Malocclusion and Orthodontics - Treatment Overview
Orthodontic treatment uses appliances, tooth removal, or surgery to fix the way
teeth and jaws are aligned. There are many ways to treat poor bite (malocclusion). Expert opinions differ about when to
start treatment. Your dentist or orthodontist may give you a choice between
early or later treatment or may prefer one specific approach.
general categories of orthodontic devices (appliances) are functional and
Functional appliances use the
muscle action from speaking, eating, and swallowing to create forces that move
teeth and align the jaws. See a picture of a
functional appliance .
- Some functional appliances are removable, while
others are bonded to the teeth.
- A functional appliance may fit
between the upper and lower teeth (a splint) or may span across the mouth
between the molars, pressing the bone outward.
Fixed orthodontic appliances are
sets of wires and brackets cemented to the teeth. These are commonly called
braces . Over a period of about 24 to 28 months, the
wires are tightened and adjusted, gradually applying enough force to move the
teeth (bone remodeling).
Retainers are removable
appliances made of molded plastic and wire. They hold the teeth in place after
braces are taken off. If the teeth start to move back out of position, the
orthodontist may bond a short retaining wire to the back of some teeth. This
wire will hold the teeth in place.
Child and teen treatment
The aim of
treatment in the childhood and teen years is to move permanent teeth into
place. The orthodontist will time the treatments to match your child's natural
Treatment for crowding, the most common
malocclusion problem, may mean removing (extracting) some permanent teeth. But
orthodontists avoid removing permanent teeth when they can.
malocclusion treatments for children and adolescents are:
(serial removal). Removing some baby teeth may ease
- Growth modification.
This involves wearing fixed or functional appliances during the day and night
to move the jaw into a better position.
- Fixed appliances (braces) gradually move the teeth. For
children and teens, this treatment phase usually lasts about 24 months; for
adults, about 28 months.
- Retainers. Retainers hold the teeth in
place after orthodontic treatment. Some orthodontists recommend that retainers
be worn for many years, because teeth have a natural tendency to drift out of
- Space maintainers, made of metal or plastic. Spacers keep
the surrounding teeth from moving (drifting) into open spaces created when
teeth are pulled or lost in an accident.
Orthodontic treatment for
malocclusion is a popular option for adults, due in part to better technology.
In the past, wide silver bands held braces in place. Today they are less
obvious. Instead of the wide bands, a small metal or ceramic fastener is bonded
to each tooth, and a narrow wire passes through the fasteners.