Friday, December 18, 2015

Types of malocclusion

Malocclusion means all kinds of possible deviations from ideal occlusion. It manifests itself with a misalignment of the teeth in the dental arch, delayed teething, having supernumerary or missing teeth as well as having teeth of abnormal size or shape.

Malocclusion does not only affect your appearance, but also has an impact on the oral cavity functions. In effect, you might suffer from breathing, chewing, swallowing or even speech disorders. Overbite, underbite and crossbite are the most common kinds of malocclusion.

An overbite is a type of malocclusion which means an inappropriate relation between the upper and lower dental arch. The lower dental arch is far behind the upper arch. The upper front teeth overlap the lower teeth and the lower incisors are behind the upper incisors. This kind of malocclusion affects also our facial profile as it is marked by a deeper mentolabial fold and a sticking out upper lip.

A crossbite is a misalignment of the dental arches. In this type of malocclusion the lower teeth have a more buccal position in relation to the upper teeth. Moreover, an abnormal relation of the incisors is noticeable and causes visible facial asymmetry.

An underbite is characterized by the protruding lower dental arch in relation to the upper arch. The lower front teeth noticeably overlap the upper front teeth. This kind of malocclusion affects facial profile as the lower lip sticks out and the mentolabial fold is smooth.

Open bite
Another type of malocclusion is an open bite. It occurs when the upper and lower teeth do not touch each other. This type of malocclusion may occur both in the front and back part of the dental arch. The malocclusion is also marked by an unproportionally longer lower face.

Deep bite
In this condition the upper incisors significantly (deeply) overlap the lower incisors. We speak of a deep bite when the overbite exceeds 2-3 mm.

Crowding of teeth
This is a type of malocclusion which means a disproportion between the available and needed space for a tooth. In effect the teeth can erupt in the lingual position, canine teeth can stick out of the dental arch and the incisor teeth can be rotated, or it might turn out that there is not enough space for the teeth.

Too much space between the teeth.
In contrast to teeth crowding, this malocclusion means a disproportion between the size of the jaw/mandible and the teeth. The jaw is too big and the teeth cannot fill all of the space. In effect, there are extra gaps between the teeth.

Orthodontic retention phase What happens after your braces come off?

In order to maintain the effects of the orthodontic treatment, we have to undergo the retention phase, which will prevent possible return of malocclusion. What is the retention phase and how long does it take?

During the orthodontic treatment our teeth change their position. The braces force the teeth to move from places where they have stayed during our whole life. Unfortunately, usually the braces are not enough to hold the teeth in the desired position for our whole life. Without appropriate treatment our teeth will most probably come back to their previous position.

How to keep the teeth in their new position?
After completing the orthodontic treatment, we have to undergo so-called retention phase, which stabilizes our new bite. In order to do that, we use retainers. The aim of the retainers is to allow our jaw, teeth and gums to get used to the new order and to keep the teeth in their new position.

Types of retainers

There are two different types of retainers:
- fixed retainers, a permanent retainer, which is fixed to your teeth during the whole period of the retention phase. They consist of thin wires, which are attached to the interior side of the upper and lower incisor teeth. They are usually used after extraction of a lower incisor tooth, by the patients suffering from periodontal diseases, as well as to treat midline diastema.
- removable retainers, most common are so-called clear plastic retainers and hawley retainers. It is advisable to wear it 24 hours a day right after removing the braces. After some time, it is enough to wear the retainer only during the night plus 2-3 hours during the day.

How long does the retention phase last?
It is impossible to precisely determine how long will the retention phase last. It depends on many various factors, among others how long did the orthodontic treatment last, how serious was the malocclusion or how old is the patient. Sometimes, the orthodontist recommends to wear the retainer for the rest of your life.

We should always follow the doctor's recommendations about wearing the retainer. We have to be aware of the fact that removing the braces does not mean the end of the orthodontic treatment. Some teeth need constant "help" in order to stay in the right places. If we neglect that, we may lose all the effects achieved thanks to the braces.

I have malocclusion. What to do if you don't want to or cannot get braces?

Braces are not for everyone. Are there any alternatives to braces?

There is a lot of people who don't want to get braces due to emotional, aesthetical or professional reasons. There are also people, who can't get braces because of health problems - e.g. diseases of the immune system exclude the possibility of getting dental braces.

What to do if we don't want the braces to be visible?
If we are afraid of the unattractive appearance of the traditional braces or of pain, which sometimes accompanies the treatment, we have the possibility of choosing invisible braces. Nowadays, the invisalign aligners are becoming more and more popular. These aligners have no metal elements. They are not visible at first sight and they produce the same effects as the traditional braces.
Invisalign is made of smooth materials and therefore it doesn't irritate lips or gums. It is custom-made for each patient. A lot of doctors regard it as a very good option for treating diastema, crossbite, deep bite and crowding of teeth.

