INTRODUCTION / DISCLAIMER
ARE YOU CONSIDERING ORTHODONTIC TREATMENT?
Please read the following for some general information before embarking on treatment:
General information regarding orthodontics and orthodontic treatment
The subsequent information is only general in nature and for educational purposes only. The association does not accept responsibility for any damage or injury arising from the use of the information.
Patients seeking orthodontic treatment should consult an orthodontist for a full assessment and who will tailor a specific plan suited to your individual needs.
WHAT IS ORTHODONTICS AND ORTHODONTIC TREATMENT?
Orthodontics is a specialised field in dentistry related to the study of growth and development of the face, jawbones and teeth. It specialises in the diagnosis, prevention and treatment of problems in the arrangement of teeth and jaws. It usually involves using corrective appliances such as braces to help move teeth that are crooked or that do not bite in the correct manner (abnormal bite) – often termed a malocclusion. By fixing these problems, orthodontics can also help keep your mouth healthy as crooked teeth can be harder to clean, putting you at a greater risk for cavities and gum disease. It also is known to improve ones self-esteem and confidence apart from giving one an improved facial appearance, straight teeth and an improved bite.
Orthodontic treatment involves the use of corrective appliances, commonly known as ‘braces’, to bring the teeth and jaws into a better position.
“WHAT CAN ORTHODONTIC TREATMENT GIVE YOU?”
- Straight teeth
- A good occlusion (bite)
- A better smile
- A Improved facial appearance
- An improved self-esteem and a more confident you
However, please be aware that Orthodontic treatment may not solve all your dental health problems.
EXAMPLES OF MALOCCLUSION
- Deep bites
- Impacted Teeth
- Jaw Asymmetry
- Cleft Lip and Palate
- Many Others
WHO IS AN ORTHODONTIST?
An Orthodontist is a SPECIALIST in the specialty of Orthodontics. An Orthodontists would have successfully completed at least three years full-time of formal post-graduate clinical and research training in clinical orthodontics, leading to a post-graduate qualification and who has a qualification recognized by the Ministry of Health/ Education.
WHEN TO CONSIDER SEEING AN ORTHODONTIST?
The face, jaws and teeth grow from birth until adulthood. It is now widely accepted that growth and maturation of human body does not cease until death. However, most growth and development occurs in childhood and adolescence. However, changes do occur, as a result of ageing, in adulthood.
It is recommended that a child see an orthodontist as early as 7 years of age in the event there is some anomaly if development of the dentition, when the adult teeth are beginning to grow and erupt into the mouth, to determine if there is a need for early orthodontic treatment.
Conventionally, most treatment is done in the early teenage years, when the permanent adult teeth (except the wisdom teeth) have grown into the mouth.
Some treatment is occasionally best left until most growth has stopped. For example, imbalanced jaw relationships that require orthognathic surgery, are usually only corrected in early adulthood.
Adults can also have orthodontic treatment as long as their periodontal (gum) health are in a good and stable condition as the teeth can still move.
However, tooth movement may however be slower.
Some treatments require multi-disciplinary management between many doctors/specialties. For instance:
- Management of a patient with a Cleft Lip and Palate may require the cooperation of the Plastic Surgeon, the Speech Therapist, the Paediatric Dentist and others.
- Management of a patient with a jaw deformity/imbalance, may require combined surgical-orthodontic treatment, together with an Oral and Maxillofacial Surgeon.
A SIMPLE EXAMPLE OF ORTHODONTIC TREATMENT
WHAT ARE THE RISKS OF ORTHODONTIC TREATMENT?
As with any dental treatment, there are some risks when having orthodontic treatment. Your orthodontist will explain them to you before embarking on a course of Orthodontic treatment. Some of the more common ones are:-
- Pain, discomfort, mouth ulceration during treatment
- Decalcification (white/brown spots) of teeth
- Dental caries (tooth cavities)
- Gingivitis (swollen and bleeding gums)
- Root resorption (roots of teeth becoming shorter)
- Poor Compliance may result in incomplete treatment resulting in minimal /no improvement and possible large extraction spaces remaining.
- Relapse (teeth becoming crooked again). This may be due to insufficient retainer wear or/and adverse growth changes.
FOR GOOD OUTCOME OF TREATMENT
If you wish to obtain a good result, while minimising the risks of orthodontic treatment, you are advised to follow the instructions given by your orthodontist.
YOUR RESPONSIBILITIES WILL INCLUDE:-
- Keeping your teeth clean during treatment. You will have to brush your teeth after every meal
- Do your best to keep your braces intact. Breakages usually will prolong treatment and increase costs of treatment. The outcome of treatment may also be affected.
- Do your best to follow all the instructions given by the doctor
- Not miss your appointments
Failure to accept these responsibilities may lengthen your treatment, make it difficult to get a good result and may cause the problems mentioned earlier.
It may be wise NOT to have orthodontic treatment if you are unable to comply to your treatment requirements.
ORTHODONTIC TREATMENT PROCEDURES
In general, the outline of a course of orthodontic treatment is as follows:-
- Consultation to include treatment fees
- Treatment Plan
This is just a consultation appointment. There will only be a comprehensive examination. No treatment is usually carried out at this stage.
The orthodontist will usually advise you on:-
1) the nature of the problem.
