Crooked teeth are straightened by the use of special devices and techniques [orthodontics]. An orthodontist is a dentist who has been specially trained to use a selection of braces (orthodontic appliances), both fixed and removable, to improve the appearance and health of the teeth and gums.
In general, orthodontic treatment is undertaken for two different groups: children, typically aged between 12 and 14 years old, or adults. The specific timing of treatment will, however, vary from patient to patient. A dentist is the first person to speak to. Based on the concerns, a decision will be made, if appropriate, to refer to an orthodontist.
The orthodontist will need to know what particular concerns there are about the teeth. He or she will undertake a detailed examination and possibly take x-rays and photographs of the face and teeth. Before deciding on the best course of treatment, the orthodontist will also take moulds of the teeth. The orthodontist will then explain the preferred course of treatment to obtain the best results. Options will be discussed as well as any potential problems and/or limitations with the proposed treatment.
The orthodontist may ask the dentist to remove one or more of either:
- Baby teeth – Occasionally baby teeth stay in the mouth for longer than they should and delay the adult teeth coming through. In these cases, their removal will significantly help.
- Adult (permanent) teeth – Many people have too many teeth for the size of their jaws and so the removal of some of the adult teeth may be needed to make space to straighten the crooked ones. The decision to remove teeth is never taken lightly and is based on careful consideration of the position of the teeth and how they bite together. If the teeth are not too crooked, it may be possible to have treatment without having any removed.
The following factors could delay the start of treatment:
The number of adult teeth in the mouth
Orthodontic treatment that involves the use of fixed braces usually starts when all the adult teeth have appeared in the mouth. However, a removable brace can be fitted at an earlier age if it is necessary.
The general condition of the teeth and gums
If there is dental decay or gum disease, orthodontic treatment will need to be delayed until it is treated. If it is not, there is a real risk of both the decay and the gum disease getting worse when a brace is fitted.