Orthodontics and adults
Although children and teenagers commonly require orthodontic treatment to correct developmental problems with their teeth, an increasing number of adults are now also seeking treatment. This can be to correct problems that were not treated in the past or to improve the appearance and function of their teeth.
The principles of treating adults are much the same as for treating children, although the costs may be higher if more complex treatment is required. The British Orthodontics Society (BOS) estimates that the cost of treating an adult can range from £2,000 to £6,000, depending on the complexity of the treatment.
Another reason why adults may need orthodontic treatment is if they have a condition known as sleep apnoea. This is where the muscles and soft tissue at the back of the throat collapse inwards during sleep. This causes breathing difficulties and disturbed sleep which resukts in tiredness the following day.
People with mild sleep apnoea often benefit from an orthodontic device called a mandibular repositioning splint (MRS), which is designed to prevent the area at the back of the throat from narrowing.
Orthodontics is a Greek word that literally means ‘to straighten teeth’. It is a type of dental treatment that aims to improve the appearance, position and function of crooked or abnormally arranged teeth. Orthodontics uses mechanical devices, such as a brace, over a certain period of time (usually 18 months to two years) to correct the position of the teeth.Healthcare professionals who specialise in orthodontics are known as orthodontists. They usually work in dental surgeries or specialist hospital units.

Who needs orthodontics?
Sometimes, a child’s teeth and jaw do not develop in the normal way. The medical term for teeth that are out of position is malocclusion.Some cases of malocclusion occur for no obvious reason. Other cases are the result of certain behaviours, such as frequent thumb sucking, or an injury to the teeth or bones of the face.Many cases of malocclusion do not pose serious health concerns. However, if malocclusion is not corrected during the teenage years, it may affect the appearance of the teeth and the shape of the face. This could cause psychological and emotional problems, such as lack of self-confidence, anxiety and depression.
More severe cases of malocclusion can affect the functioning ability of the teeth, mouth and jaw. For example, it can make it difficult for a person to eat food; cleaning the teeth may be harder and the teeth may be vulnerable to damage.

Why orthodontics is necessary
The primary goal of orthodontics is to improve the appearance and function of misaligned or crooked teeth. Sometimes, problems that affect the normal development of teeth run in families. This suggests that there may be certain genes that you inherit from your parents which disrupt the development of your teeth and jaw. Genes are units of genetic material that control how your body and characteristics develop.
In many cases, developmental problems with a person’s teeth and jaw occur for no apparent reason. However, a person’s teeth and jaw can sometimes be damaged in an accident, such as a fall, or as a result of activities, such as thumb sucking, that persist well into childhood. In children, crooked or abnormally arranged teeth are not usually an immediate health problem. However, these types of abnormalities may affect the later development of the child’s teeth, mouth and jaw. In severe cases, such abnormal developments can affect a child’s physical appearance as they grow older.


Reasons for treatment
Some of the most common reasons why people are referred to an orthodontist for orthodontic treatment are listed below.
•Protruding upper front teeth - one of the most common reasons for needing orthodontic treatment, particularly as the teeth may be more prone to damage during falls or contact sports.
•Crowding - people with narrow jaws often lack enough space for their teeth, resulting in crowding.
•Impacted teeth - the adult teeth come through in the wrong position.
•Asymmetrical teeth - in some people, the centre of their upper and lower teeth do not match, giving their teeth an asymmetrical or crooked appearance.
•Deep bite - the upper teeth cover the lower teeth too much.
•Reverse bite - the upper teeth bite inside the lower teeth.
•Open bite - the upper and lower front teeth do not meet when the mouth is closed; an open bite often occurs as a result of prolonged thumb sucking.

Cleft lip and palate
Cleft lip and palate is a type of birth defect where a child is born with a split (cleft) either in their upper lip or the roof of their mouth (the palate) or both. It occurs when separate areas of the face do not join together properly when a baby is developing in the womb. Most children with a cleft lip and palate will need one or more courses of orthodontic treatment to correct the appearance and function of their teeth and jaw.

How orthodontics is performed
In the first stage of orthodontic treatment, an assessment of the current state of the patient's teeth and their likely development is made. This usually involves taking X-rays and making plaster models of the teeth. After completing the assessment, the orthodontist will be able to provide more information about the type of treatment that is needed, and the likely results.

