Dental Brace in Orthodontics

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Our body doesn't like pressure!

As you know, when you press on your skin with your finger the area goes white. This is because by pressing you also press on the skin’s blood vessels – pushing away the blood in that area. This has no effect when done for a short time. As soon as you let go the blood flows back into the skin.

Being bedridden for a long time leads in the same way to the death of tissues whereby the pressure here is maintained not by one’s thumbs but rather by one’s body weight, what doctors call decubitus ulcer, or bed sores. Decubitus ulcer is observed mainly in old, bedridden people and are always a sign of incorrect lying down.

Pressure is bad for our body tissues. Now our body ‘hangs on to’ its teeth with a tissue-binding mechanism called desmodont. Desmodont consists of a number of small fibres stretching between the root and the jawbone. Through the desmodont chewing pressure is transformed into a tensile load. When you press on your teeth therefore, a pull results in your bone.

Teeth move about!

Teeth are not anchored firmly in the bone, rather they are ‚moveable‘. If one only applies pressure one way, for example with a brace on the tooth, then the desmodont can break down and a tooth movement will take place. This is the principle of the dental brace. The position of our teeth ensues from a balance of tongue and cheek pressure, since our tongue and facial muscles also exert pressure on our teeth. That’s why the teeth of people with big tongues are usually slightly more spread out, in contrast with those with a strong chewing musculature whose teeth are often close together or bend inwards.

Whilst teeth between the first and second decades of life tend to bend inwards and develop a close condition (tertiary closeness), which comes about through lip pressure and the pressure of the ever stronger facial muscles, from the fifth decade of life onwards the teeth behave in quite the opposite way.

As a result of the ever-slackening facial musculature, the loss of tone in the tissues and the constant tongue pressure, the teeth move further apart from each other. Lip pressure also declines, just like the tone of the facial muscles (above all the alveolomaxilliary muscles) and the tongue controls the pressure which is released from inside outwards.

It thereby happens that through a normal, or possibly also resulting from disease, deterioration of the gums (paradontitis) and the concomitant reduction of bone, the teeth are no longer so well fixed in the jaws. This all leads in the end to a very slow sliding apart of the front teeth. The teeth slide forward and thereby create spaces. As the process moves along the teeth loosen more and more quickly until the patient finally realises and seeks advice. With Aligner, for example, this incorrect spacing can be treated simply and efficiently!

 

Is it all the same what kind of brace I get to correct my bite?

No, since every brace has its advantages and disadvantages. Removable braces are only of use in the early years of childhood, and then only in a few specific cases. Removable braces were used a lot in the past but now we know that despite using a removable brace in childhood a permanent one would have to be used later and so we spare children the removable one, much to their joy.

With the so-called Aligner tooth rotation can hardly be treated, especially in the canines, if at all. The advantage of the Aligner is that it is almost invisible, just like the Lingual Technique. The Lingual Technique is very elaborate and also found to be rather uncomfortable by patients. Which the most useful treatment is can best be answered by your orthodontist (a dentist specialized in braces). A ‘real’ orthodontist has normally undergone a further four years of specialized study and only works on dental braces. He can even move teeth around.

Ceramic Braces

Ceramic Braces

Let yourself be treated by an orthodontist! He can also answer our questions as to, for example whether the incorrect situation of your teeth can damage your health, whether it can have negative effects on your health. Some incorrectly situated teeth can damage teeth, the hinge of the jaw and the brace. So there’s not only an aesthetic reason but also a medical one!

Unfortunately a ‘normal’ dentist, i.e. one without the necessary special training, may also do orthodontic work. These dentists can be recognised from the fact that apart from the orthodontics they also offer other things. The best thing is to ask your therapist if he has the specialized training. The trend is not only for whiter teeth, but rather for one to have a perfectly even dentition, like a garden fence. Braces don’t cause damage and when correctly set can lead positively from crooked teeth to a healthy bite!

These are the most frequently asked questions about Dental Braces.

Are Braces Possible at Any Age?

