Concept
Harmony between the teeth and jawbones consists of the teeth being in proper proportion and correctly aligned with one another. There must also be a correct relationship between the top and bottom teeth. The top teeth should close over those on the bottom, and must also come into contact with them.
It is also important from the aesthetic and functional point of view for a correct relationship to exist between the upper and lower jawbones, and between both of these and the rest of the face.
If this harmony doesn’t exist, thereby altering the look of the face or the chewing, breathing or pronunciation functions, the situation can be corrected by means of orthodontics.
Orthodontics consist of moving the teeth into line, and of changing growth of the upper or lower jawbones if required. This procedure enables us to improve the aesthetics of the mouth and the face, while also perfecting the oral functions.
Correcting badly positioned teeth
In orthodontics, the teeth are aligned using a wire or arch, which gradually moves them into the correct place. The teeth are joined to this arch by means of square fastenings known as brackets, which are glued to the tooth surface using a special adhesive and come with a groove into which the arch is fitted. The arch is firmly held against the bracket groove by elastic or metal ligatures. These ligatures must be changed every month since they move with the teeth and eventually come loose.
The brackets are often metal. However, in the event of desiring a more aesthetic effect, they can also be fitted in white plastic or ceramic
The arches which guide the teeth are changed as the treatment progresses. The first ones used are in nickel-titanium (thin and flexible), so that they can reach teeth which are crowded or have large gaps between them. These will be replaced by more rigid, round or rectangular steel arches which will straighten the teeth.
Sometimes, for a short period of time, elastic bands are used between the top and bottom teeth, to move them either horizontally or vertically.
At the end of the treatment, to keep the results in place, retainers or transparent plastic aligners are used at night while sleeping.
Badly positioned teeth can be corrected in children, teenagers and adults.
Correction of the jawbone position and growth
The upper and lower jawbones relate to one another by means of the top and bottom teeth. When this relationship is correct, the same will apply to a person’s appearance and to the oral functions of chewing and speaking. Furthermore, for good aesthetics, the jawbones must correctly relate to the rest of the face and head.
Orthodontic study
While making the orthodontic study we will observe the width and length of the upper and lower jawbones, the different angles between them and the other bones in the head. This is done by taking X-rays of the patient’s face and head.
These measurements have a racial component, and within each race the measurements will tell us whether the upper and lower jawbones have the right dimensions. They will also tell us how growth will proceed in the case of children or teenagers. Furthermore, any changes in the jawbones of all patients, including adults, will tell us whether they can be corrected using orthodontics or whether surgery is required.
Changes and treatment
The lower jawbone may sit further forward (prominent jawbone) or back with respect to the upper jawbone. We may also sometimes find that the upper jawbone is set back from the lower jawbone and the rest of the face, giving the impression of a prominent jaw, even if it is of normal size.
The upper jawbone, and therefore the palate, may be narrow, meaning that the top teeth close within the bottom ones. This causes the lower jawbone to shift in order to be able to meet the upper jaw, making the chin look as though it is twisted to one side.
In children and teenagers the palate can be broadened using a resin brace glued to the top teeth. This is known as a rapid palatal expander. In adults this broadening procedure can only be achieved with surgery.
In children and teenagers we can modify growth of the upper jawbone by using extraoral appliances which either push it forwards to stimulate growth, or backwards, to slow growth, as required. The system which pulls the jawbone forward is known as a facemask, and the one which pulls it backwards, cervical pull headgear. Both are only worn at night.
In adults growth has stopped, and we can only move the jawbones by means of maxillo-facial surgery. However, using bracket orthodontics, we can improve the way the teeth meet. And sometimes, without surgery, we can also improve their aesthetics and function.
If you think that you or your children have any of these problems, ask us about them and we’ll explain the different options
