If the position of your teeth is getting you down, but you’re worried that the only options available to you will cause you discomfort, you’ll be pleased to hear that there’s more to orthodontics than traditional fixed braces. Understanding your orthodontic issues and the options for treatment can be a useful first step in conquering your dental phobia.
When you think of the ideal smile, you may imagine perfectly straight teeth. While having straight teeth is considered to be desirable from an aesthetic point of view, it’s also important for your oral health.
Problems with the position of your teeth can cause a raft of different oral health issues. These include :
- An increased risk of tooth decay and gum disease
- Painful temporomandibular joint disorders
- Difficulty chewing
- Speech problems
The position that your teeth grow in can be a problem for many people. For anyone that’s affected by these issues, specialist dental care should be sought from an orthodontist.
But if you have a phobia surrounding dental procedures, the idea of making multiple trips to an orthodontist for treatments that could take months or even years to complete can be daunting. In this guide, we’ll demystify the orthodontic process and explain everything you need to know.
Why Orthodontics Is Used
Orthodontics relates to the position of your teeth in relation to one another. This can either be how they interact when your mouth is closed (occlusion) or how close or spaced out they are along the jaw.
When your jaw is closed, if your upper and lower arches of teeth don’t line up, this is malocclusion.
If you have a jaw that is too small to hold all of your teeth, overcrowding can occur. Teeth that are overcrowded run a higher risk of developing decay due to their proximity and the challenges you may have removing debris and bacteria from between them.
To address this, an orthodontist may remove one or more teeth and fit a brace or provide you with an aligner. The exact procedure recommended will depend on the severity of the crowding.
Having ‘buck teeth’ can affect your speech and your ability to chew while always being at risk of damage or injury if you have an accident. The problem could be caused by thumbsucking in childhood or having teeth that are just too large in relation to the rest of your mouth. Braces or aligners can be used to correct teeth that protrude.
If you’ve previously lost a tooth or your teeth don’t fill your jaw, spaces may form. Not only can these make you self-conscious, but these areas can also become hotspots for trapped food and bacteria. This problem is the opposite of overcrowding.
Aligners or braces can be used to bring your teeth closer together.
This can sometimes be referred to as a ‘closed bite’ or ‘deep bite’. While clenching your teeth, if there’s an opening between the two rows of teeth, this can cause excessive wear and tear, speech problems, difficulty chewing, tooth decay, and self-esteem issues.
This can be due to having a small jaw, missing teeth, or injury. Overbite can be treated using aligners, braces, retainers, or surgery.
If the upper row of your teeth are set too far back or the lower set is too far forward, it can cause an underbite or anterior crossbite. This can lead to temporomandibular joint disorder (TMD) , a painful condition where your jaw feels as though it’s locked in position, as well as bacterial infections, bad breath, and sleep apnea.
Treatment typically involves wearing a brace, however, in some extreme cases, surgery may be required.
If you have a crossbite, your upper teeth may look like they’re behind the lower arch when your mouth is closed. Alternatively, your lower teeth may overlap the upper set, this is known as a reverse bite.
Crossbites can lead to your tooth’s enamel becoming worn and excessive pressure being put on your jaw.
Braces or aligners can help in most cases, and surgery may be needed when the malocclusion is particularly severe.
If you have an open bite, your upper front teeth don’t overlap the row below. This will cause wear on your teeth, make it difficult to chew, and may lead to speech problems. A brace or aligner can be used to rectify this.
When adult teeth fail to emerge from the gum or jaw or only partially emerge, it can cause considerable pain and discomfort. The most common occurrence of impacted teeth is when wisdom teeth fail to erupt.
Impacted teeth can leave gaps in your mouth, give you jaw ache, headache, and cause bad breath.
Using a brace with a ring attached to the impacted tooth, it is possible to rescue it and bring it into its correct position.
Types of Orthodontic Appliance
When most people think of orthodontic appliances, traditional metal braces usually spring to mind. Metal braces have been used for many years, and are still an effective solution for dealing with malocclusions.
Metal braces consist of:
- Brackets affixed to each tooth
- Archwires which run through the brackets
- Small elastic bands that wrap around the bracket and hold the wire in place
Throughout your treatment, your orthodontist will invite you in for an appointment where the wire will be tightened. The tension of the wire gently pulls your teeth toward their intended position.
Ceramic braces work in the same way as metal braces, however, the brackets are made of clear or tooth-coloured ceramic brackets. This makes this type of bracket less visible.
A self-ligating brace is similar to a traditional metal or ceramic brace, however, the archwire isn’t held in place by elastic bands. Instead, each bracket has a built-in mechanism that holds the wire.
If you have self-ligating braces, your orthodontic appointments will generally be shorter. Cleaning your teeth while wearing a self-ligating brace can also be easier, and you may experience less discomfort.
