The first step for any patient who wants orthodontic treatment is to research the options available to them. There is a lot of information online about the types of orthodontic appliances, but I can't say that it is easy to find or organised clearly enough for someone who has not yet seen an orthodontist to find their way around it.
Orthodontic treatment is most often carried out with fixed appliances – the familiar braces. Braces can be made of different materials – metal, ceramic or sapphire. They can differ in how the archwire is held in the bracket – conventional (with small elastic ties) or self-ligating (with clips) – and they can also differ by manufacturer or system – Damon, Alexander, Roth, MBT; the variety is huge.
Besides braces, teeth can also be straightened with clear aligners. Aligners also come from many different manufacturers – Invisalign, ClearCorrect, OrthoCaps and many others.
Orthodontics is a constantly evolving specialty, which is why manufacturers in the field offer a wide variety of appliances and treatment tools. Of course, it is good to learn what types of appliances and braces exist, but the reality is that your orthodontist is the one who can advise you on what will work in your case. Based on their training and experience, every orthodontist has chosen to work with a few types of appliances (braces, splints, aligners) and will offer you a system they know. This means that one doctor may work with Damon braces, for example, while another may offer you a different type. The best braces are the ones your orthodontist knows best, and all types of braces can straighten your teeth. So don't try to work out which braces you want to wear – find your orthodontist, who will carry out your treatment.
Interestingly, different orthodontists may sometimes have different opinions about your case. It sounds unusual, but the reason is that each person has a unique combination of deviations (how the teeth are positioned relative to the jaws, the lips and the face). This makes it completely impossible to systematise orthodontics as a specialty in a textbook that says “in this case, the solution is this”. That is why, apart from the basic knowledge of the specialty, orthodontists learn everything from scientific publications, of which there are many, and from their own experience.
Why do healthy teeth sometimes need to be removed to straighten a smile?
Nobody wants to hear “we need to take out some teeth” at the orthodontist's. There is a widespread belief that orthodontists remove teeth because it makes things easier for them. I have to say that this is not true. Treatment with extractions is technically more difficult for the orthodontist than treatment without extractions. Without extractions, a treatment may last 12-16 months; with extractions, it usually takes 18-24 months. Of course, it depends on the case – there are short and long treatments, but removing teeth is hard for both sides. So why is it sometimes necessary? The answer is simple: if you have finished growing (you are over 15-16 years old) and you do not have enough room for your teeth, you should know that your jaws have remained narrow and your teeth clearly have not fitted on that narrow base. If the crowding is mild or moderate, there are ways to compensate, but if the lack of space is severe, we have no choice but to advise removing teeth. Although I have refined my techniques for treatment with extractions over the years, whenever I can avoid extracting, I tell myself: “Oh, great! An easy case.”
This article is for information only and does not replace an examination by a dentist.
