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Malocclusion and Dental Braces

Braces, also called orthodontic appliances, are devices which gently correct irregularities in the arrangement of your teeth.

Malocclusion

Braces treatment, also known as orthodontic treatment, aims to correct malocclusion — faulty contact between the upper and lower teeth when the jaw is closed — and bring teeth and jaws into a harmonious position with the face. This may improve appearance, oral health and function.

There are three main types of malocclusion:

• Class I malocclusion refers to a normal bite between the upper and lower teeth when the jaw is closed, but the teeth are not well-aligned or spaces are present

• Class II malocclusion refers to the lower teeth lying behind the upper teeth when the jaw is closed

• Class III malocclusion refers to the lower teeth lying in front of the upper teeth when the jaw is closed

Dental Braces

Braces can do wonders for your self-confidence and self-esteem by treating your malocclusion. By straightening your teeth, they help to improve your appearance and smile. They will also improve your overall dental health as it is easier to brush well-aligned teeth than those that are crooked and/or crowded together.

Types of Braces

Basically there are two types: fixed braces and removable braces. The first are fixed to the teeth for the whole duration of the treatment, while the second are appliances which can be taken out of the mouth when you eat or brush your teeth. Consult your dentist for the type most suitable for you.

Fixed braces can be classified into:

• Traditional metal braces: these consist of stainless steel brackets that are “glued” to the front surfaces of the teeth. A metal archwire runs through the brackets and is held in place by elastic bands which come in different colours

• Self-ligating braces: these are gentle "gated" braces that are designed with a unique self-locking mechanism incorporated into the bracket. The gates replace the coloured elastic bands which hold the archwire in place

• Tooth-coloured braces: these consist of ceramic or composite plastic brackets that blend in with the surrounding tooth structure and make the braces less noticeable. Depending on the system, the archwires may be made of metal, metal with a tooth-coloured coating, or a transparent, polymer composite material

• Lingual braces: these are discreet metal braces that are custom-fitted to the back surfaces of the teeth and are invisible during normal day-to-day activities

Removable braces can be classified into:

• Aligners: the invisible aligner system of straightening teeth involves a series of custom-moulded aligners worn over your teeth to gradually reposition them to the final aesthetic result. The transparent aligners are hardly noticeable. They can be removed for eating, brushing and flossing, or for events when you do not wish to be seen in them. It is important for the aligners to be worn for 20 hours every day for the treatment to be successful. Mild to moderate malocclusions can be treated successfully with this system

• Functional appliances: these are usually indicated for a child who is still growing. They can modify the direction in which the jaws are growing

• Removable active appliances: these are usually used at a dental stage where some baby teeth have still not been replaced by the permanent teeth and they serve the purpose of relieving a traumatic bite, which results from an abnormal position of a tooth or teeth

When to Start Wearing Orthodontic Braces

Generally, in children, orthodontic treatment is started when all the milk teeth have been replaced by the permanent teeth. However, in special cases, such as where functional appliances are indicated, it may be crucial for treatment to start earlier to prevent later complications and to take advantage of the growth of the face. Early treatment is justifiable and recommended only when long-term results can be achieved by eliminating the need for, or reducing the complexity of future orthodontic treatment.

Orthodontic Braces for Adults

You are never too old for braces. In certain cases, it may also be easier for dentists to perform restorative procedures such as implants, crowns or bridges on aligned teeth. However, because the bone structure is denser in adults, treatment time may be a little longer compared to teenagers.

Duration of Orthodontic Treatment

The length of treatment will depend on a number of factors, one of which is the difficulty of each case. In average cases, treatment ranges from about 18 months to three years, with visits to the dentist/orthodontist once every four to eight weeks for reviews during the course of treatment.

Initially, there may be some discomfort. However, your lips, cheeks and tongue will soon get used to the braces. There is no downtime; you can go about your daily activities straight after the braces have been put in place.

Risks of Wearing Braces

The most common problems are tooth decay or demineralisation (loss of minerals) of the teeth, as well as gum disease. These problems can be prevented by good oral hygiene and correct brushing techniques. Other risks include root shortening and relapse. Relapse can be prevented by wearing retainers to retain the teeth in the corrected position.