In this days, when a beautiful smile is an advantage in both private and professional life, orthodontics has became one of the most popular and rapidly developing dental specialities. The scope of orthodontics includes monitoring of the development of the dentition and face and correction of abnormalities in the system of mutual relationships between the teeth and bones of the face. Successful orthodontic treatment, apart from the improvement in appearance and well-being, provides delayed ageing of the face, improvement of articulation, easier tooth cleaning (decreased tendency for dental caries, build-up of tartar and periodontosis) and improved chewing quality (hence a better performance of the alimentary tract). Moreover, the treatment eliminates headaches related to disorders of the temporomandibular joints (TMJ). Considering the wellness of our patients and our commitment to the supreme quality of services, the work at our Clinic is established on the long-term experience of our team and also involves the use of the most recent technological developments. Our team regularly participates in scientific meetings and training with world-class lecturers, and our Clinic is supplied with the latest-generation equipment and top quality materials.

ORTHODONTIC PREVENTION

Orthodontic prevention consists of the inclusion into a child's upbringing factors of promoting the regular development and growth of the teeth and jaws, and elimination of harmful factors. This type of treatment is designed mostly for the parents (counselling) and young children. At this stage of treatment the visits involve the assessment by the orthodontist as to whether the child's occlusion (bite) has the acceptable level for its age, and whether such functions as breathing, speech and swallowing are correct. In the case of any abnormalities, the dentist recommends appropriate exercises or treatment with simple appliances.

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REMOVABLE APPLIANCES

Removable appliances are devices which can be inserted and removed from the mouth by the patient. Depending on the bite defect being treated, various types of removable appliances may be used. They comprise an acrylic plate in a colour selected by the patient and, depending on the appliance type, wire elements that fix the appliance or elements exerting pressure to the teeth, such as screws, and springs. The most suitable time for their use is the period of development of children and youth. To benefit from the positive results of the treatment, the child has to observe the principles of wearing the appliances, i.e. the recommended duration and the manner of use of the device.

PERMANENT APPLIANCES

Permanent appliances (braces) are devices comprising catches of various types (brackets and rings) placed permanently on the tooth surface with special adhesives. The catches provide a support for springy wires that provide the actual force acting on the teeth. Due to the fact that the appliances exert a constant pressure for the whole period of treatment, they allow an exact effect of the treatment to be obtained. Depending on the patient's therapeutic and aesthetic needs, various orthodontic brackets may be recommended:
- metal ones, more precise, cheaper and providing the possibility of diversification of the appearance by the application of colourful rubbers supporting the arch and application and, in certain cases, special exceptionally small brackets.
- aesthetic ones, ceramic (matched to the tooth colour) or of pure monocrystalline sapphire (the only completely transparent brackets), less visible, but of lower mechanical endurance.

SELF-LIGATURING SYSTEMS

Self-ligaturing systems are modern orthodontic systems enabling significant reduction in the duration of both subsequent visits, and the whole treatment period. The unique design of the brackets minimises discomfort for the patient and promotes the maintenance of perfect oral hygiene.
Both adults and children, with no age limits, may wear permanent appliances. Self-ligaturing brackets are available in both metal and esthetic version.

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ORTHODONTIC MICRO-IMPLANTS - MICRO-SCREWS

Orthodontic micro-implants are very tiny orthodontic screws which are inserted, as with conventional implants, into the jaw bones. The procedure of implantation of the screws is painless, as it is performed under local anaesthesia. The aim of the micro-screws is to counteract the forces applied by the orthodontist during moving teeth into various directions. The application of the micro-screws gives new possibilities for orthodontics in the 21st century. It allows the reduction in the duration of the treatment and of the period of wearing the full appliance, as well as making small corrections without the need for the insertion of a permanent appliance on all the teeth.

LINGUAL TECHNIQUE

The core of the lingual technique is the application of orthodontic brackets that are stuck to the internal tooth surface from the side of the tongue. As the method guarantees complete invisibility of the appliance, the lingual technique is particularly recommended to adults, whose profession may require them to perform at public functions; however, there are no age limits for this method. Due to the application of special, smaller brackets of smoother outline, a minimum effect of this appliance on the tongue's functions and speech has been obtained; also the hygiene of the teeth and appliance elements is easy to maintain.

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COURSE OF ORTHODONTIC TREATMENT

1. Orthodontic consultation
2. Presentation of the treatment plan
3. Commencement of the actual treatment
4. Check-ups
5. Retention phase

1. ORTHODONTIC CONSULTATION

At the first visit the dentist takes a detailed medical history from the patient to understand as far as possible the reasons for the patient's visit, and his or her needs and expectations, which allows an individual treatment plan to be drawn up as an initial step to the satisfactory results of the treatment. The next stage necessary for planning the treatment is a detailed examination of the occlusion and muscle functions, and taking impression for plaster diagnostic models of the patient's teeth. Additionally, photos of the dentition are taken, which are attached to the patient's digital record. A full analysis of the occlusion setting also requires X-ray imaging (panoramic X-ray and remote side X-ray of the skull), which may be performed at the time in our X-ray laboratory.

