Definition and Overview

Orthodontics is a branch of dentistry that focuses on correcting improper positioning of teeth particularly if it causes problems including aesthetic issues or unsightly appearance and unbalanced facial structure or it makes proper dental hygiene and maintenance more challenging. Teeth that are crowded together, for example, are harder to clean, increasing the patient’s risk of developing cavities that can lead to tooth decay and gum disease.

Meanwhile, severe positioning issues can make it difficult for a patient to chew properly, necessitating more effort from the jaw muscles which increases the risk of developing temporomandibular joint disorder (TMJ).

Orthodontics addresses such problems by guiding teeth into better positions with the use of dental braces that patients must wear between 18 and 24 months depending on the severity of their condition.

Dental braces now come in many different types, such as fixed braces and removable ones. Although traditional braces are made of metal, advances in orthodontic technology allow patients to use simpler structures that can be easily clipped on to the affected teeth or more aesthetic options made of transparent plastic materials and dubbed as “invisible braces” or “aligners”. However, these alternatives tend to come with certain limitations, and most severe orthodontic problems still benefit the most from traditional fixed metal braces.

To make orthodontic treatment possible or more effective, dentists also use other devices and perform other procedures, such as:

  • Headgear – These are used to correct the positioning of the back teeth and worn when sleeping or for a few minutes each day.

  • Tooth extractions – In cases of overcrowded mouth, orthodontists perform extraction so the overall positioning of the teeth can be improved.

  • Retainers – Also referred to as “space maintainers”, these are plastic trays that are worn over the teeth after a successful orthodontic treatment with the goal of holding the newly aligned or positioned teeth in place during the healing process. Since teeth tend to continue changing position throughout a person’s life, many patients who have undergone orthodontic treatment are advised to wear retainers for life either at nighttime or for a few hours each day.

  • Dental x-raysDental x-rays are commonly used to diagnose and evaluate the extent of teeth positioning problems and play a key role in the planning stage of orthodontic treatments.

  • Palatal expander – This is used in cases where the arch of the upper jaw or the roof of the mouth needs to be widened.

  • Surgery – Used only in severe cases, surgery may be used to correct jaw problems that do not respond to all non-surgical treatments.

Dentists who specialise in the treatment of teeth positioning problems are called orthodontists. They are general dentists who hold a degree in dental medicine and received specialty training in orthodontics.

When Should You See an Orthodontist?

Patients should see an orthodontist if they have the following oral or dental problems:

  • Crooked teeth
  • Misaligned teeth
  • Spacing problems, or teeth that are crowded or have large gaps/spaces in between
  • Abnormal teeth arrangement
  • Overbite or buck teeth
  • Underbite
  • Crossbite
  • Open bite
  • Misplaced midline
  • Abnormal jaw development

An orthodontic treatment typically begins with a consultation during which the orthodontist will assess the patient’s teeth and discuss the potential benefits or improvements that can be expected from an orthodontic treatment as well as how they can be achieved. If the patient decides to move forward with the treatment, the dentist will then take x-rays of the patient’s entire mouth. The images acquired will then be used as the guide during the fitting process.

During the entire course of treatment, patients are strongly advised to wear their braces as instructed by the dentist. Using braces incorrectly will likely result in an unsuccessful treatment. They will also be asked to go back to the dentist’s clinic every three to six weeks to have their braces adjusted.

Additionally, they will be given instructions on how to keep their braces clean to prevent plaque accumulation and enamel and tooth decay, all of which can occur during the actual treatment process, i.e. when the patient is still wearing the braces.

Although a successful orthodontic treatment will make it easier to clean teeth, it does not guarantee against tooth decay, so it is still important for the patient to practice proper oral hygiene.


  • American Association of Orthodontists
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