•Orthodontic appliances
Orthodontic treatment uses appliances to correct the position of the teeth. The four main types of appliance are:
•removable appliances - which are usually plastic plates that cover the roof of the mouth and clip on to some teeth; they can be taken out and cleaned
•functional appliances - a pair of removable plastic braces that are joined together or are designed to interact together and clip on to the upper and lower teeth
•fixed appliances - a non-removable brace that is fixed to each tooth with a metal or ceramic bracket or attachment
•headgear - this is not an orthodontic appliance itself, but it is used with other appliances to add a certain type and direction of pressure

The four types of orthodontic appliances
are discussed in more detail below.

•Removable appliances
Removable appliances can be used to correct minor problems, such as slightly crooked teeth. They can also be used to discourage children from sucking their thumb. Although the appliance is easily removable, it should only be taken out of the mouth for cleaning. However, removing the appliance may also sometimes be recommended as a precaution during certain activities, such as cycling or playing a wind instrument. Your orthodontist can advise you about this.

•Functional appliances
Functional appliances can be used to treat problems with the relative position of the upper jaw and teeth and the lower jaw and teeth, such as a retruded lower jaw and teeth (backward movement of the lower jaw). Most people who use functional appliances will need to wear them all of the time. It is very important to follow your orthodontist’s instructions about how and when to wear the appliance because if it is not worn correctly, the treatment will be unsuccessful.
It may be necessary to remove your functional appliance while you are eating.

•Fixed appliances
Fixed appliances are the most common type of orthodontic appliance. They can be used to treat cases where a number of teeth need to be corrected, or where a high degree of precision is required to guide the development of the teeth and prevent problems in the future. You will be able to eat normally while wearing a fixed appliance. However, certain foods and drinks, such as toffee, hard sweets and fizzy drinks, must be avoided because they can damage the appliance and teeth. Your orthodontist will be able to give you further dietary advice. If you are using a fixed appliance and you play a contact sport, such as rugby, you should wear a gum shield to protect both your mouth and the appliance.
NHS braces are usually made out of metal, so they will be noticeable on the front of your teeth. Many private orthodontists now offer ceramic or clear plastic braces that are much less noticeable. However, these types of braces are usually more expensive than the metal variety.

Headgear is used to correct the position of the back teeth or to keep them in position while the front teeth are being treated. Most people only need to wear headgear for a few hours during the evening or when they are sleeping. You will not be able to eat or drink while you are wearing headgear.It is important that you follow all of your orthodontist’s instructions relating to the use of your headgear, such as how to put it on and take it off, and how to use it at night. Failure to use headgear correctly could lead to a facial injury or, more seriously, an eye injury.Your orthodontist will be able to train you to use your headgear correctly and safely.

Other treatments:
Retainers are often used near the end of a course of orthodontic treatment. Retainers are dental devices that hold newly fixed teeth in place while the surrounding gum and bone adjusts to the new position of the teeth. Retainers can be either removable or fixed.

•Tooth removal
In some cases, it may be necessary to remove a tooth to correct the position and appearance of nearby teeth. However, as a result of recent advances in orthodontic treatment, the need to remove a tooth has become much less common.

•Risks of orthodontic treatment
Like any type of medical treatment, orthodontic treatment carries a risk of complications as well as benefits. The best way of minimising any possible risk is to maintain a high standard of oral hygiene and always follow your orthodontist’s instructions.

•Enamel decay
Each tooth is covered with a hard outer surface called enamel. A common complication in people who are having a course of orthodontics is that the enamel in one or more of their teeth begins to decay. This can happen for a number of reasons. Orthodontic appliances can sometimes stimulate the production of saliva, which combines with small particles of food and bacteria to form a sticky film known as plaque. The plaque causes the enamel to decay. In addition, many people with appliances find it difficult to keep their teeth clean. In more severe cases of enamel decay, the outer layer of a tooth breaks down and the inside of the tooth can become infected, resulting in toothache. If the decay is extensive, it may need to be repaired with a filling or crown. See the Health A-Z topic about Tooth decay - treatment for more information.

•Reducing the risk
To reduce your risk of enamel decay, your orthodontist may recommend that you use toothpaste with high levels of fluoride or a mouthwash that contains fluoride. Fluoride is a mineral that helps to strengthen enamel. Avoid eating foods and drinking drinks that are high in sugary or starchy carbohydrates because they will stimulate the growth of bacteria in your mouth. Examples of sugary or starchy carbohydrates include:
•fizzy drinks
•coffee and tea with sugar added
•white bread

Healthier alternatives include:
•brown bread
•leafy green vegetables

Please contact White Rose Dental Studio if you wish to have an orthodontic assessment with our in house specialist