Orthodontic treatment is the branch of dentistry concerned with the position of the teeth and the relationship between the upper and lower jaws. It is planned individually after an examination, and it is carried out over a period of months rather than in a single appointment.
What orthodontic treatment involves
Teeth are moved gradually through the bone by means of light, controlled forces applied by an appliance. The appliance may be fixed to the teeth or removable, and it is selected by the dentist according to the findings recorded during the examination. Because the movement is gradual, appointments are arranged at intervals so that the progress can be followed.
Situations that are assessed
Reasons that patients are referred for an orthodontic assessment include crowding, spacing between the teeth, teeth that have not erupted into their expected position, differences in the way the upper and lower teeth meet, and concerns about the appearance of the front teeth. Whether treatment is indicated, and which approach is suitable, is decided by the dentist after the examination.
When an assessment is usually arranged
An orthodontic assessment during childhood allows jaw growth and the eruption of the permanent teeth to be followed. Assessment is not limited by age, however; adults are also examined, and the plan is drawn up according to the condition of the teeth and the supporting tissues at that time. Where the supporting tissues need attention first, gum treatment may be arranged before orthodontic movement begins.
How the treatment proceeds
- Examination and records. The teeth and jaws are examined. Radiographs, photographs and impressions or digital scans are taken where they are considered necessary.
- Planning. The dentist explains the findings, the approach that is being proposed, the appliance to be used and the expected duration.
- Preparation. Any treatment needed before appliances are fitted, such as fillings or cleaning, is completed first.
- Fitting the appliance. The fixed or removable appliance is placed and its use is explained.
- Review appointments. The appliance is adjusted at intervals set by the dentist and the movement of the teeth is followed.
- Retention. When the appliance is removed, a retainer is used for a period determined by the dentist so that the new positions are maintained.
Types of appliance
Fixed appliances consist of brackets bonded to the teeth and a wire that connects them; metal and tooth-coloured brackets are both used. Removable appliances and clear aligner systems are used in situations the dentist considers suitable. Appliances used during childhood may also be directed at the growth of the jaws rather than the position of individual teeth. Which of these is appropriate is a clinical decision made after examination.
Living with an appliance
A feeling of pressure or tenderness in the first days after an appliance is fitted or adjusted is commonly reported and is discussed at the appointment. Hard, sticky and very chewy foods are generally avoided while a fixed appliance is in place. Cleaning takes longer than usual, and the dentist or the dental hygienist demonstrates the brushes and aids to be used around the brackets and wires. Attending the scheduled review appointments affects how the treatment progresses.
After the appliance is removed
Teeth have a tendency to move throughout life. For this reason a retainer, either fixed behind the teeth or removable, is used after the active phase. The dentist explains how long it should be worn and arranges review appointments. Where the appearance of the front teeth is also being discussed, restorative options such as laminate veneers and zirconia crowns or a smile design assessment may form part of the wider plan.
Orthodontic treatment in adults
Teeth can be moved at any age as long as the supporting tissues are healthy, so treatment is not limited to childhood. In adults the gum and bone condition is assessed first, because movement is planned around the support that is actually present. Existing crowns, bridges and fillings are also taken into account, since they affect how the teeth can be gripped and moved. Treatment in adults is often planned alongside other dental work rather than in isolation.
Orthodontics before restorative or implant treatment
Where a tooth has been missing for a long time, neighbouring teeth may have tilted into the space and the opposing tooth may have moved down into it. Restoring such a gap without first correcting the position can leave too little room for the planned restoration. In these cases limited orthodontic movement is carried out before implant treatment or a prosthetic restoration, and the sequence is agreed between the dentists involved at the planning stage.
Extractions as part of a plan
Some plans require space to be created before the teeth can be aligned. Where the jaw cannot accommodate all the teeth in their correct positions, removing selected teeth may form part of the plan; in other cases space is gained by expansion or by reshaping contact surfaces. Which approach applies is determined from records and radiographs, not from the appearance of the front teeth alone, and the reasoning is explained before treatment begins.
What lengthens a treatment plan
An estimated duration assumes that appointments are kept, appliances are worn for the hours specified and breakages are rare. Missed appointments interrupt the planned sequence of adjustments. Aligners that are worn for fewer hours than prescribed do not deliver the planned movement, and repeated bracket breakages mean the same stage is repeated. Oral hygiene also affects the plan, because treatment may be paused if gum inflammation develops.
A loose bracket or a wire that catches
A bracket that has come away or a wire end that presses into the cheek should be reported to the clinic rather than left until the next scheduled visit. Orthodontic wax placed over the point that rubs gives temporary relief. Wires should not be cut or bent at home, as this changes the planned force. If a small piece has come loose in the mouth it should be removed carefully and kept to bring to the appointment.
Arranging orthodontic treatment from abroad
Orthodontic treatment differs from most other dental work in that it requires regular adjustment appointments over many months, so it is rarely suitable for a single trip. Where a patient lives abroad, what can be planned depends on how often travel is possible and on whether follow-up can be arranged locally. Please discuss this with the clinic before treatment is started rather than afterwards, so that an achievable plan is agreed at the outset.
Frequently asked questions
How long does orthodontic treatment take?
The duration differs from person to person. Your dentist gives an expected timeframe after the examination and the records have been assessed, and reviews it as treatment progresses.
Is there an upper age limit?
Orthodontic assessment is not restricted by age. What matters is the condition of the teeth and of the tissues that support them, which is established at the examination.
If you have a question about this subject, you can reach our clinic.
Does an appliance affect speech or eating?
An adjustment period is usual, and its length differs from person to person. Your dentist explains what to expect for the specific appliance being used.
What happens if I do not wear my retainer?
Retainers are used to maintain the positions reached during treatment. Your dentist explains the wear schedule and follows it up at review appointments.
How do I arrange an orthodontic examination?
You can reach our clinic through the contact page to arrange an appointment.
The information on this page is for general information purposes only and does not replace an examination by a dentist. Diagnosis and treatment planning are carried out by the dentist following an intraoral examination and, where considered necessary, radiographic evaluation.
Related content
Related pages
- Our dental treatments — an overview of the treatments carried out at our clinic.
- Our dentists — the dentists working at our clinic.
- Contact us — appointment and directions.
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