ORTHODONTICS (Braces Applications)

Orthodontics; It is a dental branch that deals with the correction of tooth perversions with the lower and upper jaws. Since it is more difficult to clean perplexed and poorly positioned teeth, there is a risk that the teeth will be lost early due to periodontal ( gum ) disease and tooth decay. It also causes more pressure on the jaw muscles; They can cause temporomandibular joint disorders and thus headache, back, and pain in the shoulder.
Crooked teeth also affect your appearance. With orthodontic treatment, you can have a healthier mouth, a more impressive appearance and teeth that will stay in your mouth for a longer time.

Do I Need Orthodontic Treatment? Only a dentist or orthodontist can determine your need for orthodontic treatment. After an examination that includes many diagnostic methods such as your comprehensive medical and dental resume, oral and dental examination, creation of jaw models and taking some special x-rays and photos, it can be determined whether you need orthodontic treatment and the type of treatment to be performed.

Situations Where You Need Orthodontic Treatment;
• OVERBITE, the upper front teeth are positioned far in front of the lower front teeth,
• UNDERBITE the lower front teeth are located in front of the upper front teeth, or the upper teeth are located further back than the lower teeth,
• CROSSBITE : the lower and upper front teeth close on top of each other,
• OPENBITE : the midline of your upper front teeth does not coincide with the midline of your lower front teeth,
• GAPS : having gaps between the teeth due to Decussation or naturally,
• PERPLEXITY : there is not enough space in the jaws for the arrangement of teeth.

How is Orthodontic Treatment Performed? Treatment to move the teeth or affect the growth of muscles or jaws can be fixed or mobile. These treatments are done by applying very light forces to the teeth or jaws. The type of treatment is determined according to the severity of your problem.

Fixed applications consist of the following;
• Bracket Fitting: Bracket installation, which is the most widely used method, is performed using wires, brackets and tires. Brackets are glued on the teeth, wires are passed through the brackets and force is applied to the teeth. Thus, the teeth are gradually moved to ensure their proper positioning. The treatment may take a few months or a few years, and adjustments are made every month to ensure that the correction of the teeth is the desired way. The brackets used today are lighter and contain less metal. It is produced transparently for adults in various commercials in order to motivate children.
• Special Fixed Applications: These devices, which are made to pass the finger sucking habit, are attached to the tooth with tapes. Since they are not very comfortable during feeding, it is recommended to use them as the last option.
• Fixed Placeholders: In cases where milk teeth are lost prematurely, other teeth are prevented from sliding into the cavity until the permanent tooth comes out by using a placeholder.
• Aligners: It is preferred by many orthodontists because there are no brackets and wires to align the teeth as an alternative to the fixed treatment performed by installing brackets for adults. Aligners are usually transparent and are removed for eating, brushing and flossing only.
• Movable Placeholders: They perform the same function as fixed placeholders. It consists of an acrylic base that sits on top of the jaw and fills the space between plastic or braces and certain teeth.
• Enhanced Appliances to Reposition the Jaw: These devices, called splints, are placed on the lower jaw or upper jaw and help close the jaw in a better position. They are also used to correct (temporomandibular joint) disorders.
• Lip and Cheek Bumper: A device that pushes the teeth back and prevents the lip and cheek from getting between the teeth. Lip and cheek muscles can exert force on the teeth and bumpers cut this force.
• Jaw Expander: It is a device that allows the upper jaw to expand. It is made of a plastic material that fits on the palate. Thanks to the force applied with screws, the bone under the palate opens by moving.
• Movable Reinforcers: A passive device used to protect the location of the teeth after the end of treatment and prevent them from returning to their former state. It can also be used to leave the finger sucking habit by slightly modifying it.
• Headgear: It is a device that is connected to the front of the head with tape and a metal wire placed on the back of the head. Headgear slows down the development of the upper jaw and keeps the back teeth where they are, while allowing the front teeth to go to the back. [ref:colgate]

WHY DO ORTHODONTIC PROBLEMS OCCUR and HOW ARE THEY TREATED?