2. PRESENTATION OF THE TREATMENT PLAN

The aim of the second visit is to inform the patient about the results of the examination and analyses of the occlusion, bone conditions and face profile, and to present to the patient a treatment plan, including the course and expected duration of the treatment. This is also the time at which possible patient's questions are answered and, after approval of the plan by the patient, a decision is taken on the date of commencement of the actual treatment.

3. COMMENCEMENT OF THE ACTUAL TREATMENT

The first element of this visit is, depending on the type of treatment planned, providing the patient with a removable appliance or application of a permanent one, which is a painless procedure. Then the dentist provides the patient with any recommendations and necessary advice. At the commencement of the treatment the teeth must be healthy and free of deposit and tartar, and the gums free of inflammation symptoms. Treatment with permanent appliances lasts approximately two years.

4. CHECK-UPS

Check-ups occur at various intervals, depending on the chosen method of the treatment and the individual patient's needs:
- removable appliances: every 2-4 months;
- permanent appliances: every 4-5 weeks;
The aim of these obligatory visits is the monitoring of the course of the treatment, and activation of the appliances.

5. RETENTION PHASE

The retention phase, lasting approximately three years, is the last but not least important stage of the treatment, as it stabilises the results obtained and prevents against the reoccurrence of the defect. If the treatment has involved wearing a removable appliance, the retention appliance will be the same appliance used to date, but without activation. If the treatment has involved a permanent appliance, after removal of the appliance and cleaning the teeth from the adhesive and polishing, the patient is provided with a removable acrylic retention plate for the upper teeth and a thin wire stuck on the internal surface of the lower teeth.

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FAQ

1. What are main causes of occlusion defects?
2. How and when should I prevent occlusion defects?
3. When should I come with my child to the orthodontist?
4. Why is the treatment of children so important?
5. Is there any age limit for orthodontic treatment?
6. When should an adult visit the orthodontist?
7. What are the benefits of orthodontic treatment in adults?
8. How should I prepare myself for orthodontic treatment?
9. Is orthodontic treatment painful?
10. Should I change my oral hygiene practices when wearing a permanent appliance?
11. Can permanent appliances do damage to teeth?
12. Does wearing of permanent appliance require a dietary modification?
13. Is it necessary to apply permanent appliances to both dental arches?
14. Are there any invisible appliances?
15. What does the effect of orthodontic treatment depend on?

1. What are main causes of occlusion defects?

There are numerous causes for the occlusion defects mentioned. Acquired occlusion defects, being the most common, develop within the first years of life of a child. Factors leading to abnormal position of the teeth include the application of inappropriate dummies and teats, breathing through the mouth (instead of the nose), sucking of the thumb or lip and premature loss of a milk tooth/teeth due to injury and, first of all, dental caries. The loss of milk teeth before the time of their natural replacement leads to inhibition in the growth of the jaw, and then irregular position of the permanent teeth due to lack of sufficient space.

2. How and when should I prevent occlusion defects?

Prevention of occlusion defects should be implemented from the first days of the child's life of the child. You should pay attention to:
the timing and method of feeding of the baby (bottle or breast-fed);
the application of appropriate dummies and teats;
the early introduction of feeding using a teaspoon;
making the baby accustomed to biting and chewing solid food.
Extremely important, but a difficult and patience-consuming task is to prevent the development of bad habits or getting rid of them (e.g. sucking a thumb or lip, biting pencils, etc.). Due to the significant importance of dental caries in the development of occlusion defects, the milk teeth should be thoroughly cared for from the time of their eruption to natural loss.

3. When should I come with my child to the orthodontist?

There are various circumstances, which should encourage the parent or guardian to take the child to the orthodontist. The most important of them include:
- premature loss of the milk teeth;
- habit of sucking a thumb or dummy in a child over 3 years;
- reluctance of a child over 3 years to bite and chew solid food;
- worrying changes in the appearance of the child's face (e.g. face asymmetry, apparently retracted or protruding chin);
- reverse tooth overlapping, i.e. a lower tooth overlaps the upper one.

