Great Lakes Dental Clinic and Orthodontic Centre

A Multispeciality Centre of Excellence

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Any successful Orthodontic practice depends on a constant referral from any General Dental Practice. General Practitioners are the first Clinicians to examine a prospective Orthodontic Case during routine Dental Examination. Now if the patient has an Aesthetic Problem he will naturally seek help for it. They form the major bulk of Orthodontic patients. However there can be patients with obvious malocclusions in their mouth but is not having any immediate aesthetic concerns. Here comes the very vital role of a General Practitioner. Whether this category of patients actually gets the proper orthodontic treatment from here will depend on the DIAGNOSTIC EYE of the general practitioner.
Here I have listed some important FAQs which all General Practitioners should be aware of.

Orthodontics is the branch of dentistry that is officially known as Orthodontics and Dentofacial Orthopedics. The purpose of orthodontics is to treat any type of malocclusion, which is simply another way of saying “bad bite.”

When you have a malocclusion, it means that your teeth, lips and/or jaws don’t line up the way they should. As a result, your teeth may be crooked, your bite may not work correctly and your jaws may look unbalanced.

To fix bad bites, orthodontists — who are specially trained professionals — use braces and other corrective procedures, including materials often called “appliances,” to achieve tooth and jaw alignment. This correction of the teeth and their supportive structures makes for a healthy, attractive smile.

When most people think of orthodontics, they think of teenagers. And the fact is, most orthodontic treatment begins at ages 10, however, by age 7, most children have a mix of adult and baby teeth. Orthodontists can spot subtle problems with jaw growth and emerging teeth while some baby teeth are still present. That’s important, because some orthodontic problems are easier to correct if they’re found early. Moreover the upper jaw which is called the MAXILLA stops growing forward after 8 years. So if by chance there is a crossbite problem in your child it can lock the jaw growth permanently.

For these reasons, we recommend that your child gets an orthodontic check-up no later than age 7. While your child’s teeth may appear to be straight, there could be a problem that only an orthodontist can detect. Of course, the check-up may reveal that your child’s bite is fine, and that can be comforting news. Even if a problem is detected, we may not recommend immediate treatment. Chances are, we will take a “wait-and-see” approach, checking on your child from time to time as the permanent teeth come in and the jaws and face continue to grow. For each patient who needs treatment, there’s an ideal time for treatment to begin in order to achieve the best results. The orthodontist is the specialist.

In some cases, we might find a problem that can benefit from early treatment. Early treatment may prevent more serious problems from developing, and may make treatment at a later age shorter and less complicated. Typically, early treatment involves the use of orthodontic appliances, which may be removable, to guide the growth of young bones and create a better environment for adult teeth as they emerge. In some cases, we will be able to achieve results that wouldn’t be possible once the face and jaws have finished growing.

Beautiful, healthy smiles are possible for anyone. From age 7 to 70, the biological process of tooth movement is the same in children and adults. As the science of orthodontics has developed gentler wires and more esthetic braces, many adults are now taking advantage of improving their own smiles. Whether you are considering orthodontic care to enhance your appearance or to correct a poor bite that has contributed to dental problems, we’d love to talk with you about the benefits of adult orthodontics.

Fixed orthodontic appliances are braces that are stuck onto the surface of the teeth, and only an Orthodontist can remove them. Fixed braces consist of small squares or brackets that are stuck to the outer surfaces of the teeth and metal bands or sleeves that slide over the back teeth. Before bands are placed, it is sometimes necessary to place separators (small elastic bands that are flossed between the back teeth). The separators push the teeth apart slightly so that there is room for the metal band to pass over the teeth a few days later. When fixed appliances are fitted, it is necessary to keep your mouth as dry as possible so that the glue and cement can set. At the end of the bond up appointment, wires will be threaded into the tiny slots in the brackets and bands. These wires are held in place by tiny elastic bands, which come in various colours, red, blue, purple, pink and even turquoise to name but a few. Provided you keep your teeth nice and clean you will be able to choose your colours when the wires are ready to be changed.The wires will now start to very slowly move your teeth and will need to be changed or adjusted approximately every one to two months. As the teeth start to straighten, thicker wires are used.

Fitting the braces is painless, but later that day the teeth will feel strange. Individual pain sensitivity varies a lot. Some patients say this is mild and others find it tender. The best advice is to take pain relief that you would normally take for a headache, for example “Crocin Pain Relief” but be careful not to exceed the recommended daily dose. You can have the medicines upto three tablets a day, upto 3-4 days, preferably after food. After the 4th or 5th day everything will be just as normal.

