Orthodontics

Orthodontics is the specialty of dentistry that is concerned with the study and treatment of malocclusions, which may be a result of tooth irregularity, or disproportionate jaw relationships, or both. Orthodontic treatment can be carried out for purely aesthetic reasons – improving a the appearance of a patients teeth for cosmetic reasons.Treatment is often for practical reasons, providing the patient with a functionally improved bite (occlusion). Treatment includes fixed appliances, or "train track braces", removable appliances, or "plates", headgear, and other appliances, including expansion appliances, and functional appliances – which can alter the relationship of the jaws. After a course of active orthodontic treatment, patients will often wear retainer appliances, which will maintain the teeth in their improved position whilst the surrounding bone reforms around them. After about a year, the retainers are no longer worn and the patient has a stable, corrected, occlusion.

Orthodontists

An orthodontist is a dentist with specialist training in diagnosing and treating malocclusions, which are mis-alignments of the teeth or jaws, or both. The orthodontist will align teeth with respect to the surrounding soft tissues, with or without movement of the underlying bones (which can be moved either through orthopaedic or orthognathic movements). Orthopaedic movements are attained through the judicious use of (mainly) acrylic appliances, (functional appliances), that influence the position of the jaws relative to each other and the face, and will be carried out on growing children. The correct application of orthopaedic appliances can influence the development of an adolescent's jawline giving a much improved aesthetic and functional result. Orthognathic movement is achieved by surgically repositioning the jaw(s), in patients that have completed their growth. Such surgical treatment is carried out by maxillofacial surgeons who work closely with the orthodontic team. One of the most common situations leading to orthodontic treatment is crowding of the teeth. In this situation, there is insufficient room for the normal complement of adult teeth, which can sometimes result in teeth being extracted. Crowding of teeth is recognised as an affliction that stems in part from our modern, western, lifestyle. We do not know for sure whether it is due to the consistency of our diets, or due to mouthbreathing, or amplified by early loss of deciduous (milk) teeth due to decay. Much has been made in the media of links between tooth extraction and tempero-mandibular joint dysfunction (problems, including clicking and jamming, of the jaw joint). No research has shown a definitive link between extraction of teeth and jaw joint problems. Most tempero-mandibular joint problems are a result of the patient having a clenching habit – that is the patient bites the teeth together on a regular basis – eg when under stress. This can superimpose onto orthodontic work – or any treatment that is concurrent with this habit. Various countries have their own systems for training and registering specialist orthodontists; generally a period of post-graduate study is required for a qualified dentist to qualify as an orthodontist. In the U.K., this training period is three years, after completion of a fellowship diploma from a Royal College. In Europe and the U.S., a similar pattern is followed. There are approximately 240 openings in orthodontic programs across the US that range from 24 to 36 months. It is always worth contacting the professional body responsible for registering orthodontists to ensure that the orthodontist you wish to consult is a recognized specialist.