Stages of perfect Orthodontic treatment

Orthodontics is the branch of dentistry that deals with the treatment of growth disorders of the jaw bones, defects in development of the dentition and the correction of the position of the teeth; more generally, it can be stated that orthodontics deals with the improvement of functions related to the stomatognathic apparatus: chewing, speech, swallowing and breathing, as well as aesthetic ones. –

Orthodontic treatment consists of several stages. Awareness and understanding of all subsequent steps is very important for a comfortable and stress-free treatment.

STEP 1 — Planning your treatment

Precise planning of orthodontic treatment is key to achieving the best results. Your orthodontist must verify all contraindications for treatment examine the position of the teeth and choose the best type of orthodontic appliance. Your teeth must also be healthy and free of tartar. Before correcting malocclusion, it is necessary to cure diseases such as caries or periodontitis. Before putting the device on or starting using Invisalign overlays, full oral hygiene is also provided.

The basis for planning orthodontic treatment is consultation combined with precise diagnostics. The orthodontist will talk to you about your problems, needs and expectations and will carry out the necessary examinations, including two X-ray images (pantomographic and cephalometric) that will allow the occlusion assessment and selection of the best treatment method. You can take all the necessary photos directly during your visit to your family orthodontics clinic.

The treatment plan shows exactly what activities will be performed over the next several months. For the orthodontist, this is a very important task, because he/she must think carefully about the order of individual stages of treatment that will ensure optimal results one by one. When creating a treatment plan, your family orthodontist also decides whether to remove teeth, which may be necessary in the event of disproportion between the dental arches. Teeth removal can often be avoided, so the experience of your orthodontist is crucial.

Thanks to the use of specialized computer software, this can perform a project of orthodontic treatment much faster and much more accurately. Dental experts use digital treatment planning for the Insignia system and Invisalign technology now a day. These types of devices are made in the laboratory individually, for the needs of a particular patient. As a result, they are perfectly matched to the patient’s teeth and designed to achieve the perfect smile in the optimal time. In addition, thanks to digital smile design technology, you can see the visualization of your future smile during one of your first visits.

The panoramic image (above) is used not only in orthodontics, but also in other areas of dentistry. It shows all teeth at once, including those that are invisible in the mouth (e.g. retained teeth), as well as bone tissue surrounding the teeth.

In turn, the cephalometric image (above) shows the profile of the face and skull. In addition to teeth and bones of the maxilla and mandible, soft tissues such as lips, nose and cheeks are also visible.

Taking these photos while wearing the braces also allows for ongoing assessment of treatment progress. For the doctor it is also a tool for possible verification of previously made decisions, and for you a great opportunity to compare how your teeth are moving. In the case of digitally planned treatment, you can also check whether the treatment is proceeding as planned by applying current graphics of the occlusion to the computer project in the graphics program. The treatment planned in this way guarantees maximum predictable results.

The treatment plan contains information such as: type of malocclusion, suggested orthodontic appliance and course of individual stages of treatment. The plan prepared in this way will tell you how long the treatment will last and how much it will cost you. Experts focus on simple and transparent rules, which is why the treatment plan includes not only the price of setting up the orthodontic appliance, but also the cost of all follow-up visits, pictures of the apparatus and the price of the retention apparatus (necessary after treatment).

If the treatment plan provides for the removal of one or more teeth or for insertion of the retained tooth into the dental arch — before starting treatment, you will need to see a dental surgeon. The surgeon will comprehensively perform all necessary procedures.

STEP 2 — Putting on the device

After the diagnostics, you and the orthodontist will make a decision about choosing the best orthodontic appliance for you. Dental doctor offer a variety of treatment systems: traditional, self-ligating (e.g. Damon) or overlay (e.g. Invisalign). These devices differ in the length of treatment, interval between follow-up visits, wearing comfort, visibility on teeth and price. Thanks to this, every patient can find a solution that meets their expectations.

You can also decide if you want your permanent fixture to be metal or cosmetic . The brackets of cosmetic braces are made of white material (composite and porcelain braces) or transparent (crystal braces), which makes them discreet and hardly visible when applied to the teeth. It is also possible to make a combined camera — in this case, cosmetic brackets are only glued to the teeth visible during a smile (most often they are upper teeth from three to three), and the other teeth are glued to metal brackets. This is the optimal solution that allows you to reduce costs and at the same time maintain aesthetics while wearing the camera. The process of sticking on the camera takes about an hour and is painless. At this stage patients with full oral hygiene instructions while wearing the fixed braces, as well as diet recommendations is highly recommended.

