Orthodontics is the branch of dentistry that deals with the correction of bite and arrangement of teeth in order to improve their cosmetic appearance and function.

What are the types of orthodontic treatments offered by the Leeds dentists?
Depending upon the extent of malocclusion and cosmetic improvement required, the Leeds dentists offer the following orthodontic treatments

  • Dental Braces and Aligners – to improve misalignment of teeth, alter the appearance of crowded, crooked, or unusually spaced teeth
  • Orthodontic surgery – to improve malocclusion or bad bite occurring as a result of misaligned jaws; also known as orthognathic or corrective jaw surgery

ORTHODONTIC BRACES

What are dental or orthodontic braces?

Dental braces are devices usually made of stainless steel, ceramic or plastic, used to correct crooked, crowded or misaligned teeth. They are basically a combination of brackets and wires fastened onto the teeth, applying continuous and gentle pressure on the teeth causing them to shift back to their proper position. 

Who requires orthodontic braces?

Your orthodontist may suggest wearing dental braces for a variety of reasons, which include

  • Malocclusion or bad bite – Due to misalignment of teeth and causing severe problems in daily lifestyle such as biting, chewing, speaking etc
  • Cosmetic improvement – To improve the appearance of your teeth and hence your overall looks

What are the problems caused by malocclusion?
Correcting malocclusion is highly important especially when it can result in the following conditions

  • Abnormal swallowing patterns due to improper alignment of upper and lower teeth
  • Chewing or biting difficulties
  • High susceptibility to cavities due to difficulty in removal of plaque from between crooked teeth
  • Defects in speech
  • Growth and development problems of the jaw
  • Headache, and neck and facial pain
  • Highly prone to accidents and fracturing of teeth

How can braces help you?

  • The brackets and wires will continuously apply pressure onto the teeth and gradually shift them back to their original position.
  • As teeth shift position, the wires are adjusted periodically so that the braces continue to apply adequate pressure on the teeth.
  • Once they have aligned properly braces are removed, and retainers may be used for a brief period to hold the teeth in the new position.

How long will I have to wear braces?
The treatment period will depend upon the condition of the teeth and the extent of misalignment.  At any rate, it will take from one to three years for the braces to come off.

What are the different parts of a dental brace?

  • Small stainless steel, ceramic or plastic brackets that are bonded onto the teeth
  • Arch wires -Thin wires that are threaded through the brackets and used to pull the teeth into position
  • Bands – Stainless steel tubes made to fit on the last tooth called the molars
  • Ligating rings – Small plastic rings encircling the bracket and holding the wire against the brackets. You can have these rings either in a colour of your choice or go for transparent or white rings

What are the types of braces offered by the Leeds dentists?

Leeds orthodontists offer a variety of braces. These include

  • Removable braces
    These can be removed and are made of plastic, with wire clips and springs to move specific teeth, most often the upper teeth. Though removable, they must be removed only for the purpose of cleaning, and remain in the mouth at all times including meal times and at night.
  • Fixed braces
    Fixed braces are not removable and are made of small brackets that are glued to the teeth and joined together with a wire. They can be used on upper as well as lower teeth. They may also come with
    • Small elastic bands – attached to a fixed brace
    • A headgear – a frame with wires that come out of your mouth, attaching your brace to a headband, often worn in the evening or at night
  • Retainers
    Once orthodontic treatment using braces is finished, the retainers are put in to ensure that the teeth stay in their corrected positions. Retainers are either fixed or removable and need to be worn for at least six months.
  • Plastic aligners (Invisalign)
    A new type of orthodontic treatment to straighten teeth using removable and virtually invisible set of aligners. The treatment is not ideal for people with severe malocclusion problems.

How is the dental braces treatment carried out by your Leeds dentist?

1st appointment

  • During the initial consultation, the Leeds dentist will evaluate your dental health and conduct a thorough oral check-up to determine if braces is the right treatment for you
  • X-rays, photographs and impressions of your teeth are taken to chart out the treatment plan.
  • Several types of X-rays will be taken to support in the examination and to create models of the bite, upper and lower jaws. These include
    • Panographic x-rays – To obtaina view of the entire mouth, location of sinuses, nerves and sign of any bone problems
    • Cephalometric x-rays – To obtain side images of the height of the jaw and to check for consistency of the bite
    • Computerized tomography x-rays (CT scan) – To obtain cross- sectional and other views to help measure the exact jaw height, width and bone density
  • Based on the findings, the Leeds dentist will advise you on the treatment plan, associated risks, anaesthesia, limitations and cost
  • Teeth may be removed especially if the teeth are crowded or are too far in the front.  Most often, 2-4 teeth are removed, premolars being the frequently removed teeth.           