Damon braces are one of the most popular types of self-ligating braces.
If you’re worried about the visibility of your braces, one alternative is to have lingual braces. These are fitted to the backs of your teeth so won’t be on show.
Lingual braces aren’t always suitable for everyone, and your orthodontist will be able to let you know whether they’ll be right for you. Wearing this type of brace can also give you a lisp and is considerably more expensive than traditional braces.
Orthodontic aligners are a popular alternative to braces. Usually, these are clear trays made of medical-grade plastic that are specifically designed to fit your mouth. An aligner will gently apply pressure to your teeth, guiding them to a more favourable position.
The popularity of aligners is, in part, down to the fact that they’re usually very subtle and comfortable. Aligners can also be removed while you’re eating or brushing your teeth.
During the course of your treatment, you’ll change your aligner every couple of weeks. Each aligner tray is slightly different to the last and will help take your teeth a step closer to the end goal.
One of the biggest brands associated with this type of treatment is Invisalign. Invisalign aligners can take between 12 and 18 months to achieve results, however, after just a couple of months, many people start to see a noticeable improvement in the straightness of their teeth.
Other brands include:
- Straight My Teeth
- Straight Teeth Direct
- Smile Direct Club
Aligners are typically suitable for correcting a range of malocclusions, however, they may not be a suitable option for more complex cases.
After wearing braces or an aligner for the duration of your treatment, your orthodontist may recommend that you wear a retainer. These are made of moulded medical-grade plastic designed to fit around your teeth.
Retainers ensure your teeth remain in their new position. You’ll need to wear your retainer at night while you sleep for as long as your orthodontist recommends. This may be for a year or it could be for an indefinite period.
Braces Vs. Aligners
You may have to make a choice between braces and aligners. In this situation, it’s always useful to know the advantages and disadvantages of each.
Advantages of Fixed Braces
- Effective for a range of malocclusions
- Can be used in more complex cases
- Often the cheapest option
- Brackets can be metal or ceramic
- Lingual braces can be applied to the back of your teeth
Disadvantages of Fixed Braces
- Brackets and wires and usually very visible
- Can be uncomfortable at first
- Wires need to be tightened periodically
- Difficult to keep clean
- Food can get stuck between wires
- Can leave white spots on your teeth after treatment
- Barely visible
- Removable, so eating and brushing your teeth is easy
- Usually achieves results in a shorter period of time
Disadvantages of Aligners
- More expensive than braces
- Need to be worn for 22 hours each day to be effective
- Less effective for complex malocclusions
Corrective surgeries may be necessary if you have a severe overbite or underbite. This will shorten or lengthen the jaw. This will only be considered once less invasive treatment options have been ruled out or unsuccessful.
Wires, screws, and plates may be used to help support the jaw and achieve the surgical aims.
What to Expect When You Visit an Orthodontist
The first indication of malocclusions is usually highlighted in a routine visit with your dentist. When you first visit an orthodontist, you’ll likely have:
- A full oral examination
- Images taken of your teeth and jaws including X-rays
- Digital or physical impressions of your teeth made
This will help identify the course of treatment that’s best suited to your needs. Many modern orthodontists have the technology to show you images of how your smile may look following treatment.
Once all of the options have been discussed with you, an appointment will be arranged for your treatment to start. This will usually be the fitting of a brace or an aligner.
Periodically throughout your treatment, the orthodontist will adjust your brace or provide you with a new aligner. This will also be used as an opportunity to see how your treatment is progressing.
Asking questions about orthodontics will help you manage any anxiety you have around getting treatment. Here are some of the most frequently asked questions.
What is orthodontics?
Orthodontics is a specialist area of dentistry that specifically deals with the position in your teeth. Often, as your teeth develop, malocclusions form, causing a variety of dental health problems. Injuries and lost teeth can also cause you to need orthodontic treatment.
In many cases, seeking orthodontic treatment can help prevent further oral health complications.
Who should see an orthodontist?
If you’re self-conscious about the position of your teeth because you have gaps, overcrowding, or protruding teeth, an orthodontist may be able to help. You should also consider making an appointment if you experience jaw pain, difficulty chewing, or if the position of your teeth is affecting your speech.
Often, your dentist will be the first person to suggest that you have orthodontic treatment. Many practices have their own in-house orthodontic, while others may refer you to another provider locally.
What is the difference between an orthodontist and a dentist?
All orthodontists are dentists, however, not every dentist is an orthodontist.
An orthodontist is a dental specialist that has completed additional masters or doctoral level study and training specifically relating to issues surrounding the position of your teeth. They may work in a dental practice or within an orthodontics department in a hospital.
What other options are available other than wearing a brace?
