When the middle of the upper two central incisors and the middle of the lower two central incisors do not overlap, this is called a midline shift in orthodontics.
Figure 7. The middle of the upper teeth does not coincide with the middle of the lower teeth
  • Gaps (Figures 8 and 9) – if there is one or more gaps between the teeth, orthodontic treatment should be done to close them.
There are widespread gaps between the upper teeth. In orthodontics, this condition is called polydiastema.
Figure 8. There are gaps between the upper teeth
There are widespread gaps between the lower teeth. In orthodontics, this condition is called polydiastema.
Figure 9. There are gaps between the lower teeth
  • Crowding (Figure 10) – due to size mismatches between the teeth and the jaw, the teeth cannot fit into the jaws and crowding occurs.
There is a serious crowding of the teeth due to lack of space both in the lower jaw and upper jaw.
Figure 10. Crowding present in upper and lower teeth

Advantages of Orthodontic Treatment

Orthodontic treatment can not only create perfect smiles; it can also shape your life. The orthodontic journey offers both aesthetic and functional benefits:

  • Aesthetics: A proper smile can significantly boost self-confidence. The changes that come with orthodontic treatment can give you a new sense of pride in your appearance.
  • Better Function: Crooked teeth or jaw problems can affect proper speech and chewing functions. Orthodontic treatment not only straightens your teeth, but also improves speech and chewing functions.
  • Reduced Dental Problems: Teeth that are crowded or crooked can lead to cavities and gum disease because they are more likely to harbor bacteria. Orthodontics aligns the teeth, reducing the areas where harmful bacteria can hide.
  • Correcting Jaw Position: Problems such as deep bite, reverse bite and crossbite can put pressure on the jaw and lead to temporomandibular joint (TMJ) disorders. Orthodontic treatment corrects these alignment problems, reducing potential complications.
  • Easier Cleaning: Properly aligned teeth are easier to clean, floss and maintain. This means better oral health, fresher breath and a lower risk of periodontal disease.
  • Long-Term Financial Gains: Investing in orthodontic treatment now can prevent many dental problems in the future. This results in significant savings in future dental treatment costs.

Conditions Unsuitable for Orthodontic Treatment

Before starting orthodontic treatment, it is important that your teeth and gums are healthy. Serious dental problems, especially advanced cavities or gum disease, can be exacerbated by wearing braces and can negatively affect your oral health.

If you have cavities or gum disease, you should first consult a dentist to have these problems treated. Once these problems are under control, you can consult your orthodontist to find out if orthodontic treatment is right for you.

Orthodontic Treatment Options

Today, there is a wide range of orthodontic appliances available, from metal or ceramic braces to clear aligners. These treatments can be fixed or removable.

Each option has its own benefits and uses. Orthodontists have the expertise to evaluate factors such as age, jaw imbalances, and differences in tooth size. They will work with you to determine the most appropriate treatment option for you and create a smile that is unique to you.

How is Orthodontic Treatment Performed?

Orthodontic treatment – that is, braces – is necessary to solve the problems listed above. A wide range of orthodontic appliances are used to move the teeth. These appliances work by applying gentle forces to the teeth and jaws. Your doctor will create an orthodontic treatment plan according to the extent of your existing problem.

Orthodontic Treatment for Adults and Children

Fixed Orthodontic Treatment with Metal/Clear Braces

Fixed orthodontic appliances are the most commonly used appliances for orthodontic treatment. Brackets (Figure 11) are the best example of these appliances. Sometimes small appliances called bands are attached to the back teeth, which encircle the tooth and function in the same way as brackets. Archwires are components that pass through the brackets/bands and help us to move the teeth. The doctor increases the force applied to the tooth by activating (tightening) the archwire. These activations are usually done between 4-6 weeks. Modern braces are smaller, lighter and less visible than older braces.

The elastics (called ligatures) attached to the brackets can be of different colors (Figure 12), and if desired, gray elastics in the color of the metal (Figure 10) can also be ligatured. In addition to metal brackets, porcelain/sapphire brackets are also available (Figures 13 and 14).