4. Why is the treatment of children so important?

Orthodontic treatment of children in necessary, as occlusion defects do not reverse spontaneously, but become worse with the child's growth. Also, the fact that crooked teeth may be the cause of complexes in children from their earliest years, and may pose more difficulties in cleaning (increased susceptibility to dental caries and gum diseases), and that abnormal occlusion may promote speech disorders, is also of importance. The orthodontic treatment of children brings results faster than in adults, and commonly allows the removal of permanent teeth to be avoided and prevents complications of occlusion defects, if started at appropriate time.

5. Is there any age limit for orthodontic treatment?

Age provides no limit for orthodontic treatment. The treatment may be commenced at any age, with the appropriate method selected. However, the prerequisite is the presence of bone tissue in sufficient amount and quality, the lack of acute periodontal inflammation, healthy teeth, and the lack of dental deposit and tartar.

6. When should an adult visit the orthodontist?

Adult patients commonly decide to start orthodontic treatment for aesthetic reasons. This is an important reason indeed, but there are also others:
- attrition of the teeth;
- headache in the forehead, pain in the ears and neck of unknown origin;
- elongation of the crowns of the teeth;
- elongation of the crowns of the teeth;
- crowded teeth (in particular when wisdom teeth are coming through);
- loosening of individual or a group of teeth;
- appearance of rapid ageing of the face around the angles of the mouth.

7. What are the benefits of orthodontic treatment in adults?

Successful orthodontic treatment in adult patients provides:
- an improvement in appearance and the well-being of the patient, and thus more self-confidence;
- easier tooth cleaning, which reduces susceptibility to dental caries, tartar build-up and periodontosis;
- improvement of chewing quality, which has a direct effect on the performance of the alimentary tract;
- delayed ageing of the face;
- elimination of disorders of the temporomandibular joints and related headache;
- an easy, full smile.

8. How should I prepare myself for orthodontic treatment?

Before the commencement of orthodontic treatment, in particular involving permanent appliances, all the teeth have to be healthy, free of dental deposit and tartar, and the gums have to be free of inflammatory symptoms (softening, redness, bleeding, pain).

9. Is orthodontic treatment painful?

If the treatment involves the use of a permanent appliance, just after its application and a few days after (on the second or third day) a feeling of discomfort or even soreness may occur, in particular during biting solid food. However, such symptoms should subside within a week, and the patient should become accustomed do the appliance within a few days. A similar feeling, but less intensive, may occur after the activation of a removable appliance. Protruding elements of the device may irritate the mucous membrane of cheeks and lips, but there is an excellent remedy for the problem, a special wax that adheres to the appliance and allows the mucous membrane to become accustomed quickly to new conditions.

10. Should I change my oral hygiene practices when wearing a permanent appliance?

If you wear a removable appliance, you may apply your normal method of cleaning your teeth. The other problem is to keep the appliance itself clean; it should be cleaned with a separate toothbrush or special brush for prosthetic appliances and toothpaste or liquid soap. On the other hand, cleaning the teeth with a permanent appliance requires more accuracy, more time and additional accessories (interdental toothbrush, special dental floss, dental irrigator). It is recommended that professional tooth cleaning and fluoridation in the surgery be undergone every several months.

11. Can permanent appliances do damage to teeth?

Permanent appliances do not damage the teeth! Only the failure to observe regular principles of hygiene by the patient may, under the new condition, lead to the demineralisation of enamel and development of caries.

12. Does wearing a permanent appliance require a dietary modification?

In the initial period, just after the application of a permanent appliance, it is recommended to eat only soft meals, due to the hypersensitivity of the teeth to biting. During the whole treatment period you should avoid very hard or sticky food (in particular nuts, chewing gum or toffee-like sweets and candies). Such food may hinder tooth cleaning or damage the appliance, which prolongs and complicates the treatment. The selection of aesthetic brackets requires avoiding large amounts of coffee, tea, red wine, certain fruit juices (e.g. blackcurrant one) and meals (e.g. curry), and smoking, as these products promote the build-up of deposit which is difficult to remove.

13. Is it necessary to apply permanent appliances to both dental arches?

The final decision needs to be taken by the orthodontist who, having considered the examination results, the type of occlusion defect and the patient's opinion, determines whether appliances on both arches are necessary for the satisfactory results of the treatment.

14. Are there any invisible appliances?

There are no completely invisible permanent appliances among the conventional ones currently available. However, there are aesthetic appliances available with brackets matched to the tooth colour (ceramic) or completely transparent (of pure monocrystalline sapphire), as well as arches matched to the tooth colour. In some patients the lingual technique may be applied, in which the brackets are fixed to the internal surfaces of the teeth.

15. What does the effect of orthodontic treatment depend on?

The following factors influence the effect of the treatment:
- type of the occlusion defect;
- age of the patient;
- type of the appliance used;
- level of oral hygiene;
- regular attendance at scheduled check-ups.

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