SMILE, only a few are blessed with a perfect and beautiful smile naturally. But orthodontic treatment can make a huge impact if one doesn’t have a perfect smile or aesthetic face. The orthodontic treatments and the braces help to correct crooked teeth, misaligned teeth, incorrect smiles, and improve facial aesthetics.

What are braces?

To correct the orthodontic issue, braces are used for children and adults both. Braces¹ are orthodontic appliances which are fixed onto teeth and can be removed by orthodontists only. Also known as dental braces, teeth braces, and orthodontic braces. Braces are used to correct malalignment, bite issues such as underbite, overbite, overjet, crowding of teeth, tipped or rotated teeth, to close the space between two teeth (diastema), and smile correction.

Few teeth alignment problems in children

Understanding these misalignments is very important for oral health.

Bad bite 

Also known as teeth crowding, misalignment, malocclusion or irregular teeth.

Malocclusion

• Edward Angle², the father of modern orthodontics has defined malocclusion as misalignment or incorrect relation between teeth of upper and lower dental arches when they approach each other as the jaw closes
• Angle’s classification is based on one anatomical point, that is maxillary (upper) first molar and classified malocclusion into three major types
• Angle’s class I: there is a normal molar relationship seen. The mesiobuccal cusp³ of the maxillary first molar occludes in the buccal groove of the mandibular first molar⁴
• Angle's class II: it is characterized by the distobuccal cusp of the upper first molar occludes in the buccal groove of the lower first molar
• Angle's class III: the mesiobuccal cusp of maxillary first molar occludes in the interdental space between the mandibular first and second molar

Deep bite⁵

• It is the most common type of malocclusion and is very difficult to treat
• It is a vertical misalignment of teeth. Also called an overbite
• However it is normal in some people which is necessary for functioning, but if the vertical overlapping is excess it leads to deep bite
• In deep bite, the lower anterior teeth (mandibular) are completely covered by upper anterior teeth (maxillary)
• Normal overbite is 2-4mm, if it exceeds this range then it is a deep bite or overbite

Cause of deep bite:

• It may be due to tongue thrusting which pushes the upper anterior teeth more than what is needed
• Thumb sucking for a longer period
• Mouth breathing
• Another term which is frequently used with overbite is overjet. Overjet is horizontal misalignment or horizontal overlapping of upper and lower anterior teeth

Mandibular prognathism

• Also called an underbite⁶
• The word itself explains the protrusion of the lower jaw beyond the upper teeth

It may be due to:

• Thumb sucking habit
• Prolonged bottle feeding
• Nail biting

Underbite⁷ may pose problems like:

• Difficulty is speaking
• Difficulty in mastication
• Pain in the face region due to malocclusion

Crossbite

• It is a type of misalignment which is seen in the transverse plane⁸
• It is a condition in which a tooth is abnormally placed buccally, lingually or labially concerning the opposing tooth
• Crossbite affects a single tooth or more than one tooth. It is most common in anterior teeth

What are the different types of braces available?⁹

Traditional metal braces

• Metal braces are the traditional braces used for over 100 years from now
• These are the most popular and widely used braces
• Metal braces consist of stainless steel, brackets and wires
• The brackets and wires are attached to the teeth with the help of bands
• These elastic bands come in different colours, so one can customize their braces according to their favourite colour and enjoy the treatment

Clear braces

• These are also known as ceramic braces¹⁰ or tooth-coloured braces
• They are made up of ceramic materials (polycrystalline alumina) which is similar to the colour of teeth
• They are less visible and are predominantly used by adults due to its tooth-coloured material to avoid social embarrassment
• They are more aesthetic than metal braces, hence preferred by teens
• Their function is similar to metal braces but ceramic braces get stained easily because of its lighter-coloured brackets

Internal braces

• Internal braces, invisible braces, hidden braces or lingual braces¹¹
• These braces are best for image-conscious people
• Their function is similar to metal braces
• Lingual braces are placed lingually (behind the teeth)
• People with lingual braces face problems like lisping of words, tongue injury

Clear aligners

• Clear aligners¹² are plastic braces used to treat minor dental problems
• These are the latest innovations in the field of orthodontics

Perks of braces for children

Initially, every individual will feel discomfort due to the braces but as one gets accustomed to it there are many advantages.¹³

• Correction of misaligned teeth and bites: this one is basic and everyone knows about it. By using braces at an early stage one can straighten their teeth and misaligned bites
• Boosting self-confidence: crooked teeth or irregular teeth make one feel more conscious about their smile. Hence with the help of braces, children can get it corrected and smile or talk without hesitation
• Prevention of tooth decay: misaligned teeth cause decaying of teeth due to improper oral hygiene maintenance, a few parts of the teeth couldn’t be cleaned. Braces treatment can help to prevent tooth decay by aligning them in the proper position
• Improved speech: with a gap in teeth, children face problems while spelling a few words and making particular sounds. The gap between the teeth makes a whistling noise
• With proper alignment of teeth, speech difficulties are overcome.

Things to take into account before getting braces

Age 

There is no fixed age for getting braces because we can see adults getting braces for minor alignments. But if we consider children, the age range is between 10- 14 years. At this age, children start to get permanent teeth. There is no point in aligning baby teeth or temporary teeth.¹⁴

Duration of the treatment

Duration varies from case to case. For minor problems like spacing, it takes 6-8 months. For children, who have misaligned teeth, bite correction, the duration will be 18-24 months.¹⁵

Types of braces

Different types of braces are available as we have read above. Metal braces are the traditional ones used for children. With advanced technology and innovation, nowadays metal braces are made of small sizes.

Process of getting braces¹⁶

1. At first, the orthodontists advised to take a few x-rays of the teeth, jaw and face for a treatment plan
2. Before starting the treatment, it is advised to get complete oral prophylaxis (cleaning)
3. During the treatment, the teeth are etched for bonding purposes and then the brackets are attached to the teeth with the help of gums
4. Follow-up is done after 4 weeks and appointments are given every 4-8 weeks where orthodontists can check the alignment process
5. After the complete procedure is done, braces are removed and permanent retainers are given.
6. Retainers¹⁷ are given to control the relapsing of teeth
7. Oral hygiene tips – when the braces are on, specialized brushes are given to clean the teeth
8. During the treatment, it is advised to consume more liquid food as sticky or starchy food gets adhered to tooth surfaces and braces making it difficult to clean. Thus, oral health is compromised

Summary

Braces are the orthodontic devices used to treat misaligned teeth, bites, crooked teeth, spacing of teeth and correction of smile.

These braces are made up of different materials and are of different types. There are metal braces, ceramic braces, lingual braces, and clear braces. There is no fixed age to get braces. After the complete treatment, one gets their smile corrected, properly aligned teeth, space between teeth is closed. With all these changes, there is a boost in self-confidence of the patient after treatment.