In today's competitive world, the personality and style of an individual contributes significantly towards success. But without a beautiful smile these are incomplete. A beautiful smile can make a difference between success and failure.
The shape, size, colour and position of the front teeth are primarily responsible for a beautiful smile. The positions, shape and colour of the gums also contribute to it. The shape, size and position of the lips which determine the display of the teeth during smiling and talking, are also important.
An orthodontist can change the positions of teeth with braces. The horizontal and vertical positions of the lips can be influenced to some extent by changing the positions of teeth.
A cosmetic dentist can change the shape, size and colour of teeth and the level and shape of gingival margins.
The front teeth in the upper jaw influence the smile of a person the most. Positions of these teeth are very important. When the teeth are well aligned, leveled and their inclinations are proper, the smile becomes more attractive.
If the upper front teeth are crowded or spaced out; if one or more teeth are extruded (long) or intruded (short); if the teeth are projecting outwards or inclined inwards, then the smile gets adversely affected. All these conditions are due to improper positions of teeth.
Orthodontics not only deals with the correction of irregular and protruded teeth, it deals with the correction of irregular jaws as well.
Since the teeth are borne by the jaws, any discrepancy in the position of the jaws can lead to improperly placed teeth, thereby affecting the smile. As a result of jaw discrepancy the lower face may become short or long, and the chin may become protruded giving a "moon-face appearance" or it may be deficient giving a "bird-face" appearance. Also, any discrepancy in the jaw size to the total size of the teeth results in crowding, proclination or spacing of the teeth.
Jaw discrepancy can result due to an excessive or reduced growth of one or both the jaws. These conditions can be corrected by growth modification appliances. There are different kinds of these appliances like removable, fixed, intra-oral (to be worn in the mouth only) or extra-oral (to be worn in the mouth taking support from the neck or the head).
The growth modification treatment gives best results when commenced before the pubertal growth spurt of the child. For girls the treatment should start before the age of 10 to 11 years and for boys, before the age of 11 to 12 years. The first check up of a child by an orthodontist must be at the age of 6 years followed by regular check ups every 6 months. This helps in prevention and early correction of a developing problem. It is not advisable to wait till all the milk teeth fall off because major growth increments may be over by then.
Growth modification treatment cannot be done in adults. If a person requires correction of severely disproportionate or displaced jaws after the growth is over, then orthodontic treatment alone would give a compromised result. Only surgical correction of one or both the jaws combined with orthodontic treatment would give the best possible result in such cases.
Teeth become irregular or protruding when the jaws are smaller and the teeth are bigger. Spaces develop among teeth when the teeth are smaller and the jaws are larger. Any irregularity of the teeth can be treated orthodontically even at the age of 40 to 45 years. It is not the age of the patient but the condition of the tooth-supporting bone that determines the feasibility of orthodontic treatment.
For the correction of crowded or protruding teeth, it becomes necessary to remove two permanent teeth from each jaw. This creates spaces in which the front teeth are moved to align them and relocate them in a better position. Removing teeth does not affect the eyes or any other part of the body. It is not necessary to remove teeth in cases where spaces exist among teeth. These can be closed by moving the teeth.
Removable or fixed orthodontic appliances, commonly known as braces, are used to align and relocate teeth. Fixed braces have much better control over the tooth movements and hence give much better results. Usually metal braces are used but now tooth-coloured ceramic braces (also known as clear braces) are also available which are aesthetically more acceptable.
Today many adults want to improve their smiles but are not willing to wear metal braces. For them other options like tooth coloured braces, lingual (invisible) braces and in some countries "Invisalign" are available to choose from.
Different materials are used to manufacture tooth coloured brackets. Ceramic brackets are the most popular. Ceramic brackets with metal inserts are more advantageous to use because the teeth get corrected faster with these. Ceramic brackets are strong, not very visible, inert and stable in the oral conditions.
Other materials used to manufacture tooth coloured brackets are Urethane, Plastic, and Polyoxymethylene etc. These materials are not as strong as ceramic and tend to wear out faster.
Lingual braces are fixed onto the inner sides of the teeth. These braces have been used for many years. Their popularity is now growing as more adults are seeking orthodontic treatment. They are not seen at all so the patients who are conscious about wearing braces can get their teeth repositioned to get an aesthetic smile.
The latest lingual brackets are highly refined and low profile. Therefore, they are more comfortable for the patients. We use the Multi-Purpose Attachments for many of our patients wherever possible. These are the thinnest possible brackets available and therefore are most comfortable for our patients.
Invisalign / ClearPath/ Clear Aligner are appliances used for straightening teeth without the conventional fixed braces. A series of custom made trays are prepared according to the corrections required for a patient. These trays bring about changes in the positions of teeth sequentially. The patient is supposed to wear the trays as instructed and check ups are done every 6-8 weeks by the orthodontist or dentist to monitor the progress.
In many cases, it may not be possible to achieve the best possible aesthetic smile; functional and stable results without repositioning teeth with orthodontic appliances. These patients have the option of choosing appliances which are not very visible or not visible at all. Due to recent advances in orthodontics, the time taken for orthodontic corrections has reduced. In most cases aesthetic improvements can be achieved in a few weeks to a few months.
Invisalign is not available in India as of now.