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By Mayo Clinic staffIf your primary care dentist notices problems with your teeth or jaws that may require treatment, he or she will likely refer you to an orthodontist — a dentist who specializes in diagnosing, preventing and treating dental and facial irregularities.
Most alignment problems become apparent once the permanent teeth begin to erupt. But your orthodontist may recommend waiting until enough teeth have come through before applying braces. Most children get braces between the ages of 8 and 14, while their facial bones are still growing and their teeth are more susceptible to movement.
Preparation for braces generally involves:
- Physical examination. Your orthodontist conducts a full examination of your teeth, jaws and mouth.
- X-rays. Your orthodontist, your dentist, or a dental assistant takes a series of X-rays to determine the position of teeth. The most common is the panoramic X-ray, which shows all the upper and lower teeth in biting position, and any teeth still developing within the jaws. Special head X-rays may also help determine the size, position and relationship of jaws to teeth.
- Plaster models. Your orthodontist typically obtains plaster models of your teeth to evaluate your bite. To do this, your orthodontist or hygienist makes an impression of your teeth using a soft material. This process takes only a few minutes to complete. From this impression, the orthodontist can create a plaster model of your teeth (dental cast). In some cases, this dental cast may be scanned into a digital format for further evaluation or treatment decisions.
- Potential tooth extraction. If the mouth is very overcrowded, your orthodontist may recommend removing one or more permanent teeth to allow room for the remaining teeth to fit comfortably. In severe cases, jaw surgery is required in combination with orthodontics to correct a malaligned bite.
After your orthodontist has evaluated your teeth and jaws, he or she customizes a treatment plan for you. This most often involves the use of fixed braces, which are temporarily bonded to your teeth and can't be taken out.
- Why do people get braces? Academy of General Dentistry. http://www.knowyourteeth.com/print/printpreview.asp?content=article&abc=w&iid=322&aid=1304. Accessed June 11, 2010.
- Braces and retainers. Cleveland Clinic. http://my.clevelandclinic.org/devices/dental_care/hic_braces_and_retainers.aspx. Accessed July 27, 2010.
- Today's orthodontic treatment. American Association of Orthodontists. http://www.braces.org/learn/Straight-teeth-are-healthy-teeth.cfm. Accessed June 11, 2010.
- Barbara Woodward Lips Patient Education Center. Orthodontic instructions. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2010.
- Harrison JE, et al. Orthodontic treatment for prominent upper front teeth in children (Review). Cochrane Database of Systematic Reviews. 2007:CD003452.
- Braces and orthodontics. American Dental Association. http://www.ada.org/2598.aspx. Accessed June 9, 2010.
- What is malocclusion? American Academy of Pediatric Dentistry. http://www.aapd.org/publications/brochures/maloccl.asp. Accessed June 10, 2010.
- Littlewood SJ, et al. Retention procedures for stabilising tooth position after treatment with orthodontic braces (Review). Cochrane Database of Systematic Reviews. 2006:CD002283.
- Heasman P. Master Dentistry, Volume Two: Restorative Dentistry, Paediatric Dentistry and Orthodontics. 2nd ed. Philadelphia, Pa.: Elsevier Limited; 2008:283.
- Carr AB (expert opinion). Mayo Clinic, Rochester, Minn. July 26, 2010.
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