Orthodontic treatment – Dr. Nadya Delcheva

ORTHODONTIC TREATMENTS

Orthodontic treatment is generally divided into two main stages:

First Stage – Active Orthodontic Treatment

This is the period when patients wear orthodontic appliances, whether braces or aligners.

I recommend that the first orthodontic examination be done at around the age of 6. At this age, we can assess whether the child needs treatment, when to start, and which devices would be most appropriate.

Prevention in Orthodontics

Early consultation (around 6 years old) with an orthodontist can potentially prevent the need for future orthodontic treatment. Preventive procedures might include correcting the position of certain teeth, addressing harmful habits, extracting a baby tooth to allow the permanent tooth to erupt properly, placing orthodontic space maintainers, and more.

The second orthodontic consultation is typically recommended around the age of 9, when the canine teeth begin to erupt. This is one of the most common causes of dental issues. Since children are at a peak growth phase, treatment with lighter appliances over a shorter period can often yield maximum results.

If orthodontic treatment begins during the child’s growth phase, the development of the jaws can be guided in a favorable direction using orthodontic appliances. Growth continues to be part of the treatment until it ceases (around ages 16-17). The best time to start treatment is when the patient or parent decides they want to achieve a beautiful and well-aligned smile and are committed to maintaining it.

Types of Orthodontic Appliances

1. "Removable" Appliances

These are appliances that the patient can remove from the mouth, such as when eating or playing sports. There are various types, but the most common are plates (also known as splints). These are often used in cases of primary or mixed dentition.

2. Invisalign and Clear Aligner Systems

These systems involve custom-made, clear aligners that fit over the teeth and are worn consistently. They must be removed when eating or drinking and during oral hygiene routines. This method is generally suitable for mild orthodontic corrections and is preferred by patients who do not want to wear braces.

3. "Fixed" Appliances (Braces)

These appliances consist of small brackets that are attached to the teeth and connected by an orthodontic archwire. The appliance applies continuous pressure to move the teeth into their desired position. Braces are permanently fixed and cannot be removed by the patient.

Braces can be attached to both the outer surface of the teeth (the most common method due to the faster and more comfortable results) or on the inner (lingual) side. Lingual braces are completely invisible but can cause more discomfort and are more difficult to clean.

The material used for braces can vary:

Metal Braces: Fast and effective, but more noticeable.
Aesthetic Braces: Made of ceramic or sapphire, providing a more discreet look but at a higher cost.

4. Duration of Treatment

There is no set timeframe for orthodontic treatment as it depends on the individual characteristics of each patient. Typically, braces treatment lasts around 1.5 to 2 years.

During treatment, patients must visit their orthodontist every 4, 6, or 8 weeks for adjustments and activation of the braces. Missing appointments can extend and complicate the treatment process.

Second Stage – Retention Phase

This stage is just as important as the active treatment phase. After the braces are removed, special retention devices (retainers) must be worn to maintain the results achieved. These retainers help hold the teeth in place while the surrounding tissues stabilize.

Patient's Role in the Treatment

To ensure the success of orthodontic treatment, patients must:

Follow all instructions from their orthodontist.
Wear their orthodontic appliances for the prescribed amount of time.
Take care of their appliances.
Maintain excellent oral hygiene.
Avoid missing scheduled appointments.

Neglecting these responsibilities can compromise treatment goals and prolong the treatment process.

Important Notes: Wearing braces requires strict oral hygiene. Braces can correct bite issues at any age, as long as the patient has good periodontal health. Before starting orthodontic treatment, all teeth must be healthy. Braces can still be fitted if the patient has crowns, bridges, implants, missing teeth, or severely loose teeth.

Consultation
We recommend consulting with an orthodontist before undergoing any complex or expensive dental treatments. Correctly aligned teeth and a proper bite can enhance the beauty and stability of dental work. In some cases, orthodontic treatment can reduce or eliminate the need for bridges or implants.