Disorders involving the jaws (such as the lower jaw being in front or behind) are usually hereditary. In this case, the method of treatment is decided according to the age of the patient. If the patient is in adolescence and his lower jaw or upper jaw is behind, he can be treated with orthodontic methods. If the patient is an adult, severe skeletal disorders are treated with orthodontic-surgical cooperation. Depending on dysfunctions (such as mouth breathing), jaw incompatibilities may occur. In a patient who breathes mouth, the upper jaw is usually V-shaped because it remains narrow.
Habits such as using a pacifier or bottle for a long time, thumb sucking, nail biting, etc. can cause orthodontic disorders. Habits should be treated as early as possible (ages 7-10). Thus, the skeletal disorder that will be adversely affected by the use of a simple appliance is prevented. If habits are recognized at an early age, they can be prevented with some habit-breaking appliances. Skeletal stenosis in the upper jaw can be treated with the help of orthodontic appliances. Sometimes the individual inherits the size of the jawbone from one of the parents and the size of the teeth from the other. If the jaw is large and the tooth is small, the teeth are spaced. The fact that the tongue is larger than normal and there are tooth cavities in the mouth also cause the teeth to be spaced. If the jawbone is small and the teeth are large, the teeth cannot fit into the jaw and crowding occurs. Another cause of crooked teeth is early or late deciduous tooth loss. Every milk tooth has a falling out time. For example, if a milk tooth that should fall out at the age of 10 falls out at the age of 8, the permanent teeth in the mouth will slide into this space and the tooth that needs to come out cannot find a place for itself. In this case, this tooth develops outside or inside the dental arch, or in some cases remains impacted.

Can orthodontic treatment be done at any age?
There is absolutely no age limit in orthodontic treatment. However, treatment planning and duration may vary according to age. In recent years, adult orthodontics has become widespread all over the world. It is possible to minimize aesthetic concerns, especially by using porcelain brackets. Sometimes, orthodontic treatment can be performed in order to prepare for the prosthesis in order to make better prostheses, and the teeth can be made more suitable for the prosthesis. Such treatments are short-lived, orthodontic treatment ends in 4-12 months.

Is orthodontic treatment a painful procedure?
The practice session and Deconfliction sessions are absolutely painless and simple. However, wounds may occur on the cheeks when the wires are first attached. These wounds go away on their own within 1 week and usually do not occur again. In rare cases (bracket breakage, wire breakage, etc.) wounds may occur again. Such problems can be solved with a small intervention of the physician. In addition, patients are given a "patient candle" for the first session, and the patient can prevent excessive irritation that may occur during the time until the doctor comes by placing this candle in the area where the wire hurts. In addition, after the braces are first inserted and after the intermediate sessions, when the teeth are clenched and hard things are eaten, pain occurs in the teeth. However, this pain goes away on its own within 3-4 days.

Do braces rot teeth?
Wires do not rot the teeth at all. On the contrary, the areas where the brackets are attached are protected from caries as bacteria cannot enter under them. However, the risk of decay is greater than with a wireless mouth, as the brackets hold more bacteria around them. This risk disappears when oral care is good and the braces are thoroughly cleaned.

Can teeth be brushed with braces?
After the braces are attached, the teeth can be easily brushed as before. There is no risk of breaking or coming out while brushing. However, since a more separate cleaning is required, a little more careful and detailed brushing is required. For this purpose, specially designed orthodontic brushes and interface brushes can be used.

What should be considered after the wires are attached?
Hard foods that may cause the wires to break should be avoided. Hard things such as apples and pears should be eaten by cutting, not by biting and plucking. Especially core foods such as plums and olives should not be thrown into the mouth with the core, they should be eaten after the core is separated outside. Acidic drinks should not be drunk. Sticky things such as chewing gum, Turkish delight should be avoided.

