Orthodontics

What is Orthodontics?

Orthodontics is a specialised branch of dentistry concerned with the development, positioning, and alignment of the teeth and jaws. Orthodontists diagnose and treat teeth and jaws that have not grown or aligned properly, addressing concerns that range from purely cosmetic to those that significantly affect how a person bites, chews, and speaks.

Orthodontists undergo additional, advanced training beyond general dentistry, focused specifically on the intricacies of tooth movement, jaw growth, and facial development. Using tools such as braces, clear aligners, and, in more complex cases, coordinated surgical treatment, orthodontics aims to achieve a result that supports not just a straighter smile, but genuinely better oral health and function.

The temporomandibular joint is located in front of the ear, on both sides of the head; and is made up of the lower jawbone and the skull. Pain and loss of normal function to the temporomandibular joint can be caused by habitual teeth grinding during sleep, trauma and injuries as well as arthritis caused by inflammation in the joint.

Understanding Jaw Growth and Tooth Development

The alignment of a person's teeth and jaws is shaped by a combination of genetics and physical habits over the course of childhood and adolescence. As the jaw grows and permanent teeth gradually replace baby teeth, there is a specific window during which the jaw's growth can still be guided or influenced, which is part of why orthodontic evaluation is often recommended well before all the permanent teeth have come in.

The temporomandibular joint, located just in front of each ear, is where the lower jawbone meets the skull, and it is this joint that allows the jaw to open, close, and move side to side during everyday functions such as chewing and speaking. Because tooth position and jaw growth directly affect how evenly forces are distributed across this joint, orthodontic problems are not purely cosmetic — they can place uneven strain on the jaw joint and the muscles that support it, which is why orthodontics is closely linked to jaw joint health.

Types of Malocclusion

Malocclusion refers to a misalignment between the upper and lower teeth or jaws, and it can present in several distinct patterns:

• Crowding: Occurs when there is insufficient space in the jaw for all the teeth to align properly, causing them to overlap, twist, or sit out of position.
• Spacing: The opposite of crowding, where gaps exist between teeth, often because the jaw is larger than needed for the number or size of the teeth present.
• Overbite: An excessive vertical overlap in which the upper front teeth extend too far down over the lower front teeth when the jaws are closed.
• Underbite: Occurs when the lower front teeth and jaw extend further forward than the upper front teeth, creating a protruding chin appearance.
• Crossbite: A misalignment in which one or more upper teeth sit inside, rather than outside, the corresponding lower teeth when biting down.
• Open bite: Occurs when the upper and lower front teeth do not touch when the back teeth are brought together, leaving a visible gap.

Other Common Orthodontic Conditions

• Jaw discrepancies: Growth abnormalities affecting the size, position, or relationship between the upper and lower jaws, which can affect both bite function and overall facial balance.
• Craniofacial abnormalities: Conditions affecting the growth and development of the skull and face, which may require coordinated care between orthodontics and other specialties depending on their severity and cause.
• Temporomandibular joint disorders (TMD): Problems affecting the jaw joint itself, causing pain, clicking, or limited jaw movement, which can be influenced by bite alignment, habitual teeth grinding, trauma, or inflammation within the joint.

How Orthodontic Problems Affect Overall Health and Wellbeing

Orthodontic issues are not purely a matter of appearance. Left unaddressed, they can have a meaningful impact on both oral health and general wellbeing:

• Chewing and digestion: Misaligned teeth can make it harder to chew food thoroughly, requiring more effort from the jaw muscles and potentially contributing to digestive discomfort when food is not broken down adequately before swallowing.
• Speech articulation: Certain types of malocclusion, particularly significant gaps or bite misalignments, can affect the ability to pronounce specific sounds clearly.
• Oral hygiene and decay risk: Crowded or overlapping teeth are considerably harder to clean thoroughly, increasing the risk of trapped food, plaque build-up, tooth decay, and gum disease over time.
• Jaw joint strain and headaches: Uneven bite forces can place additional strain on the temporomandibular joint, contributing to jaw pain, headaches, and even earaches in some cases.
• Facial appearance and self-esteem: Because the position of the teeth and jaw directly shapes facial appearance, misalignment can affect confidence and self-esteem, particularly during adolescence.

Recognising When to See an Orthodontist

• Visible crowding or spacing: Teeth that appear noticeably crooked, overlapping, or unusually spaced are a common and straightforward reason to seek an orthodontic opinion.
• Difficulty biting or chewing: Ongoing discomfort or difficulty when biting into or chewing food can indicate an underlying bite misalignment.
• Jaws that shift or make sounds when closing: A jaw that clicks, shifts noticeably, or makes sounds when opening and closing may indicate a developing bite or joint issue worth assessing.
• Early or late loss of baby teeth: Baby teeth lost significantly earlier or later than expected can affect the space available for permanent teeth, making early evaluation worthwhile.
• Mouth breathing or prolonged thumb-sucking in children: These habits can influence jaw and palate development over time, and an orthodontist can advise on whether early intervention would be beneficial.
• Protruding teeth or a receding chin: A noticeable forward or backward relationship between the upper and lower jaw is often a sign of an underlying jaw discrepancy best evaluated early.

