Orthodontics - a multifaceted speciality of dentistry (PART-2)

Prof (Dr) Bhabatosh Kumar Roy highlights the know-how of orthodontics for dental treatment

There is not one "right" chronological age for orthodontic treatment. Ideally, children should have an orthodontic evaluation no later than the age of 7. But there is an ideal time to begin treatment for an individual who needs it. Timing is determined by the type of problem that the child has or may be developing, and the child's stage of dental development. Rely on your orthodontist to advice you on the ideal time for your child to be treated.
Around age 7, children have a mix of baby (primary) and permanent teeth. A check-up as permanent teeth take the place of baby teeth, and as the face and jaws are growing, gives the orthodontist a wealth of information. If a problem exists, or if one is developing, your orthodontist is able to advise you on whether treatment is recommended, when it should begin, what form treatment will take, and estimate its length.
Remember, there is a difference between an orthodontic check-up and actually starting orthodontic treatment. Only a few orthodontic problems will need correction around age 7. Even so, not all treatment is done using braces. This is because there are a few self correcting anomalies, taken care of by nature itself.
In the event that a problem is detected, chances are your orthodontist will take a "wait-and-see" approach, and will check your child's growth and development periodically. If treatment is needed, it can begin at the appropriate age for your child.
Waiting until all the permanent teeth have come in, or until facial growth is nearly complete, could make correction of some orthodontic problems more difficult. Some things cannot be accomplished once the face and jaws are no longer growing.
Only a few orthodontic problems will need correction around age 7. Even so, not all treatment is done using braces. This is because there are a few self correcting anomalies, taken care of by nature itself.
When a child has early treatment (while most baby teeth are present), the type of treatment varies based on the kind of problem a child needs corrected. The goal of early treatment is to create a better environment for permanent teeth as they come in. For some patients, early treatment could consist of removal of a stubborn baby tooth, so that the succeeding permanent tooth can arrive in its proper place.
representative image
Image: representative image
Some patients may need help with how to position their tongue when they swallow, while others may need intervention to stop a thumb- or finger-sucking habit. These are sometimes treated with habit breaking appliances. If a child's upper jaw is too narrow, so that the permanent teeth do not have room to come in, treatment could consist of a palate expander to widen the jaw.
Therefore sometimes preventive or interceptive orthodontic treatment is all that a patient needs. More often, though, patients will require a second phase of comprehensive orthodontic treatment after a child has most or all of their permanent teeth. This completes the tooth and jaw alignment that was started with a first phase of preventive or interceptive treatment. Braces are often recommended to optimize tooth and jaw alignment after most or all of the permanent teeth are in.
Teeth are moved by placing gentle, controlled forces on them, as the orthodontist uses "appliances" such as braces or clear aligners to guide them to their ideal positions over a period of time. Tooth movement happens because of the breakdown and rebuilding of bone tissue.
At the end of "active" treatment (when teeth are being moved), most patients will have to wear retainers to give the new bone a chance to harden and support the new positions of the teeth. It's truly a complex biological process, and orthodontists master the multi-faceted intricacies of orthodontic treatment through years of study.
In conclusion, orthodontic treatment is not just about an attractive smile. It is more about creating a healthy, functional "bite," (normal occlusion) which promotes the overall well being of an individual, thereby improving the general body growth.

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