What is the duration of orthodontic treatment?
The duration of orthodontic treatment depends on the patient's age, the severity of the problem and the treatment technique to be performed. However, patient compliance is the most important factor in the duration of treatment. If the patient comes to appointments regularly, if the oral care is good, if the brackets and wires do not break frequently, the provided apparatus, tire, etc. if used properly, the treatment is completed in a minimum time. If the planning has been done well and the patient is compatible, the duration of treatment should not exceed 2.5 years, even in the most severe cases. The average duration of treatment is 1.5 years. On the other hand, there are also treatments that end within 1 year.

Do teeth that are fixed with orthodontic treatment deteriorate again?
Our teeth are active for a lifetime. Especially under the influence of chewing forces, even people who have never undergone orthodontic treatment may experience confusion of the teeth at an advanced age. After orthodontic treatment, it takes a long time for the teeth to get used to their new positions and for a good bone support to form around them. Therefore, after the wires are removed, reinforcement should be performed to eliminate the risk of deterioration again. For this purpose, thin wires can be glued to the back of the teeth, or transparent plaques that can be inserted and removed can be given to the patient.[ref:ProfDr.AhuAcar]

THE SUCCESS OF ORTHODONTIC TREATMENT DEPENDS ON THE CONSOLIDATION PHASE

During orthodontic treatment, the bone and gum are reshaped together with the biological activity in the tissue surrounding the tooth. During this reshaping, the teeth can also be placed in a more aesthetic and healthy position in the mouth by an orthodontist. This biological activity and remodeling, which enables orthodontic tooth movement, can now be accelerated thanks to the current developments in orthodontic science and technology. The tooth movement that occurs during treatment can be accelerated mainly by micro vibration or laser energy applications without surgery or by minor surgical methods.
Micro vibrations or light energy are used to increase the biological activity in the tissue surrounding the roots of the teeth in order to accelerate the movement of the teeth by non-surgical methods. In the treatment, charged devices approved by the FDA (American Food and Drug Administration) that give micro-vibration to the teeth are used. This device should be used by the patient for 20 minutes a day. Of course, before the details about the use of the device are transferred to the patient by a specialist physician. Thanks to these devices, which can also be connected to a computer, the orthodontist can also track the patient's daily usage during the Dec checkups of the treatment. Scientific studies show that when this form of treatment is applied regularly, the duration of treatment can be shortened by 30 percent. It can be accepted that this method is a face-making improvement for adult patients and people who have dental braces problems in their work and social life. Thus, patients can achieve improvement in their teeth in a shorter period of time.

The patient relaxes with the laser
In another non-surgical method, low-dose laser energy is applied to the tissues around the teeth by the orthodontist at regular intervals. When the applied laser energy is absorbed by the tissue, biological activity and tooth movement can be accelerated. Both methods accelerate tooth movement on the one hand and provide more comfortable toleration of the feeling of squeezing caused by the force applied to move the teeth on the other hand.

Treatment in a short time with "Piezocision"
Stating that one of the most frequently applied methods to accelerate tooth movement is "Piezocision" that is, surgical orthodontics, Bezmialem Vakıf University Dean of Faculty of Dentistry and Faculty Member of the Orthodontics Department Prof. Dr. Serdar Üşümez said, “In this application, small incisions are made between the patient's tooth roots with a special device. These incisions accelerate the remodeling of the bones surrounding the roots, increasing the speed of tooth movement. This allows the treatment time to be shortened. In the piezocision application, some gingival or bone defects can be healed by grafting (tissue transplantation) to the patient.”

Does not Affect Social Life
In another minor surgical method similar to the piezocision application, small perforations (holes) are created between the patient's tooth roots with a special device. Both applications are performed under local anesthesia and the patient does not feel anything. In these applications, because minimal changes occur in the gingival tissue, sutures are not required. After the application, the patient can return to work on the same day and continue his social life.