Risk Factors for Orthodontic Problems

• Genetics: Jaw size, tooth size, and overall facial growth patterns are strongly influenced by heredity, meaning orthodontic problems often run in families.
• Childhood oral habits: Prolonged thumb-sucking, pacifier use beyond the toddler years, or tongue-thrusting can place ongoing pressure on developing teeth and jaws, contributing to malocclusion.
• Early loss of baby teeth: Losing a baby tooth prematurely, whether through decay or injury, can allow neighbouring teeth to shift into the empty space, reducing room for the permanent tooth to come in properly.
• Mouth breathing: Chronic mouth breathing, often related to nasal obstruction or enlarged tonsils and adenoids in children, has been associated with altered jaw and palate development over time.
• Facial or dental trauma: An injury to the face, jaw, or teeth can alter the natural alignment and growth pattern of the teeth and jaw.
• Missing or extra teeth: An unusual number of teeth, whether fewer or more than expected, can disrupt the normal spacing and alignment of the surrounding teeth.

How Orthodontists Diagnose and Plan Treatment

• Clinical examination: A thorough examination of the teeth, bite, and jaw movement forms the starting point for every orthodontic assessment.
• Dental impressions and 3D scans: Detailed models or digital scans of the teeth allow the orthodontist to study the exact position and relationship of every tooth before planning treatment.
• Panoramic and cephalometric X-rays: These specialised X-rays provide a broad view of all the teeth and jaws, as well as a detailed side-on view of the skull, helping assess jaw growth, tooth position, and the relationship between the jaws.
• Facial and intraoral photographs: Photographs taken from multiple angles help document the starting position of the teeth and face and allow treatment progress to be tracked over time.
• Bite analysis: A detailed assessment of how the upper and lower teeth meet when biting down, used to identify the specific type and severity of malocclusion present.

Treatment Options in Orthodontics

• Traditional braces: Fixed appliances consisting of brackets bonded to the teeth and connected by a wire, which applies gentle, continuous pressure to gradually move teeth into their correct position. Braces may be made of metal, ceramic, or placed behind the teeth (lingual braces) for a less visible option.
• Clear aligners: A series of custom-made, removable, transparent trays that gradually shift the teeth over time, offering a more discreet alternative to traditional braces for suitable cases.
• Functional and growth modification appliances: Removable or fixed devices used primarily in growing children to help guide jaw growth and correct certain bite discrepancies while the jaw is still developing.
• Retainers: Custom-made appliances worn after braces or aligner treatment is complete, helping to hold the teeth in their new position while the surrounding bone and tissue stabilise.
• Orthognathic surgery: For more significant jaw discrepancies that cannot be corrected by tooth movement alone, surgical repositioning of the jaw may be recommended, generally performed in coordination with orthodontic treatment before and after surgery.

The Right Age for Orthodontic Treatment

One of the most common questions in orthodontics is when treatment should begin, and the answer depends on the specific concern being addressed rather than a single fixed age.

• Early (interceptive) treatment: For certain jaw growth or developing bite problems, treatment during childhood, while the jaw is still growing, can take advantage of this growth to guide development more effectively than if the same problem is addressed later.
• Adolescent treatment: The most common period for comprehensive orthodontic treatment, once most or all of the permanent teeth have come in, allowing both tooth position and bite to be addressed together.
• Adult treatment: Orthodontic treatment remains entirely possible in adulthood, though because the jawbone is no longer growing, certain more significant jaw discrepancies may require a combined orthodontic and surgical approach rather than tooth movement alone.

Caring for Teeth During Orthodontic Treatment

• Thorough daily cleaning: Braces and aligners create additional surfaces where food and plaque can accumulate, making thorough brushing and flossing, sometimes with specialised tools, particularly important during treatment.
• Dietary adjustments: Hard, sticky, or chewy foods can damage braces or dislodge brackets and wires, so certain dietary adjustments are generally recommended throughout treatment.
• Wearing aligners as directed: Clear aligners are only effective when worn for the recommended number of hours each day, making consistent wear essential to staying on track with the treatment timeline.
• Attending regular reviews: Scheduled visits allow the orthodontist to adjust braces, issue new sets of aligners, and monitor that treatment is progressing as planned.

Life After Orthodontic Treatment

Completing active orthodontic treatment is not quite the final step. Teeth have a natural tendency to drift back toward their original position over time, which is why wearing a retainer as directed, often indefinitely at a reduced frequency, plays a crucial role in protecting the results achieved.

Beyond the retention phase, the benefits of orthodontic treatment often extend well beyond the appearance of a straighter smile, supporting easier cleaning, more comfortable chewing, and reduced strain on the jaw joint for years to come.

Our dedicated teams of experienced multidisciplinary specialists and healthcare professionals work together to provide treatment plans tailored to the needs of our patients on their recovery journey.

Speak to our Specialists today.