In principle, yes, though with increasing age moving teeth becomes more difficult. At a younger age removable braces are often sufficient. The body is still growing and it’s enough to give the body a ‘push’ in the ‘right’ direction – including with, for example, a removable brace! Once growth is over teeth can be ‘brought into line’ with permanent braces, throughout one’s life. Whether the result will last, that is, whether a so-called ‘retainer’ will be needed depends on whether an ideal dentition – so-called Class I – will have been achieved or not.

It will also depend on your musculature, the site of your tongue and a whole lot of other factors whether your teeth, after successful therapy, will have a tendency to wander back.

Fixed Brace or not?

Due to their growth-phase it is possible to work with removable braces with young people. Impulses are enough to move teeth and the brace doesn’t need to be worn permanently. Once the growth phase is over, then one needs to work with a permanent brace since the force needed to move the tooth must be applied to it all the time.

Invisible Braces?

Invisible braces such as, for example, Aligners, are also used to correct crooked teeth. The rotation of canines, however, is very difficult to achieve with these.

Braces and kisses, a contradiction?

It’s always possible to kiss, regardless of which brace you are wearing and no lingual acrobatics are needed! Eating and laughing are perfectly possible too thanks to modern braces.

Brace costs!

In Europe health insurance normally only covers a small part of the costs, depending also on the misalignment of the teeth. In the USA it’s all covered by private insurance – as long as you have the additional coverage. It’s best to discuss costs with the person doing the treatment. The treatment is often charged on a yearly basis, which is why treatments sometimes last three, four or more years.

It’s better to calculate the costs per treatment since an experienced therapist can estimate the complexity of the work right from the beginning of the treatment. Furthermore most crooked teeth are corrected in one or two years and whatever takes longer than that usually needs to be operated on.

How Long?

Generally 2 years are enough to correct most misalignments. Whatever takes longer would or should be operated on. In these operations it’s not the teeth but rather the jaw that is aligned to the correct position.

Why are teeth crooked?

Why teeth come to a crooked position is due to different reasons, chief of which is caries in the milk teeth. Because of this milk teeth are often extracted, but milk teeth are however an important growth stimulus for the jaw. If they’re missing then the growth of the jaw slows down and the remaining teeth have too little room in too small a jaw which results in crooked and too-close teeth.

Braces and Periodontitis?

Some misalignments are associated with a higher risk of periodontitis and/or gum recession. Through orthopaedic treatment periodontitis and therefore loss of teeth can be reduced. Sometimes, the misalignment of teeth promotes the appearance of inflammation with our tooth-holding device.

With the correction of the misalignment this can be reduced – but be careful, with a brace and poor oral hygiene periodontitis can result. Should you have received a permanent brace and/or already are a wearer of one, then buy a mouthwash as this will enable a much more thorough cleaning of your mouth.

Can tinnitus be treated with a brace?

Tinnitus (whistling sounds in the ears) can be caused by an incorrectly aligned jaw. In such cases correction of the alignment of the jaw can have a beneficial effect. One’s bite and therefore the position of the jaw can also be affected by faulty dental work. Over the years the means of chewing can be so disturbed that the processes at the hinge end of the lower jaw bone can become elongated and be pushed back in the direction of the middle ear when closing one’s mouth, causing enormous pressure on the two nerves which lie there.

The middle ear and the hinge of the jaw lie very close together and are separated only by a thin layer of bone. Phantom sounds in the ear, also known as tinnitus, or headaches around the temples may result. In such cases an extremely thin sliver of clear plastic often helps to bring the processes of the lower jaw bone back to their original position.

In this way the patient wears a so-called Pivot-bar in his upper jaw for at least four weeks, day and night, which is slightly raised at the back in order to compensate the incorrect bite. When closing the mouth the lower jaw now moves to this contrived bite position and pulls the hinge of the jaw downwards. The individually-set bar is adjusted and ground to shape regularly until the ideal bite is fixed.

Click here to see the video: Brackets

 

This post is also available in: German

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