Dental Arts of Wyomissing Blog
Posts for: January, 2016
Orthodontics can produce an amazing smile transformation. With today’s advanced appliances and techniques even the most difficult malocclusions (bad bites) can be overcome. All of this innovation, however, depends on one basic anatomical fact: though firmly set in the mouth, our teeth can still move.
Teeth are actually held in place by the periodontal ligament, a strong, elastic tissue that attaches to them through tiny collagen fibers on one side of the ligament and to the jawbone with similar fibers on the other side. When pressure is placed against a tooth, the bone on the opposite side of the force begins to dissolve (resorb), allowing the tooth to move. As it moves, new bone is built up behind the tooth, to stabilize it. Orthodontists take advantage of this natural mechanism through orthodontic hardware like braces that applies pressure in the desired direction of movement, while the ligament and bone do the rest.
There is, though, a downside to this process. The teeth, bone and gum tissues can contain a kind of “memory” for the former natural position of the teeth. Over time, the lower front teeth tend to take a gradual migratory movement back towards their original position. Also, as we age the lower front teeth may crowd each other as there is a genetic influence for teeth to move to the midline of the face, causing a pressure that allows the skinny lower front teeth to slip behind each other. As a result of both of these tendencies, corrected teeth may retreat from their new positions.
To stop these tendencies, we use an appliance known as a retainer after braces or other hardware is removed. As the name implies, this appliance “retains” the teeth in their new position. For structural “memory,” the retainer will keep the teeth in their new position until the impulse to return to the old one has faded, about eighteen months. Retainers can also slow or stop the natural genetic influence of movement, but it may mean wearing a retainer for an indefinite period, especially individuals who’ve undergone orthodontic treatment later in life.
The length of time you’ll need to wear a retainer after braces — and what type, whether a removable appliance or one permanently attached — will depend on a number of factors including the type of malocclusion, your individual mouth structure and age. We’ll recommend the best option that ensures the best chance of keeping your teeth in their new position.
If you would like more information on retainers after orthodontic treatment, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Why Orthodontic Retainers?”
Braces are a common part of many teenagers’ life experience — but not every bite problem is alike. Sometimes, there’s a need for accurately moving only a few teeth while making sure others don’t. This is where Temporary Anchorage Devices (TADs) can help streamline that effort and even reduce treatment time.
Orthodontics wouldn’t work at all if we didn’t already have a natural tooth movement mechanism in our mouths. That ability rests with the periodontal ligament, a tough, elastic tissue between the teeth and the bone that firmly attaches to both with tiny collagen fibers. Though quite secure in holding teeth in place, the ligament attachment also allows teeth to move in response to changes in the bone and jaw structure.
Braces are made of brackets cemented to tooth surfaces through which tiny wires pass. The wires are anchored, usually to other teeth or groups of teeth, and tightened to apply pressure against the other teeth. The ligament does the rest: as the teeth are “pressured” to move in a certain direction, new bone, ligament and an anchoring substance known as cementum forms behind it to secure the tooth in its new position.
The anchorage teeth are not intended to move. In some situations, though, it’s difficult to keep them from not moving — much like trying to keep a boat anchor from not dragging through sand on the sea bottom. TADs help alleviate this problem: it’s a mini-screw or mini-implant that’s temporarily placed in the jawbone to which the tension wire can be secured. They’re placed in the best positions for isolating the teeth that need to be moved without compromising the position of nearby teeth that don’t.
With the site numbed with a local anesthetic, we install the TAD through the gum tissue into the bone with a special device; their screw-shaped design holds them securely in place. They’re then removed when the orthodontic treatment is complete.
While a simple procedure, precise placement requires collaboration between the orthodontist and the oral surgeon or dentist who installs them. They also need special attention during daily hygiene to keep them clean. Still, with difficult bite situations they can help bring about the right outcome — a straight and beautiful smile.
If you would like more information on orthodontic treatment options, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “What are TADs?”