2nd appointment

  • The Leeds dentist cleans the teeth and polishes them, to ensure the removal of surface deposits in order to enable the fixing of the brackets on the teeth later
  • Bands are then placed on the back teeth and cemented in the position
  • A cheek retractor is placed between your lips and teeth, which helps to keep the lips away from the teeth
  • Cotton rolls and a suction device are placed to remove the accumulating saliva in order to keep the teeth dry during the fixation of brackets
  • An acid solution or gel is used to etch the teeth to create surface roughness that will help the brackets to adhere to the teeth
  • A special adhesive is applied on the surface beneath the bracket that helps to fix it onto the teeth
  • The procedure will take 11/2 – 2 hours to complete

Future appointments

  • Follow up appointments are scheduled every four weeks
  • During the follow up appointments, the progress of treatment, issues with wires and braces are noted and repaired
  • Braces are tightened gradually at every appointment without hurting the teeth and surrounding tissues

Removal of braces
On completion of the treatment period and achieving desired results, the braces are removed by your Leeds dentist using special pliers. No pain or discomfort will be experienced.

What are the possible side effects to look for following the fixing of braces?

  • Soreness and pain – May occur a few hours after the braces have been fixed.  Your Leeds dentist will prescribe a pain reliever to alleviate any such discomfort.  Also, apply wax over areas of the braces that cause discomfort to the cheeks and lips.
  • Piercing wires – If after a few days or weeks of treatment, the wire starts piercing, it indicates that the teeth have begun to move. Fix an appointment with your Leeds dentist to have your wires trimmed.

Caring for the braces – Why and How?

Plaque and food particles tend to accumulate in the braces.  Hence, regular cleaning of the braces and maintaining dental hygiene is essential to prevent gum disease and tooth decay. Its excellent if you could follow a strict dental regime for hygiene, either designed by yourself or one that has been charted out by your dentist.

Here are some guidelines that can help you maintain your braces in excellent condition and prevent gum disease

  • Cleaning the braces frequently
    Since food tend to get trapped within the braces, fall through and accumulate between the teeth, its highly crucial that you clean them at least twice daily, or ideally after each meal.
  • Using appropriate cleaning instruments and materials
    To maintain your braces and teeth in clean conditions, you must have the following instruments
  • A soft toothbrush or a special orthodontic – to brush your teeth.
  • Superfloss or floss threaders – to aid in efficient flossing
  • An interdental or a proxabrush – which will fit between the wire and the tooth in order to remove hard-to-reach plaque and food debris
  • Oral irrigators – to use prior to brushing and flossing to facilitate the removal of food debris and plaque
  • A mouthwash containing fluoride – to help prevent the occurrence of cavities
  • Cleaning techniques and order – Follow these cleaning techniques in the order mentioned below
  • Begin with a soft toothbrush, brushing top to bottom on each tooth that has a brace attached
  • Then use the proxabrush to brush between the braces and teeth ensuring that you cover all the surfaces of each tooth before moving onto the next tooth.
  • Start on the outside of your upper teeth, positioning the bristles at a 45-degree angle, toward the gum. Brush two to three teeth at a time using a circular motion, making at least ten strokes.
  • Next, brush the inner surfaces in the same manner.
  • Brush the chewing surfaces.
  • Repeat the same process for the lower teeth as for the upper ones.
  • Repeat until all teeth have been cleaned
  • Use a fluoride mouthwash to rinse away any extra debris that is left in the mouth after brushing
  • Avoiding and controlling certain food habits and general habits
    Eating certain foods and general habits such as chewing on pencils can damage the braces, and make their cleaning a tedious process. Hence, it is best suggested to avoid such habits or at least keep a control over them. Here are some suggested food and general habits you can pay attention to
    • Avoid eating hard foods such as toffees, apples or nuts as they can bend or break the wiresloosen the bands, or break the brackets
    • Avoid sugary snacks such as sugary sodas and juices as they increase the risk of tooth decay. If you cannot avoid at least cut these foods into small pieces before consumption to reduce the risk of them getting stuck or damaging the braces
    • Avoid gum, popcorn, and hard or sticky candies.
    • Avoid chewing on items such as pens, pencils or fingernails as it can damage braces
    • Fruits and raw vegetables should be cut up into smaller pieces and chewed on the back teeth.
  • Checking the braces for problems – You are likely to come across some issues with your braces like wires or brackets becoming loose, or wires breaking during the period of their use.  In such cases, you must fix up an appointment with your orthodontist at the earliest as some of them can lead to severe problems if neglected. Here is what to look out for
    • Broken or protruding wires– such that they poke into the cheek, tongue or gum. Try any of the temporary solutions until you visit your orthodontist
      • Use a pencil eraser to push the poking wire into a less bothersome position
      • Use orthodontic wax to cover the sharp end
      • Rinse your mouth with an antiseptic solution or warm saltwater if you have developed a mouth sore due to a protruding wire

Important – Never cut these wires, as bits of metal may be swallowed or inhaled into the lungs and cause additional problems.