However, it is worth to notice that invisalign treatment demands a lot of self-discipline. In order to achieve the best effects, you should wear it all the time, except while eating and tooth brushing. When patients have long breaks between wearing the aligners, the treatment prolongs or even becomes impossible.

Other alternatives to braces
Sometime, in the case of a not serious malocclusion, the patient can opt for veneers. In this way we can hide some minor orthodontic problems. Unfortunately, there is a risk that while putting the veneers the surface of teeth will get damage. We should also remember that the veneers will not treat the malocclusion but only hide it.

Lingual braces are another discrete alternative to the traditional braces. They are cemented onto the backside of the teeth and owing to that - completely invisible. The lingual braces are as effective as the traditional braces. Unfortunately, it is still an unpopular and very expensive method as it requires help of a specialized support. The lingual braces can be put on only by orthodontists who possesses a special lingual brace certification.

Dental braces: types and prices

Beautiful smile as well as healthy and straight teeth are very often an effect of a long-term and expensive treatment. Modern orthodontics offers a great variety of different malocclusion treatments. Unfortunately, we have to pay for some of them.

There is a song which teaches children that in order to have healthy teeth it's enough to "just eat well and drink well [..], play safely and clean well". Unfortunately, songs for children don't reveal all of the truth. Not everyone can have a glamorous smile. Patients with malocclusion have to struggle with necessary treatments and, what follows, great expenses.

Phases of orthodontic treatment
The treatment always starts in an orthodontist’s office. The orthodontist classifies your type of malocclusion and then discuss the treatment and its duration. During the next visit, your orthodontist will carefully examine your occlusion, make a study model, take X-ray imagines of your face and occlusion as well as gather your medical documentation, especially your X-ray images (a panoramic radiograph and a cephalogram)

After discussing possible treatment methods, the patient (or the parent of a minor patient) choose the type of the braces, which are made by a specialist on the basis of the study model. During the next visit, you will either receive removable braces or the doctor will put the fixed braces on your teeth.
Both cases require regular orthodontist appointments during the whole treatment process. During the visits, the orthodontist modifies your braces according to the treatment progress. After the treatment, there come the retention phase. Usually, the patient receives another braces – the dental retainer, which may be either removable or fixed.

Types of braces
- Removable braces – most often it is used to treat malocclusion by children who still have milk teeth (alternatively who already have some permanent teeth). For a successful outcome the braces need to be worn over a dozen hours a day. It is advisable to wear the braces during the whole night and a couple of hours during the day. The treatment last for about 2 years.

- Fixed braces – only the orthodontist can put it on as well as remove it. It is attached to the outside surface of the teeth. This kind of braces is usually used in order to correct dental arch. It can also stimulate jaw expansion.

- Fixed lingual braces – it is also put on by the orthodontist and it is attached to the inside of the teeth, and therefore invisible.

- A retainer – it can be either removable of fixed. It is designed to hold your teeth in their new position after the treatment.

Can braces do harm?

Can everyone wear braces? Unfortunately, some patients cannot. Why?
Everyone would like to have white, healthy and straight teeth. Majority of us, when able to afford it, can straighten their teeth and eventually overcome complexes, which might have been disturbing us since our childhood. Straight teeth are important not only from the aesthetical point of view: malocclusions may cause a lot of diseases such as mobility or drifting of teeth, periodontal diseases or temporomandibular joint diseases. Moreover, it is hard to clean crooked teeth what results in plaque and tartar.

What are the contraindications for dental braces?
People who suffer from diseases that weaken the immune system such as leukemia, or from hormone disorder, uncontrolled diabetes as well as people taking drugs for osteoporosis cannot get the dental braces. The diabetics should consult the doctor about their plan to get the braces and only after having confirmed a stable blood glucose and hormone level can they go to an orthodontist.
Patients with too many missing teeth or those suffering from periodontal diseases also cannot get the dental braces. All periodontal diseases as well as possible inflammation in the mouth have to be treated before getting the braces.

When can dental braces do harm?
If you want to have dental braces, it is important to pay attention to regular orthodontic appointments. During a visit, the doctor check your denture and adjust the braces, so that the treatment produce the desired effects. Braces which are not checked by a doctor for several months may be very harmful for the patient.

Usually, the appointments are set once a month and in the case of the self-ligating brackets - every 6-8 weeks. With braces, it is extremely important to take care of the oral hygiene. While brushing your teeth, you have to reach all the areas where caries may develop. Improper tooth brushing can also cause discoloration.

Don't panic in case of caries. An orthodontist can remove the braces or a part of it, so that the dentist is able to cure the tooth. After the dental treatment, the braces should be put on again as soon as possible.