According to a survey by the American Academy of Cosmetic Dentistry, the first thing most people notice about a smile is straightness of teeth. This is often determined by genetics; unfortunately, many of us aren’t lucky enough to have inherited perfectly aligned teeth. That’s where the dental specialty of orthodontics comes in: For over 100 years, orthodontic treatment has been helping people of all ages straighten crooked teeth and improve their smiles.
How Orthodontics Works
Orthodontics, the science of straightening teeth, harnesses the body’s ability to remodel bone — a process that is occurring naturally all the time. Though we don’t usually think of it this way, bone is a living tissue that is constantly breaking down and reforming little by little in response to slight stresses. This stress (or force) can come inadvertently from everyday activities such as biting and chewing; or it can be applied intentionally through orthodontic appliances. The way orthodontics moves teeth can be compared to the way a stick is pulled through sand: As the stick (tooth) moves, the sand (bone tissue) in front of it clears away, and then fills in the space behind. Likewise, the bone surrounding your teeth is being reformed as gentle forces are exerted with an orthodontic appliance.
Types of Orthodontic Appliances
Various types of orthodontic appliances can be used to move teeth. The best choice for you will depend on the nature of your bite problem (malocclusion), and on how discreet you want to be about your treatment. The most common orthodontic appliances include:
These apply gentle force to the teeth through a thin metal wire attached to small metal brackets bonded to the front of each tooth. The force can be adjusted by placing small bends in the wire, and/or by using elastics.
These function exactly the same way as traditional metal braces, except that the brackets are transparent and barely visible. It is only the wire running through them that can easily be seen. Ceramics cost more than all-metal braces and are less resistant to breakage, but they are a favorite option of many adults — including celebrities such as Tom Cruise and Faith Hill.
The main difference between these braces and the ones mentioned above is that they go on the back (tongue) side of the teeth instead of the front. This means they cannot be seen at all. However, they can be a little more difficult to get used to wearing because they can rub against the tongue, and they aren’t suitable in all cases.
Many adults and older teens choose these clear plastic “trays” instead of braces because they are barely noticeable. Aligners are not cemented to the teeth, but instead are worn over them. They must be worn 22 hours per day, but can be taken out for eating and daily oral hygiene — both of which can be hampered by traditional orthodontic hardware. Though aligners have become more versatile over the years, they have some limitations for certain complex orthodontic problems.
No matter which type of orthodontic appliance has brought your teeth into optimal alignment, a retainer will be needed to hold them there once you finish the active phase of treatment. There are several different kinds of retainers, including removable appliances and thin wires bonded to the back of the teeth.
What’s the Best Age for Orthodontic Treatment?
Healthy teeth can be moved at any age, so you’re never “too old” to get your teeth straightened. However, there’s a good reason why the American Association of Orthodontists recommends that every child have an orthodontic evaluation by age 7: Certain orthodontic problems are much easier to treat while the jaw is still growing. Specialized appliances (to expand the palate, for example), can only benefit children who have not yet reached puberty. An early exam enables your child to be monitored, so that if intervention is needed, it can take place at exactly the right time.
But remember: No matter what age you are, there’s plenty that can be done to transform the smile of your genes into the smile of your dreams.