  • Loose brackets – which may poke at gum tissues or soft tissues such as the tongue or cheek. Cover any sharp ends with orthodontic wax until you visit the orthodontist.
  • Loose bands – The metal cemented around the back teeth may come loose, in which case save the band and schedule an appointment with your orthodontist
  • Loose spacers – The tiny circular spacers made of rubber and inserted between teeth in order to open a small gap between teeth helps orthodontic bands to slip into place more easily. If a spacer slips out of place, fix an appointment with your orthodontist to have it replaced
  • Allergic reactions – Certain people may have allergic reactions to the metal or latex used in the braces and bands
  • Use mouth guards whenever necessary – Though you can take part in almost any activity, always take special precautions such as wearing mouth guards while participating in contact sports.
  • Keeping the retainers clean
    Even if you have come off your braces and now use retainers, you need to follow a strict dental regime for hygiene to keep your retainers clean, and prevent tooth decay as well as gum disease. Here are some guidelines to follow
    • Brush the retainer clear of food at least twice per day. Incase of a removable retainer, clean the device daily with a toothbrush and toothpaste.
    • It is crucial to clean the side that has contact with the roof of your mouth.
    • Hot water should not be used to clean the retainer, as it can distort the shape of the retainer
    • Store the retainer in its case and keep it away from pets
    • Soak the retainer in a denture cleaning solution at least once per week but only after consulting with their dentist as some solutions may corrode metallic areas of the retainer
  • Meet your dentist regularly – In order to monitor the health of your teeth and gums as well as the progress of your treatment, its essential that you keep regular appointments with your orthodontist and dental hygienist

 ORTHODONTIC SURGERY – ORTHOGNATHIC OR CORRECTIVE JAW SURGERY

Corrective jaw surgery or orthognathic surgery is a procedure done on the jaws in conjunction with orthodontic treatment to correct or establish a stable functional balance between the teeth, jaws and facial structures for aesthetic, functional and health reasons. 

Who requires a corrective jaw surgery?
The procedure is required when misaligned jaws are present resulting in

  • Over-bite or under-bite
  • Gummy smile
  • Teeth that don’t seem to fit with jaws
  • Improper chewing function, speech, long-term oral health
  • Chronic jaw or TMJ pain
  • Breathing problems
  • Facial deformity

acquired after birth as a result of hereditary, environmental influences or trauma/illness to the face

Who are the ideal candidates for the procedure?

  • Candidates with an improper bite or jaws that are positioned incorrectly affecting chewing function, speech, long-term oral health and appearance
  • Candidates with injury to the jaw and birth defects affecting jaw alignment

What happens during the initial consultation with the Leeds dentist?

  • During the initial consultation, the dental history, complete medical history and X-rays are taken
  • The examination may include
  • Radiographic and imaging analysis (x-rays)- Provides cross- sectional and other views that measure the precise jaw height, width and bone density
  • Dental model analysis – A thorough dental examination is performed where the structure and health of the mouth, gums, teeth, jaws, head and neck will be examined and models will be made of the bite, upper and lower jaws
  • Photographs are taken for further comparison after procedure.
  • A thorough dental examination is performed where the structure and health of the mouth, gums, teeth, jaws, head and neck will be examined and models will be made of the bite, upper and lower jaws.
  • The dentist discusses and advises on options of treatment, type of facilities, risks, anaesthesia, limitations and cost

How must you prepare for the procedure?

  • You are instructed to interrupt recreational activities and social habits, such as contact sports and even smoking few weeks prior to the procedure
  • You may be given an antimicrobial mouth rinse, anti-inflammatory medication and/or antibiotics before the surgery.
  • You must inform the dentist if you have any particular medical condition such as high blood pressure or allergies towards epinephrine in local anaesthetics
  • You must not eat or drink for at least 6 hours prior to the surgery.

How will the Leeds dentist perform the orthognathic surgery?

