W DENTISTRY
L
EMBRACE THE OPTIONS
BY RICHARD GIBSON
Richard Gibson, Principal of Wallasey Orthodontics and Consultant
to Liverpool University Dental Hospital talks to us about dentistry.
When it comes to maximising the potential of your natural teeth,
orthodontics wins – hands down! A non-destructive, conservative
approach to straightening your teeth, dazzling with your smile
or improving your bite is not only possible – but more accessible
than you think. After a thorough discussion and examination
with your orthodontist they will talk you through the options
available to manage your individual case.
Broadly speaking active orthodontic appliances fall into 3 categories;
removable, functional and fixed braces.
Removable braces encompass any appliance that the patient can
remove themselves during a course of treatment. As a child, simple
removable appliances made from acrylic (usually with metal clips)
can be used to make subtle changes to the position of teeth using
tipping movements. These appliances can be used for adults but
tend to be less well tolerate and severely limited in their action. In
the adult mainstream market, the largest provider of removable
appliances is Invisalign – who produce a sequence of aligners
(clear plastic gumshields) to facilitate tooth movements. Aligner
therapy has been incredibly well marketed and has its place in the
orthodontic arena. Originally, it was aimed at the general high street
dentist and again allowed tooth movements limited to tipping teeth
into a straighter position. More recently the theoretical side of the
process has started to catch up with the marketing hype, with the
development of attachments (small tooth coloured blobs) stuck to
the tooth surface to give greater scope to elicit more substantial
changes. Regardless of the intention, aligners are worn for 2-3
weeks before moving onto the next in the series – treatment time
is dictated by the complexity of the movements and of course how
often you remember to put the aligners in! Although removable
– they are intended for nearly full-time wear (23 out of 24 hours a
day).
64 wirrallife.com
Functional appliances are largely restricted to growing patients
(adolescents) and are intended to guide the development of the
teeth and jaws by posturing the patient into a new bite. Research
has proven their impact to be largely on the teeth (70%) but some
skeletal changes are seen (30%) and can offer some impact on the
profile of a patient. These braces are largely removable but do come
in different shaped and sizes. Fixed versions are available and can
have a positive effect in young adults as well.
Finally, the biggest sector of appliances are fixed braces. Fixed braces
offer a specialist the opportunity to have full control over both the
crown and root of the teeth and therefore don’t limit the treatment
outcomes or the aspirations of the patient. 3D control affords the
ability to leave the teeth in the most stable long-term position. Fixed
braces are made up of 3 parts; the bracket, the wire and the ligature
(the item that holds the wire into the bracket). The brackets can be
placed on the front of the teeth or hidden around the back – both
offering the same level of control. When on the labial surface (front
of the teeth) a silver bracket affords high efficiency and reliability but
lacks the aesthetic merits of a tooth coloured ceramic (porcelain)
bracket. On the lingual surface (back of the tooth) a custom made
gold bracket is preferential due to the varied anatomy on the back of
the teeth and therefore hidden out of sight.
It’s fair to say that not all the above appliances are appropriate for
everyone but discussing the available options with a specialist
orthodontist will ensure you receive the most suitable solution.
With 0% interest and affordable payment plans – the smile you’ve
always wanted has never been so close.
Contact us for a complementary smile check with our qualified
orthodontic therapist or book in for a full consultation to embrace
your smile. www.wallaseyorthodontics.co.uk