Is There An Ideal Type of Orthodontic Treatment? | Dr. Ana Castilla

Is There An Ideal Type of Orthodontic Treatment?

The field of orthodontics has come a long way in the last few decades, and patients have more options than ever before! Depending on your own wants and needs, you can find the best treatment options for you.

For “Invisible” Teeth Straightening

Back in the day, straightening your teeth meant wearing metal brackets and wires. While traditional braces work extremely well and still have their place, patients can now choose from other treatment options that straighten teeth more discreetly.

         Clear aligners. Aligners like Invisalign are made of clear plastic, making them hard to see. As a bonus, they are removable and can be taken out for eating, drinking, and cleaning teeth.

         Ceramic braces. These are like traditional braces except the brackets are clear. Since they still use a metal wire, they are not totally “invisible,” just much less noticeable.

         Lingual braces. These are also like traditional braces except they are attached to the tongue, or lingual, side of the teeth, meaning there is literally nothing visible on the front of the teeth.

For Faster Teeth Straightening

One of the most frequent questions I get from patients is “How long will treatment take?” My patients know that moving teeth takes time, but they still want treatment to be over as fast as possible so they can see their dream smile at last. Fortunately, there are some effective ways to shorten treatment time.

         Mechanical pulsation devices. These non-invasive and relatively inexpensive tools work by amping up cellular activity in the jaw bone to accelerate bone cell turnover, which is what allows teeth to move. The device is a vibrating mouthpiece that a patient wears for just 20 minutes a day, and the makers claim it can reduce treatment time by up to 50%.

         Photobiomodulation. Like mechanical pulsation devices, PBM works by stimulating bone and gum tissue to accelerate bone cell turnover. But PBM uses low-energy light pulses instead of mechanical pulsation.

         Corticotomy. This option is the most invasive and the most expensive but it is also the most effective. Plus, it’s been around the longest. It involves making cuts in the outer part of the bone called the cortex, leading to an influx of healing cells that accelerates turnover of bone cells, as above.

For Affordable Teeth Straightening

If money is a concern and you’re searching for the least expensive way to straighten teeth, traditional metal braces may be your best bet. They are time tested, priced well, and they work!

However, if you’re interested in clear aligners or something else, it’s worth speaking with your orthodontist about payment options. Many offices offer discounts for upfront cash payments, or low-interest or no-interest payment plans over time. You may find that you can go forward with the treatment you really want with a payment plan that fits your family’s needs.

To Fix a “Bad Bite” in Younger Patients

Bad bites, or malocclusions, come in many forms: overbite, underbite, crossbite, and open bite. Some bad bites can be fixed with braces and elastics, but more severe bites need other treatments. That’s because the underlying issue isn’t with the teeth, but with the jaw.

The patient’s age is a big factor when it comes to addressing problems with the jaw. Since the upper and lower jaws don’t stop growing until adolescence, children and young adolescents have many more options compared to adults.

First we’ll look at options for younger patients, then look at adults in the next section.

         Headgear to fix overbites. Worn partially outside the mouth, headgear is a good option for addressing protrusion, especially a protrusive upper jaw. Though headgear must be worn for 12-14 hours a day, that can include sleep time.

         Facemask, aka reverse-pull headgear, to fix underbites. Like headgear, a facemask also needs to be worn for 12-14 hours a day. But it’s used to treat underbites by “pulling” on the upper jaw to help it grow forward.

         Functional appliance to fix overbites. Worn inside the mouth, a functional appliance fixes bad overbites by applying forces to the lower jaw.

         Expander to fix a narrow upper jaw. A rapid palatal expander (RPE), often simply called an “expander,” addresses one of the most common issues – a narrow upper jaw. The expander applies forces that open the palate, allowing new bone to form, thus widening the jaw.

         Lower expander to fix narrow lower jaw. Unlike the upper jaw, the lower jaw cannot actually be expanded. However, some orthodontists use lower expanders to “tip” the teeth in a way that widens the dental arch. Since I believe the same result can be achieved through braces, I don’t favor lower expanders in my practice.

To Fix a “Bad Bite” in Adults

Since the upper and lower jaws stop growing in adolescence, adults who want to address a bad bite won’t benefit from the treatment options listed above. Instead, they’ll have to turn to other treatment options which are more invasive. (This is why we encourage parents to bring their children to see the orthodontist by the age of eight[1].)

         Temporary Anchorage Devices (TAD) to help fix bites. Also called mini implants, these should not be confused with dental implants that replace missing teeth. A TAD is essentially a mini screw placed in the mouth – typically in the roof of the mouth, or between the roots of certain teeth – to help orthodontists address severe bite problems.

         Jaw surgery. Unfortunately, jaw surgery is sometimes the only effective treatment for certain bite problems in adults. I say “unfortunately” because while it’s effective, it’s also the most invasive and most expensive option. Jaw surgery should be performed by a specialized type of dentist with training in surgery called an oral and maxillofacial surgeon.

Which Treatment Is Right for You?

As you can see, orthodontic treatment covers a wide range of options, from old-fashioned metal braces to high-tech light-pulsing devices. Talk to your orthodontist about your goals and priorities (e.g., is it more important for treatment to be fast or affordable?), and together you’ll find the right plan for you.