  • The Leeds dentist administers general anaesthesia on you
  • Incisions are made on the inside of the mouth to expose the bones to be cut.
  • The jaws are corrected depending upon the type and area of correction such as
    • For lower jaw surgery, the rear portion of the jawbone behind the teeth is separated and the tooth-bearing portion is either brought forward or moved back.
    • For upper jaw surgery, the upper jawbone is shortened or lengthened or repositioned forward or backward
    • For uneven jaw surgery, a wedge of bone may be removed from or added to the upper or lower jaw.
      • If other facial bones contribute to the asymmetry, they may be repositioned during the procedure.
  • The jaws are fastened together either by
    • Rubber bands or wires attached to the teeth or
    • Rigid internal fixation with miniature screws and plates
      • The sutures are finally closed

The surgery takes 3-4 hours to complete.  The surgery is performed as an inpatient procedure and may require a stay of 2-5 days in the hospital

What must you expect following the surgery?

  • You may experience some degree of swelling and bruising during the first two weeks following surgery.
  • When the lower jaw is repositioned, a period of lower-lip numbness or tingling is present that lasts for weeks or months.
  • You may experience mild to moderate amount of pain following orthognathic surgery, which can be controlled by medication prescribed by the Leeds dental surgeon.
  • Numbness or a tingling sensation in the face, jaw, teeth or tongue may be experienced as healing takes place.
  • If upper jaw surgery has been performed, there may be some oozing of blood from the nose

Life after your orthognathic surgery
Daily activities and routine

  • Activities should be limited the week following surgery.
  • You can return to their normal activities within a week or two after their surgery. 
  • All strenuous activities and heavy exercise should be avoided the first month after surgery.

Follow up and further orthodontic treatment

  • You must go for a follow up for the Leeds dental surgeon to monitor the healing, and review the changes in the facial structures and occlusion (bite). 
  • The Leeds orthodontist will adjust the braces to fit the new repositioned jaw. 
  • Orthodontic treatment will resume three to six weeks after jaw surgery and frequently last six to 12 months to ensure optimal positioning of the teeth.

Invisalign

Invisalign is a teeth straightening system that is an alternative to braces, where invisible, removable aligners are used to straighten your teeth gradually, in contrast to the bands, metal brackets or metal wires used in braces. 

What is Invisalign made of?
Invisalign consists of a series of clear, removable aligners made out of clear, flexible, and virtually invisible plastic.

When will your orthodontist suggest the use of Invisalign?
Your orthodontist may suggest wearing Invisalign for a variety of reasons, which include

  • Malocclusion or bad bite – Due to misalignment of teeth and causing severe problems in daily lifestyle such as biting, chewing, speaking etc
  • Cosmetic improvement – To improve the appearance of your teeth and hence your overall looks, especially when your have teeth that are crowded, crooked, or with unusual spaces between them

Note – In case of severe malocclusion, braces may be recommended over Invisalign

What makes an Invisalign a more attractive option than braces?

  • More visually appealing than traditional braces – uses virtually invisible plastic making it more aesthetically appealing than the bands, metal brackets and metal wires of braces
  • Easier to maintain dental hygiene – Aligners are removable allowing you to brush and floss your teeth normally
  • No restriction over foods – Since aligners are removable you don’t have to worry about the food you eat.  Before eating, simply remove your aligner and feel free to eat all kinds of food without worries of food getting stuck as in the case of dental braces.

How is the treatment plan for Invisalign carried out by the Leeds dentist?

  • During the initial consultation, the Leeds dentist will evaluate your dental health and conduct a thorough oral checkup to determine if Invisalign is the right treatment for you
  • X-rays, photographs and impressions of your teeth are taken to chart out the treatment plan.
  • 3d technology is used in fabricating a series of custom made aligners for your teeth, generally amounting to 15-30 aligners
  • The Leeds dentist will advise you to wear a set of aligners for 2 -3 weeks, and replace it with a the next set of aligners in the series
  • You will have to visit your Leeds dentist to track the progress of your treatment every 2-6 weeks
  • In a similar manner, when you have finished wearing each aligner in the series, you will have completed the treatment successfully and rewarded yourself a beautiful smile
  • The treatment can take from 6-18 months to complete, depending upon the extent of repair required

What is the principle behind an Invisalign?
Each set of aligner in the series applies force on your teeth moving your teeth another step closer to the desired result.  The new set of aligners that replace the previous ones at every two weeks will be slightly tighter in fit than the former.

Caring for your Invisalign
Since Invisalign consists of removable aligners the routine care is much simpler than that of dental braces.  Here are a few tips on caring and using Invisalign

  • Make sure to brush your aligners each time you brush your teeth
  • Soak and clean the aligners by placing them in a denture cleaner while you are eating
  • Avoid removing them at night