In the past, malocclusions would ordinarily only be dealt with using a fixed appliance such as a traditional brace. While they are very effective, wearing metal braces for up to two years can be off-putting to many. Thankfully there are more options available these days.
For very minor adjustments, veneers and composite bonding, are two minimally-invasive treatment options that deliver immediate results. While neither of these addresses the actual position of your teeth, they can make them appear straighter.
Aside from fixed braces, orthodontic aligners can be very useful. These can typically be removed and are often less noticeable and more comfortable than braces.
How long does orthodontic treatment take?
That depends on the severity of your malocclusions and the treatment route that you choose to take. Some options, such as Six Month Smiles can work in as little as six months. Treatments like this are designed for minor orthodontic problems, and if your need is more severe, you may need to wear braces or an aligner for up to two years or more.
Is orthodontic treatment painful?
Braces and aligners work by applying gentle pressure across all of the teeth they are designed to straighten. Because they work gradually, you won’t feel any pain during the process.
If you wear a brace and you have the wire adjusted periodically, it’s quite normal to feel some slight discomfort immediately after your appointment as your teeth get used to the change in pressure.
Fixed braces use brackets and wires. Having these attached to your teeth can take some getting used to and you may worry about them scratching the inside of your lips and cheeks. Once you’ve worn them for a couple of weeks, you should be used to how they feel and you’ll barely notice they’re there.
Will fixed braces leave marks on my teeth?
Braces can often be fixed on your teeth for two or more years. During this time, the areas where the brackets make contact can become stained due to decalcification. This can leave white spots or patches where the brackets were.
Fortunately, there are treatments available that can help reduce these stains.
Will I need to wear a retainer after orthodontic treatment?
Sometimes, after your teeth are realigned, you may need to wear a retainer. Retainers are made of plastic and are moulded to fit your teeth. Usually, these need to be worn during the night and will preserve the changes made during your treatment.
While it may take a while to get used to wearing your retainer, they cause no pain or discomfort and are perfectly safe to sleep in.
Is orthodontic treatment available on the NHS?
Yes, it’s possible to get orthodontic treatment on the NHS. If you’re under 18, you’re eligible for NHS funding. For adults, in certain circumstances, it’s possible to get funding for treatment, however, most people will need to pay.
There may be waiting lists for NHS care. Your dentist or orthodontist will be able to advise you on how long you may need to wait.
How much does orthodontic treatment cost?
Orthodontic treatment costs vary dramatically and depend on the following factors:
- What type of orthodontic treatment you’re getting
- Whether you’re having the treatment privately or through the NHS
- The location and expertise levels of your orthodontist
It’s usual for an orthodontist to only be able to give you a quote after your initial consultation. Their quote will take into account:
- Any extractions you need
- How many appointments you’ll need throughout your treatment
- Whether you’ll need a retainer after treatment
Adult braces on the NHS come under band 3 which currently stands at £282.80.
Treatment using aligners can start from £1,000. Prices vary depending on how many stages of treatment you’ll need as well as which type of aligner you get. Invisalign, which typically starts at around £1,500, is possibly the most popular choice, however, there are several competitors available in the UK.
Traditional and self-ligating braces generally start at around £1,500, while lingual and ceramic options tend to cost upwards of £2,000. Of course, if you’re a private patient, you’re free to shop around and find the best price
What can I eat when I have a brace?
If you have a fixed brace, you’ll need to be mindful of food getting stuck in its wires and around the brackets. Keeping your braces and your teeth clean is essential. Certain foods that are particularly hard, crunchy, or chewy may be difficult to eat and your dentist will advise you on anything that you should avoid.
Aligners such as Invisalign can be removed while you’re eating. This means you won’t need to change your diet, and there are no significant hygiene risks you need to be aware of.
What can I do about my anxiety surrounding orthodontic treatment?
Feeling anxious or fearful about any type of dental appointment is normal, however, it’s important that your worries are managed so they don’t prevent you from getting the care you need.
The first step in overcoming dental anxiety is to talk about it. Seek out a Dental Phobia Certified professional that will take the time to discuss your fears with you. The more you can learn about the treatment you need, the better prepared you will be for your appointment.
If the practice you’re attending offers sedation to nervous patients, you may want to explore this option. Many clinics offer injection-free sedation to help calm your nerves.
If possible, take an early appointment. Seeing your orthodontist at the quietest time of the day will make it easier to relax. Take a friend. If someone you’re close to comes with you, they can comfort and reassure you while you’re in the chair.
If you’re going on your own, take some music and some headphones. Having a distraction will help you turn your focus away from your treatment.
Finally, if you experience considerable anxiety or dental phobia, think about seeking assistance from your GP or a trained counsellor. Anti-anxiety medication can help you during your treatment, while talking therapy will help you address the root cause of the problem.