A Specialist Physician is Required in Orthodontic Treatment
Orthodontic treatment is a branch of science that requires a lot of care, diligence and expertise. For this reason, the selection and application of the appropriate method for the patient to speed up orthodontic treatment should definitely be done by an orthodontist. Unfortunately, there are also people in our country and all over the world who apply orthodontic treatment by going to a short-term course only without a field of expertise. Orthodontic patients should be very attentive and careful in this regard. Treatments that are tried to be applied by non-specialist physicians; it can cause permanent negative changes in the teeth, tissues around the teeth and facial proportions. For this reason, it is necessary to be examined by an orthodontic specialist before the treatment and to act in accordance with the directions of the physician. [ProfDr.SerdarÜşümez]

10 WRONG INFORMATION ABOUT ORTHODONTIC TREATMENTS
THAT IS CONSIDERED TRUE..!

I'm Over Age I Can't Be Treated!
Especially adult patients may think that it is too late for them. However, orthodontic treatment has no age limit, it can be done at any age. With the development of technology and the increase in treatment possibilities, we can easily apply orthodontic treatment to individuals of all ages. Orthodontic treatment can be applied as long as there are healthy dental tissues and the patient pays attention to what needs to be done during the treatment process. Orthodontic treatment also has many benefits for adult patients. In cases where the teeth are very crooked, interface caries may occur as it is not easy to clean. With the treatment, both tooth cleaning becomes easier and the formation of interface caries is prevented.

Orthodontic Treatment Is Only With Wires!
Orthodontic treatment is not only done with wires. We now benefit from much more advanced technologies in orthodontics. One of these treatments is Transparent Plaques. Treatment with clear plaques is a very efficient method with many advantages compared to wire treatment. These plaques are invisible, hygienic and fast. Since there are no wires or metal parts, it does not irritate the inside of the mouth and does not cause discomfort to the patient. Patients can provide oral hygiene much more easily with transparent plaques.

Orthodontic Treatment Is A Very Painful Treatment!
Since the force is applied to the tooth in orthodontic treatments, the patient feels a slight pressure. However, the experience of pain differs from patient to patient. One of our sister patients, whose treatments we started at the same time, does not suffer at all, while the other can suffer. We can call this a completely personal situation.

Orthodontic Treatment Is Very Expensive!
Thanks to new technologies, costs have also decreased along with treatment times. In addition, although patients see the same problem when they look at each other, each patient's orthodontic problem and treatment plan are unique. In this sense, the treatment of one patient may be longer and more costly, while that of another patient may not be the same.

Orthodontic Treatments Take Too Long!
Contrary to what is known, orthodontic treatments do not take very long. Orthodontic treatments have been accelerated much faster with the new methods developed. Currently, 50-60 percent of treatments are completed within 10-12 months.

My Child Does Not Need Treatment, It is Too Early!
This is a belief that we often hear from families and it is quite wrong. Even a newborn child may need orthodontic treatment. Orthodontic treatment of a baby can begin from the moment of birth. Generally speaking, we can say that orthodontic examination should be performed between the ages of 6-8 December.

Without Treatment, There Will Be No Harm to My Teeth!
Orthodontic treatment prevents greater losses that may occur at a later age. These include tooth losses, interface Decays. It also protects patients from treatments such as fillers, shots, implants and prostheses.

Crooked Teeth Will Get Better Over Time!
it is not possible for the perplexities seen after the age of 10 to improve on their own. Of course, an intervention is needed. For this reason, crooked teeth do not get better over time.

In Orthodontic Treatment, The Devices Attached to the Tooth Do Not Move Out of Place!
This is also a false belief. Transparent plaques, which we often use in orthodontic treatment, are products that can be easily removed and attached. Thanks to these products, patients can easily consume what they want compared to wires.

I Will Look Very Ugly During The Treatment!
Some patients may postpone their treatment due to weddings, graduations, presentations or important meetings. Patients who use social media very effectively can also avoid treatment, especially with metal brackets. In such cases, we recommend transparent plaques to our patients. Transparent plaques that are invisible, transparent and give fast results; They come to the fore with their features that do not cause discomfort compared to metal braces and can be removed and attached at any time. [ref:Dr.YasinErdemAkgül]