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Adult Orthodontics

When most orthodontists meet an adult patient intent on correcting crooked teeth, they usually take it slow. Amid all the brouhaha about adult braces there are oral health concerns exclusive to adults that will affect how to plan the treatment.

A touch of gum disease

Because crowded teeth and misaligned jaws are often difficult to keep clean, some adult patients have a degree of gum disease. These patients should be referred to a dental hygienist or a periodontist for cleaning and gum therapy before teeth straightening starts. Then, during orthodontic treatment, your orthodontist will need to be especially alert to new outbreaks. He or she may want to apply less pressure orthodontically early in treatment, so gum tissue attachments have a chance to strengthen. For more information on gum therapy or dental cleanings, please visit our gum disease and hygiene sections for more articles.

What about missing teeth?

Orthodontic appliances need to be attached to something to provide the "push" and "pull" that move teeth. If key anchor teeth are missing, restorative dentistry may be suggested before the appliance can be placed.

Bite problems

More and more patients with temporomandibular or jaw joint problems (TMJ) are beginning to be seen by many dentists. TMJ disorders are very painful, and may result in uneven wearing of teeth or a jaw way out of position. The priority before teeth straightening is to address the jaw problem, and try to correct the bite before any more stress is added to the situation. So in the end you'll finish your orthodontic program with healthier gums, rejuvenated bone, a better bite, and a great smile to boot.

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.

Crooked Teeth and a Bad Bite

How's your occlusion today? When your jaws meet nicely and teeth are configured properly in your jaw, that's occlusion. When the fit's awry, it's called a malocclusion .

About 2,000,000 Americans know malocclusion inside and out. So what's wrong with a little overbite? For 20% of us, it's a handicap, for 5%, it's a physical and mental hardship. That's why there's orthodontics.

The gist of jaws

The upper jaw, or maxilla, is part of the skull and it doesn't move. In children, the maxilla is joined at the root of the mouth by soft tissue that grows into one bone mass by about age 17. Our upper teeth are a little bigger than the lowers. We call the lower jaw the mandible. When the maxilla and the mandible work properly, they chew, grind, and tear our food, facilitate normal speech, swallowing, and basic oral health. When your jaws don't align well, you may not be able to eat, breathe or communicate normally.

Getting the bite right

Orthodontic theory, and attempts at bite correction, can be traced to ancient Greek and Roman cultures. But until dentists could agree on the problem, each rigged his own correction device. Some of these 19th century "designer" orthodontic appliances were fanciful, some merely crude.

The early orthodontist Edward Angle classified occlusions into three types. His principles are still the standard today.

• Class I occlusion is a "normal" bite. Since there is argument what "normal" is, Class I could be defined as a jaw/bite relationship that seems to be okay and doesn't cause any problems, although there may be some tooth crowding caused by eruption of extra teeth or missing teeth.
• Class II brings us to true malocclusions, in this case, the buckteeth of Bugs Bunny fame. It's certainly more amusing as a cartoon than reality though. Class II lower jaws are usually small and crowded. Along with a protruding upper jaw, the chin recedes. Children with Class II bites, and adults, for that matter, seem especially subject to social derision. Aside from problems with keeping teeth clean, Class Iis can expect cruel jokes.
• Class III malocclusions are relatively rare (5%)and may include a jutting lower jaw and lower teeth that close in front of the uppers (think Dick Tracy). Treatment is complex, and may require bone surgery.

In any case, seeing your dentist on a regular basis is very important. In the case of Class Iis and IIIs, seeing an orthodontist could make a big difference in your self-esteem and make your life much easier.

With more adults seeking treatment their parents couldn't afford when they were youngsters, this is a very exciting time in orthodontics—we have a world of new orthodontic materials that work better and faster.

Heavy metal bands? Most of us have heard the news about braces. They're lighter, smaller, easier to clean—dare we say it—almost comfortable. Plastics and bonding adhesives mean no more heavy metal bands around teeth. Wire and brackets can be "super-glued" directly onto the teeth (Look, Ma, no bands!).

NASA's missile technology has given us Nitinol, a "memory" metal that retains its shape better than stainless steel. Arch wires made of Nitinol exert a light, steady force that stands up to the push and pull of orthodontic appliances. And lingual braces, glued to the back (tongue side) of the tooth, are proving effective in closing moderate gaps. It's like having invisible braces.

A new breed of patient

The best part of new orthodontics for your orthodontist, though, is a willing, and eager patient. Home care is critical to any orthodontic treatment plan. Careful, constant cleaning, wearing your retainers, and avoiding foods that make a mess of all the handiwork is a must. Most adult patients appreciate the investment of time and energy and tend to go about home care with vigor.

If you're considering adult orthodontic braces, use our search area above to find an orthodontist in your town. Whether nature planned your smile a little off, or a missing tooth changed the geography over the years, you now have the option of a bite made in heaven.

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.