An alternative to traditional fixed cameras are the modern Invisalign overlays. They require individual preparation in a US laboratory. After receiving the ready camera, your orthodontist will place the first overlay on your teeth, and then check its performance and fit. Then he will give you full instructions on how to use the overlay camera with specific guidelines, including how many hours a day you should wear the device on your teeth, how often should you replace the caps, etc.

STEP 3 — Control visits

If you take treatment with a traditional fixed appliance, visits will take place every 4–6 weeks. In the case of self-ligating braces less frequently — on average once every two months . During the check your orthodontist will replace the arches and ligatures of the apparatus.

If during your treatment you need to go abroad for a longer time or if you get another treatment, you can extend the time between check-ups. Remember, however, to let your orthodontist know about it during the previous visit. Thanks to this, it will modify your treatment plan accordingly, enabling a break between visits and making sure that the treatment is going well.

If you choose Invisalign, your visits to the dental office will be aimed at ongoing monitoring of the progress of orthodontic treatment and providing you with subsequent sets of overlays. Your task will be to systematically wear overlays and replace the set with another one according to your orthodontist’s instructions. Control visits for Invisalign aligners take place every 10–15 weeks.

STEP 4 — Photo of the camera

At the moment of obtaining the planned effect, i.e. regaining correct occlusal contacts and the desired teeth positioning, the orthodontist will inform you that the orthodontic appliance can be removed. The visit during which the doctor pulls the fixed device takes only a few minutes. It consists in removing orthodontic brackets from the teeth. This operation is completely safe for teeth. A good practice after removing the permanent orthodontic appliance is to perform a thorough dental review, analyzing the condition of the individual teeth on which the brace was attached. It is also recommended to carry out preventive treatments such as scaling, sandblasting or varnishing.

If you wear an Invisalign overlay camera, step four will simply be to stop wearing the camera. Remember, however, that only your orthodontist can make this decision, so that the treatment proves effective and brings lasting results.

STEP 5 — Persisting effects — retention

This stage is often neglected by patients, but from the orthodontist’s point of view, it is the most important and practically the longest orthodontic treatment process. This is because upright teeth have a tendency to “come back” after removing the camera . Left alone, they will not move exactly to the initial state, but they can again move into an unexpected and unfavorable arrangement. For this reason, it is necessary to consolidate the achieved effects of orthodontic treatment through retention.

Retention, like orthodontic appliances themselves, can be fixed or mobile. In the case of permanent retention you will receive a retainer, i.e. a metal wire glued from the inside of the teeth (from the tongue side). The main advantage of the retainer is its invisibility and no need to remove / replace (it is a permanently attached solution). An important disadvantage of this solution is the difficult hygiene of this part of the mouth and an increased tendency for tartar to build up.

In the case of mobile retention, you will receive a retention plate that looks like a mobile device. However, the purpose of the plate is not to move the teeth, but to keep them in the position reached after treatment. Undoubtedly, the retention plate has one key advantage — thanks to the fact that it can be removed (e.g. before a meal) — it enables easier and more effective oral hygiene (it is easier to brush and floss your teeth). The retention plate also has a slight drawback, which is the discomfort associated with their size and visibility when smiling.

In addition to the retention plate, the second example of movable retention is the positioner, which looks like teeth whitening pads or a relaxation splint. It is a transparent cover, made and adjusted individually to your teeth. By analyzing the pros and cons, the positioner has them exactly the same as the retention plate. The only difference (in favor of the positioner) is your comfort, obtained thanks to the shape and size of the positioner, because it does not have a palatal or sublingual part.

The retention period depends on many aspects: your age, the initial state of your teeth, the radicality of tooth displacement, and the stability of the effect obtained. To put it simply — the older you are, the greater the changes in your treatment, the longer the retention should be.

Regardless of the type of orthodontic appliance you wear, it is assumed that the retention stage should be at least twice as long as the orthodontic treatment itself. For suppose your treatments will last 18 months, then the effect consolidation period should be 36 months. Over time, you’ll get used to retention, which will make it less onerous.

In the case of movable retention, immediately after treatment, it will be recommended to wear the plate or positioner around the clock, removing only during meals and brushing your teeth. Over time, after a few months, you can limit the time you wear the plate and positioner to a few hours a day and sleep at night. After all, you can only put them on at night and at the end of the retention not even every night.

If you wear a retainer, permanently attached, there will be no problems remembering to put on and pull off, or changing time periods as the retention progresses. The period of adaptation to permanent retainers is also relatively short.

Regardless of the type of retention, it also requires follow-up visits to your family orthodontist. However, they will not be as frequent as in the case of the orthodontic apparatus alone — usually meetings every few months are sufficient.