We see the traditional metal brackets used in orthodontic treatment and the wire and elastic ligatures attached to the brackets. Orthodontic treatment
Figure 11. Traditional metal braces
We see traditional metal brackets used in orthodontic treatment and colored elastic ligatures attached to the brackets.
Figure 12. Traditional metal braces and colored ligatures attached to them
We see sapphire brackets, which are more aesthetic brackets, and the wire attached to it.
Figure 13. Clear sapphire brackets and the wire attached to them
We see sapphire brackets, which are more aesthetic brackets, and a wire with aesthetic coating attached to it.
We see sapphire brackets, which are more aesthetic brackets, and the wire attached to it.

Lingual Orthodontics

There are also braces that are attached to the inner surface of the teeth. This treatment technique is called lingual orthodontics. In lingual orthodontics, the brackets are placed on the inside of the teeth. Therefore, the brackets or wires are not visible from the outside. Because they are completely invisible, this method is often referred to as ‘invisible braces’. However, not every patient may be suitable for this treatment method.

Clear Aligners

Clear aligners – This treatment technique is also popularly called wireless orthodontics. It is an ideal option for patients with high aesthetic expectations. The most preferred brand of clear appliances is Invisalign (Figure 15). With Invisalign, you can have orthodontic treatment without wearing braces. It is a very comfortable treatment option in daily life as you can wear and remove the aligners whenever you want.

Clear aligner used for orthodontic treatment without braces
Figure 15. Clear aligner used in Invisalign treatment

Ordotonitic Treatments for Young Children

Removable Orthodontic Appliances

Removable orthodontic appliances – are usually used in children. Many skeletal and dental problems can be solved with removable appliances in children who are still in their developmental age (Figure 16 and Figure 17). Problems that can be solved at an early age include crossbite, backwardly positioned lower and upper jaw, lower jaw being forward, upper teeth being forward, problems that develop due to long-term thumb sucking, teeth and jaw problems resulting from various bad habits, etc. Some problems in particular need to be diagnosed and treated at an early age. After the child has completed his/her growth and development, skeletal problems are usually solved surgically. Therefore, you should consult an orthodontist when your child is 7 years old. Problems diagnosed at an early age can usually be solved easily.

Hawley appliance used for maxillary expansion in children.
Figure 16. Upper jaw expansion and correction of crossbite at an early age with removable appliances
Figure 17. Upper jaw expansion and correction of crossbite at an early age with removable appliances

Orthodontic Face Mask

Face mask appliance (face mask) – is a treatment method used in children with upper jaw recession (underdeveloped upper jaw). It consists of two parts, intraoral and extraoral. There are many different face mask treatment methods. The orthodontist will decide which one is most suitable for your child.

Click to read my article about face mask treatment.

Side view of the face mask used to move the upper jaw forward. The upper part of the face mask rests on the forehead, the lower part rests on the tip of the lower jaw. In the middle part, a rubber band is attached that passes through the mouth.
Figure 18. Face mask appliance used to bring the underdeveloped upper jaw forward.

Functional Appliances

Functional appliances – is a type of orthodontic treatment performed on patients with underdeveloped lower jaw. Treatment performed with functional appliances is called functional jaw orthopedics. The most important factor in functional jaw orthopedics is to adjust the timing of the treatment well. There are many methods and appliances used in functional jaw orthopedics treatment. Your orthodontist will decide on the most appropriate method for your child.

Click to read my article about functional treatments.

An example of a removable functional appliance used to bring the lower jaw forward. The photo on the left shows the view of the appliance from the right side of the mouth, the photo in the middle shows the view from the front of the mouth, and the photo on the right shows the view from the left of the mouth. Twin Block Appliance
Figure 19. Example of a removable functional appliance used to bring the recessed lower jaw forward (Twin block appliance).

There are many appliances and appliance combinations used for orthodontic treatment. Although it is not possible to mention all of them here, what I have explained is for general information purposes. It does not replace any advice or treatment. Your own doctor determines the most appropriate treatment or treatment combination for you.

After Orthodontic Treatment

Once your orthodontic treatment is complete, you will need to use a retainer to maintain the new position of your teeth. Retainers are fixed and removable and must be worn to ensure that your teeth remain in their corrected position. Although they usually need to be worn for at least 12 months, your orthodontist will tell you how long you need to use them for your situation. For more information about retainers used after orthodontic treatment, you can read my article titled After Orthodontic Treatment.

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