2) the necessary treatment for you/your child.
It is wise that if you have any questions, the orthodontists will usually be able to answer your queries at this stage upon examination of you/your child. Should you have doubts on the advice given by the orthodontist, you may want to seek a second opinion from another specialist.
You should be aware that orthodontic treatment will usually only be recommended if you/your child:
- Has a good level of oral health with no carious teeth or gum disease
- Has a good medical health
- Is fully motivated to undergo a few years of treatment
- Is willing to accept your responsibilities as a patient
ORTHODONTIC TREATMENT FEES
In Malaysia, different clinics have different payment methods and plans. The cost of orthodontic treatment may vary from patient to patient. The fees charged usually depend on the complexity of the treatment and the type of materials used during treatment.
Tailored payment plans, to meet each individual’s financial needs, are common. Payment can usually be spread over the duration of treatment. Should you decide on having orthodontic treatment, your orthodontist will discuss the fee with you before treatment is commenced.
ORTHODONTIC RECORDS TAKING
During this appointment, some records will be taken.
This may involve any/all of the following:
- History and Examination
- Impressions for Study Models
- Photographs of your face and teeth
- Radiographs as necessary
These records will be used to assess your teeth and occlusion (bite) and plan your orthodontic treatment. This plan will be discussed with you at your next appointment.
If you have any questions, please ask the orthodontist.
ORTHODONTIC TREATMENT PLAN
During this appointment, the doctor will discuss his/her orthodontic treatment plan, which he/she feels is suitable for your problem.
Other orthodontists may have different opinions. If you are not comfortable with the plan, feel free to seek another opinion.
You can take your time to think the plan over. You do not have to decide to accept/reject the plan immediately.
If you accept the plan, you must be aware that you are committing yourself to 2-3 years of treatment, with appointments every 1-2 month, and accept your responsibilities as a patient.
There will be a fee that needs to be paid. If your braces are repeatedly damaged/broken, you may be asked to pay for the repair/replacement of the appliance.
Fixed appliances are “braces” that are stuck to the teeth based on a bracket and archwire system. It cannot be removed from the mouth and should not become detached by the user.
On average, active orthodontic treatment will take around 2 years. In some cases, treatment may take longer and in other cases, shorter. Subsequently, you will usually be given retainers.
Regular appointments during treatment are usually arranged once every 6-8 weeks.
You should expect the following:
- Some possible pain, abnormal speech patterns or mouth ulceration, in the first few days after fitting of the appliance, and after appliance adjustments. You will get used to the appliance after a while. You can take your usual painkillers as advised by your orthodontist if necessary.
- Some possible discomfort while eating and jaw clicking due to the change in tooth positions. This is usually temporary and will settle after treatment.
You must do the following during treatment:
- Maintain a good level of oral hygiene throughout. You must brush your teeth well after every meal. Failure to do so may cause caries and gum disease to develop. Use a fluoride toothpaste and a special ‘bottle brush’, if necessary, to clean under the wires. Added use of a fluoride mouthrinse may also be beneficial.
- Adopt a soft diet. Avoid hard foods. Hard large and sticky pieces of food (nuts, crisps, chunky meat, chewing gum etc) may damage your brace. You should cut large pieces of food into small ones before eating them.
Should you have a problem with your brace, please attend the clinic as soon as possible for a check-up. Please also keep any item that becomes detached from the teeth or brace and show it to the doctor.
You have now completed your active orthodontic treatment. You will be given retainers to wear. The purpose of these retainers is to hold the teeth and prevent them from moving back to their original position, a condition known as ‘relapse’. The teeth and gums need time to settle in their new position.
A common regime of retainer wear (removable retainers) is as follows:
- 6 months full-time wear.
- 6 months part-time (eg. night-time only) wear.
- Continued wear, a few nights each week after, for as long as you wish your teeth to remain straight.
Occasionally, due to your specific problem, you will have to wear your retainers indefinitely, for life, if you wish to maintain the achieved result. In this case you can either wear a removable retainer as above or have a wire attached to your teeth (fixed/bonded retainer).
The orthodontist will advise you of the best option in your case.
Due to continued growth and aging, no one can guarantee that if you have straight teeth now, you will have straight teeth in later life. This is irrespective of whether you have had orthodontic treatment or not. The best way to maintain their position is to continue wearing your retainers for long term.
You should follow the following instructions:
- For removable retainers:
◦ Wear them according to your orthodontist’s instruction.
◦ Take them out when eating, playing contact sports, brushing your teeth, swimming; anytime when it can be damaged.
◦ When out of the mouth, keep them in a secure container, before placing them in bags, pockets or elsewhere.
◦ When brushing your teeth, please clean the retainers too.
Above: Hawley Retainers in place (wire and plastic framework)
Above: Clear retainer
For fixed retainers:
◦ You must care for it just like when you were wearing your braces (brushing, soft foods, etc). An inter-dental brush is useful to keep the teeth surfaces clean surrounding the fixed bonded retainer. (see photo)
◦ Should it become detached, partially or fully, attend the clinic as soon as possible to have it checked.
Malaysian Association of Orthodontists,
21-3A, Tingkat 2, Blok L, Jalan PJU 1/3C,
SunwayMas Commercial Centre,
47301, Petaling Jaya,