Orthodontics is the science that deals with the disorders that occur during or after the development of teeth, jaw and facial areas and their treatments. The word orthodontics is made up of two Greek words. ‘Ortos’ means straight, ‘odontos’ means teeth. Orthodontics is basically based on biology, medicine and dentistry. The mouth, nasal cavity and related anatomical formations play a role in providing activities such as respiration and nutrition necessary for human life. The working area and responsibility of orthodontics directly covers these areas. From birth, the growth and development of the child is examined, and it is aimed to provide a proper occlusion and facial appearance with protective, preventive and therapeutic applications when necessary.
Briefly, orthodontic dentistry;
1. According to the teeth, dental arches and basal parts of the jaws,
2. Tooth curves relative to each other,
3. Basal parts of the jaws relative to each other and to the face,
4. Adjacent soft tissues related to these structures,
It is a branch that detects and corrects abnormal relationships at different ages and tries to prevent abnormal relationships from occurring.
Orthodontic disorders can be treated at any age. As long as your mouth and teeth are healthy with a constant and careful dental care. We basically classify Orthodontic Anomalies in two ways:
“dental anomalies” associated only with the alignment of the teeth,
Anomalies in which both the alignment of the teeth and the relationship of the jaws are disturbed.
The problems in the first group can be treated in a similar way and mostly with fixed orthodontic appliances, regardless of the age of our patient. However, in orthodontic treatments performed in childhood and adolescence, we have a better chance of solving the crowding of teeth without having to have a tooth extraction, the treatment period is shorter than adult individuals, and the permanence of our treatment may be slightly better.
There is no need to worry too much about the position of the first teeth (milk teeth) in children. The spaces between these teeth are an indicator of natural development. Tight contacts, such as in adults’ teeth, may be an indication of future shortness of space, and therefore, crowding in the teeth. Permanent teeth begin to erupt at the age of 6-7, but between the ages of 7-9, there are not many problems until the incisors erupt. Even if your family doctor refers you to an orthodontist at an early age, this does not always mean that treatment will be started very early. Most careful dentists want to make sure that a potential problem is under control and that the optimal time for treatment has not passed.
Children’s first meeting with an orthodontist should be around the age of 7-8. Because by this age, the first permanent molars come out and the permanent incisors take their place. Timely detection of irregularities with early diagnosis allows to prevent serious problems that may occur in the future. Even if no treatment is required at this age, the orthodontist monitors the growth and development and ensures that the treatment is started at the most appropriate time.
Orthodontic treatment can be done at any age. While there is no age limit in dental corrections, if there is an irregularity in the bone structure, the treatment should be done during the growth and development period. Orthodontic problems are easier to correct if detected early, before jaw growth slows. Early treatment may mean eliminating the patient’s need for orthognathic surgery and preventing more serious complications. Increasing age may prolong the duration of treatment and complicate the treatment somewhat. However, the age factor is not as important as the healthy teeth and periodontal tissues.
If we group the orthodontic treatment methods:
Fixed orthodontic treatment: It is the most preferred form of orthodontic treatment. High-tech wires of various thicknesses and twists are placed inside the brackets, which are adhered to the teeth with special adhesives. These wires apply force to the tooth in the desired direction through the brackets and the teeth move. It is also possible to move the root of the tooth. Bracket care requires patient cooperation, but the control is mostly in the hands of the doctor.
Functional orthodontic treatment: Irregularities between the jaws can be corrected during growth and development with orthopedic applications. Disorders such as cases where the lower jaw is too advanced and the upper jaw is too advanced fall into this group. The age of the child is very important. This treatment cannot be applied after growth and development is completed. Treatment is performed with removable appliances that concern both jaws or with extra oral appliances applied from the outside of the jaw. It is sometimes used with orthodontic appliances.
Orthognathic surgery: Orthognathic surgery is used in cases that cannot be corrected with orthodontic or orthopedic treatment. Disorders of the jaw and face may be congenital or may occur later due to accidents and diseases. The incompatibility of the jaws with respect to each other and the face causes both aesthetic, functional and psychological disorders in patients. First, with orthodontic fixed wire treatment, the teeth are positioned in their correct positions on the jawbones. Then, with surgery, the jaws are brought together in accordance with the skull base and facial structure. Operations are performed under general anesthesia. Some anomalies that are thought to require surgery can only be treated with fixed device applications thanks to the developments in orthodontics in recent years.
Reinforcement treatment: After the teeth are corrected with orthodontic treatment, the tissues surrounding the teeth need time to adapt to these new positions of the teeth. Because the bone tissue is not yet fully mature. Therefore, when the devices are removed, the teeth tend to return to their original positions. In order to prevent this, it is necessary to consolidate the teeth in their new places. For this, various fixed or mobile devices are used. Depending on the duration of active orthodontic treatment, the amount of tooth movement performed, the age of the patient and the type of anomaly at the beginning of the treatment, the duration of the reinforcement treatment and the type of devices used in the treatment vary.
Teeth may return to their original positions when the reinforcing devices are not properly engaged. Therefore, it should not be forgotten that reinforcing devices play an important role in orthodontic treatment.
Orthodontic treatment is an application that requires long-term discipline and patience. Orthodontic treatment requires the cooperation of the patient and the physician. If the patient-physician cooperation is at the desired level, the success of the treatment increases and results can be obtained in a reasonable time from the treatment.
Crowding in the teeth is not just an aesthetic problem. Function and hygiene are also affected. The first goal of orthodontics is to detect the defective relationships between all elements that make up the tooth, jaw and face complex, to prevent its formation and progression, and to correct it when necessary, to ensure that the system can function normally.
Since individuals with crooked teeth cannot provide adequate oral hygiene, plaque and calculus form and adhere more easily in the crooked area; hence the risk of caries increases.
Gingival problems are observed in the mouths with crooked teeth due to the deterioration of the gingival continuity covering the teeth. In addition, due to inhomogeneous chewing forces due to crowding, more force loading on some teeth may cause gingival recession in that area and even loss of vitality of the tooth. Problems are also observed in the jaw joint and it contributes to the protection of the health of the jaw joint by providing the chewing function with orthodontic treatment, thus preventing the wrong forces on the joint area.
The broken relations between the systems that make up the maxillofacial complex also affect facial aesthetics. Orthodontic treatment provides individuals with more perfect facial aesthetics.
Deteriorated relationships in the teeth, jaw and face complex and their consequences cause psychic and mental problems in the individuals concerned. These individuals can be helped with treatment. As a result of providing aesthetics with orthodontic treatment, it is also aimed to provide psychological support by increasing the self-confidence of the patient in the society.
Orthodontic disorders can be effective in the formation of a number of other diseases and disorders. Correction of the anomaly and thus prevents the occurrence of these diseases.
Correction of speech disorders caused by orthodontic disorders is also among the goals of orthodontics.