Sometimes, the braces may rub the inside of your mouth and start to form a small ulcer. This happens because your cheek muscles consider the braces to be a foreign entity and become more active for sometime. To prevent this we would advise you to use the special orthodontic wax that is available from our reception. Roll a pea size piece between your fingers to make it supple. Dry the bracket that is causing the irritation and press the wax over the top of the bracket. This will stop the rubbing. The wax is harmless if swallowed and may drop off occasionally and need replacing. The cheek or gum will soon settle down.

We highly recommend using a fluoride mouthwash every day throughout the treatment. You may use either Colgate Phosfluor or Fluoritop Mouth Rinse. Take upto half the lid of the container and rinse your teeth very well for about one minute. When the time is over, spit out the mouthwash but do not rinse your mouth with water or else the beneficial effects of the fluoride will be washed away. Do not have anything for at least 2o mins. The best time to use the mouthwash is any time after brushing. This means that your teeth will have an additional coating of fluoride which is highly beneficial to your teeth. Rinsing must be done twice daily regularly.

Very few patients will seek Orthodontic treatment for functional needs. Human occlusion is like a fine pair of scissors it cuts through the food but never cuts each other. This is what happens in perfect occlusion which is in harmony with TMJ. But in malocclusion of any form scientifically speaking there is always the possibility of the scissors cutting each other. The teeth, TMJ and the periodontium form the three corners of a triad. In order to function properly all three have to function in harmony. Whenever there is malocclusion the harmony is disturbed and the weaker link fails.

When we see the dentition of a 60 or a 70 yr old, more often we will see missing teeth, mobile teeth and attrited teeth. The most obvious reason for this which will come in our mind would be dental caries or periodintitis. And many a times we might also wrongly interpret it as an aging change. But what does recent scientific research say? “Very minimal or no evidence of aging is there of periodontium”. So there is some third cause of damage to the supporting structure of the teeth. And this third cause is ‘Trauma from Malocclusion’ which is popularly known as ‘Trauma from Occlussion’ or TFO which is a misnomer. Malocclusion increases the chance of increased force concentration on certain areas of the dentition. There are oblique lines of force during function which itself lead to angular bone loss. You would be surprised to know that when you chew a piece of apple or any other food of similar consistency the amount of force that comes between teeth has been measured to be 50- 70 kgs. Now if that level of force is acting continuously in malocclusion then teeth and periodontium and TMJ are bound to suffer in the long run. We dont need any statistics to prove it. Picture is on our floor every day.

The Ideal time to get first screened by an Orthodontist is Age 7 years. Although most 7 years may only receive check-ups ad no early intervention. Only a few cases which have traumatic influences like cross-bites or traumatic deep bites will require immediate preventive or interceptive measures. The reason being that cross-bites can cause growth disturbances especially growth restriction of the maxilla very early. And if the restriction is not corrected at 7 years then maxillary growth is deficient many a times. This is a more serious concern because in everyone maxilla stops growing in the front direction by age 8 years. So if a patient walks into your clinic with anterior cross-bite after 8 years you can be certain that he is already late for treatment.

If there is no cross bite Orthodontic intervention will happen roughly at age 11 years. One should not wait till all permanent teeth erupt as the patient’s skeletal growth might complete before that. And one might lose on the opportunity of growth modification procedures that take place during active growth spurts.

Cross bite are the most detrimental of all malocclusions. They can lead to maxillary growth deficiency in children. They can cause irreversible tempero-mandibular joint (TMJ) derangement in future. Besides they can also cause PDL breakdown and asymmetric jaw growth due to functional shifts. Hence correcting at the earliest is the best treatment.

Yes, with the introduction of modern ceramic and composite braces along with white colored wires Adult Orthodontics is quite popular in India today. If the gum structure is healthy Orthodontics today is done at any age. There is no upper age limit. When an adult patient is made aware of the esthetic and future functional problems properly he often gets motivated for treatment.

Whether the prospective patient actually gets the treatment depends 90% on your motivation. You play a pivotal role in our practice. Any Orthodontic patient comes to show us after listening to your first concerns about his medical condition. So your concern matters more to him than ours. So Dear Doctors we look forward to a stronger association with you in future.

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