Orthodontics

With increasing dental health awareness, adults are also receiving orthodontic treatment in increasing numbers. However, adult treatment is more complex and sometimes more than one specialist may be required to fix a problem. For example, adult patients are more susceptible to gum problems and if they do not correct this, they may have jaw and joint problems that require corrective jaw surgery in the future. The most important obstacle in adult treatment is that adults are no longer growing.

Reasons

1. Nutritional Disorders: In people who do not have adequate nutrition, volumetric reduction will occur in the jaw and facial structure, and since the teeth with normal volume cannot find the necessary space in small jaws, crowding, rotations and even impaction will be observed.

2. Mouth Breathing: Chronic inflammations and similar causes, if they continue for a long time, the tonsils can grow excessively. In this case, the respiratory tract narrows and breathing difficulties occur. In order to overcome this difficulty and to expand the air passage in that area, the child feels the need to bring the lower jaw and therefore the tongue forward. If this situation continues for a long time, the lower jaw will be positioned forward. If the tongue gets between the front teeth and prevents the teeth from erupting, an open bite occurs. If the patient cannot breathe through the nose, it may have a negative effect on the growth potential of the upper jaw.

3. Thumb Sucking: A newborn baby has a highly developed sucking mechanism. A baby whose sucking instinct is not satisfied acquires some habits to meet this need. This habit is not usually seen in children who are breastfed for 9-18 months..

Studies have shown that thumb sucking develops in the first few weeks of life due to hunger. Since pain caused by local irritation during the period when teeth begin to erupt can be relieved by thumb sucking, it can be thought that this habit helps dentition. Thumb sucking decreases with age.

Causes of thumb sucking

• Sudden weaning from breast or bottle feeding
• Stopping the baby's sucking too soon while feeding
• Changing the baby's feeding at longer intervals

No precautions are taken in the early stages of thumb sucking. Preventing the habit at this stage is harmful because it will affect the child's physiology. There is no definite age for the treatment of thumb sucking. The appropriate time setting is different for each child. The degree of the habit and the child's history affect the time setting. In general, if thumb sucking continues after the age of 3.5, treatment should be started.

In children who continue this habit, displacements and malocclusions will be observed in the upper and lower teeth in the affected area, depending on the number and number of fingers sucked.

4. Fake Pacifier: It is not harmful to suck a pacifier with physiological properties until the age of 1.5. It is even useful in preventing the child from acquiring a bad habit such as thumb sucking. When pacifiers are used continuously, they cause irregularities and various malocclusions in those areas as they will have long-term abnormal effects on the tissues within their effect area.

5. Lying Position: The sleeping position mostly determines the position of the lower jaw while sleeping. This gives us information about the position of the lower jaw for an average of 8 hours a day.

For example, the position of the lower jaw is different in a child lying face down and a child lying on their back. In people who have the habit of always lying on the same side and putting their hand or fist between their face and a pillow while sleeping, orthodontic problems may occur because the face on that side will be under constant pressure.

6. Bad habits such as clenching teeth, biting nails, biting pencils, and biting lips.

7. Early loss of milk teeth.

8. Teeth irregularities due to gum problems.

9. Irregularities that occur due to tooth loss.

10. Irregularities due to the wisdom teeth crowding the front teeth.

11. Genetic predisposition.

12. Hormonal disorders, systemic diseases.

Malocclusion

A bad bite looks ugly and is one of the main reasons people go to the orthodontist for treatment. It also makes chewing difficult and can lead to more cavities. Correcting these irregularities will improve your oral health and correct your chewing. Malocclusions are divided into categories. The most common ones:

• Cross Closure - In this case, the upper teeth fit inside or outside the lower teeth. Crossbite makes chewing and biting difficult, so it usually requires orthodontic treatment.
• Increasing frequency - If there is not enough room for the teeth, if the teeth are too large or if the jaw is too small, there will not be enough room for the permanent teeth to shift into the correct position.
• Deep Closure - In this case, the upper front sharp teeth overlap the lower teeth and sometimes the bite line of the upper teeth goes all the way to the lower gums.
• Reverse Closing - In this case, the lower teeth are in front of the upper teeth.
• Opening of the Front Teeth - If the upper and lower teeth do not meet when you close your teeth, this is called an open bite. Since the front teeth do not share the same force, there is a lot of pressure on the back teeth. This makes chewing less effective and causes the back teeth to wear down more quickly.
• Location Problems - Some people are missing all their teeth or have smaller teeth than normal. If the jaw is normal in size, this can cause large gaps between the teeth. In people who are missing one or more teeth, neighboring teeth can shift into the empty space, causing gaps.

Treatment Process

The most commonly used method is braces, which slowly move the tooth by applying gentle pressure over a long period of time. Most orthodontic treatment takes place in 2 stages.

• Active phase - This stage involves fitting the teeth into place using brackets and correcting the bite.
• Protection phase - This stage involves using retainers to hold the tooth in its new position for a long time. Dentists may use other devices other than braces to help young children grow their jawbone. These devices are rarely used in adults.

Bracket

You can choose between metal, ceramic and plastic brackets. However, orthodontic treatment is usually done using stainless steel brackets. Ceramic and plastic brackets are generally preferred for aesthetic reasons, but plastic brackets may become stained and discolored by the end of treatment. Since there is more friction between the wires and brackets in brackets made of plastic or ceramic, treatment time may be longer. Your orthodontist will share possible options with you.

Brackets work by applying pressure to push the tooth in the desired direction. They are used for an average of 1-3 years. Since teeth shift during treatment, adjustments are required occasionally. In the past, brackets consisted of thick steel bands that covered the tooth. With new developments, brackets have become smaller and orthodontic bands are rarely used anymore.

While these are being installed, your dentist will attach tiny brackets to your teeth using special adhesives. Wires called archwires are then passed through these brackets. These archwires provide a specific path for the teeth to move in. Tooth-colored wires are less visible but more expensive than stainless steel wires. Small elastic bands called ligatures can be used to attach the archwires to the brackets, and the patient can choose a different color at each visit.

It is normal to feel discomfort for a few days after braces are placed. Your teeth may ache and the wires may make your tongue and lips itch. Although most discomfort goes away in 1-2 weeks, there may still be mild pain while the wires are being changed or adjusted. You can use any painkiller your doctor recommends to relieve the pain.

Movable Apparatus

Simple treatments can be done with removable appliances (plates that can be removed for cleaning). They have delicate wires and springs that provide gentle pressure on the teeth.

Functional Appliance

Sometimes it is possible to change the growth of the jaw using orthodontic appliances. These functional appliances use the strength of the jaw muscles and can help solve certain problems.

Headgear

Sometimes it is possible to wear a headband (headgear) as well as the appliances. They are usually used in the evening and at night. Your orthodontist will share with you when to use them and whether they are necessary. Using them as your orthodontist tells you is very important for the smooth progress of the treatment.

Elastics

Sometimes, fixed braces may require delicate elastic bands to move the teeth. Your orthodontist will tell you if elastics are needed.

İnvisalign

These are sturdy plastic molds that are used to straighten teeth. A slightly different set is made for each patient. Each set is worn for a few weeks and then replaced. They are made of clear plastic and are virtually invisible. This means that no one needs to know that you have had your teeth straightened. These aligners should be worn 22-23 hours a day for best results. They can be easily removed when eating, brushing, or drinking. All permanent teeth must be present before using them.

Stabilizer

The purpose of a retainer is to hold the teeth in place after corrective orthodontic treatment. Once your bite is corrected, the bone and gums need time to settle around the teeth. The recommended length of time for braces varies from orthodontist to orthodontist. Most children and teenagers wear them until their mid-20s, but your orthodontist's advice should be followed as they know your treatment best.