Our understanding of Orthodontics and its scope has refined over the years. Earlier, appointments for braces were only for teenagers with terribly spaced-out or crowded teeth. Now, however, the first ortho appointment is advised at the age of 6. Its also used to correct improper bite patterns called Malocclusions.
Myofunctional Appliances
What is it?Â
Myofunctional appliances are appliances that are given to guide the growth of the face to a favourable contour. It brings about bony as well as soft tissue changes.
It harnesses the natural forces of the muscles transmitted to the teeth and jaw using the external appliance, directing them favourably.Â
Who needs it?Â
- Pre-pubertal kids where growth issues are observed
- Kids with habits such as lip biting, mouth breathers, etc.
- Narrow jaws when detected before the prepubertal growth spurt.
- Kids with mild skeletal discrepancies The lower jaw is more prominent.
Braces
What is it?Â
Braces refer to the system consisting of the bracket (a tiny rectangular or square unit bonded to the tooth surface) and a wire that connects all the brackets.
Depending on the case, elastics and bands can also be integrated into the system.
Types: Â
The brackets of the braces system can be of different types:
- Metal: cheapest, not aesthetic
- Ceramic is more aesthetic than metal since the bracket will be tooth-coloured.
- Palatal/Lingual: most aesthetic since the brackets will be placed on the inner surface of the teeth.
- Self-ligating: they can be either metal or ceramic. The self-ligating ones are better as the treatment duration is reduced.
Clear Aligners
What is it? 
Aligners are transparent trays that are custom-made to fit the patient’s teeth to bring about tooth movement. They exert pressure at predetermined points to bring about tooth movement.
It is an alternative to braces that is more aesthetic and comfortable. It’s allowing us to treat patients who were otherwise living with malposed teeth but not seeking treatment because of resistance to braces and the “ugly Betty look.”
These new-age treatment methods have the following advantages:
- Very aesthetic, almost defying detection, and not unsightly like braces.
- Easier to brush and maintain as they are removable.
- Lesser appointments are better suited for our overseas patients and kids at boarding schools, as the entire set of aligners can be given together.
The catch: very high patient compliance. One must strictly wear it for 22 hours. The treatment time span is longer than with conventional braces.
ADJUNCTIVE ORTHO
What is it?
It is a type of tooth movement carried out to facilitate other dental procedures necessary to control disease, restore function, and enhance appearance. E.g., an adjunctive ortho procedure retrieving lost space inside the mouth to allow the placement of an implant or a prosthetic bridge. Â
Who needs it?
Individuals requiring a multidisciplinary approach to their treatment that may involve:
- Disease control
- Aligning teeth when they have moved unfavourably
- Replacing missing teeth
- Establishing a proper bite
- Individuals who did not replace missing teeth after removal caused them to drift.
REVISION ORTHO
Unfortunately, we do see quite a few cases where previously done ortho treatment has reversed mostly partially and sometimes entirely.Â
Who needs it?
This ‘relapse’ can be due to:
- Non-compliance with wearing retainers
- Breakage or loss of retainers
- Eruption of wisdom teeth
- Discontinuing ortho treatment before refining the bite.
Its so amazing he is back on the team – the #orthodontist – had to chew his brains for it:)Â
Dr Tushar Hegde, our consultant Orthodontist He has very
sound knowledge of the mechanics of tooth movement. He is very professional & sincere. Has a thorough understanding of different modalities from hidden braces (lingual braces) to the trending aligners. He was on the team for 6 years from 2004 till my sabbatical in 2007. We have a follow up of over a decade of his concluded cases. Kids and teenagers now come back with wedding invites !! Their smiles are intact, perfect AND cavity free. It is all because of his dedication to perfection and the patience for occlusal refinement. This forms the cornerstone for the long term stability negating relapse.
Apart from routine braces and aligners his rejoining us is allowing for
- Adjunctive ortho – part of a larger treatment plan
- Revision ortho – where the previously done treatment has relapsed causing problems
- Late orthodontics – orthodontics for people above 35. The correction of a bad bite that causes problems later in life. Regaining space lost due loosening of gumsÂ
We started with braces for my son, Josh, under his care. Thats testimony to my faith in his ability.