Different techniques can be used to move teeth, depending on how we wish to move the teeth and what the patient wants.
Early orthodontic treatments
In children whose permanent teeth have not yet fully grown in, we use a resin brace, generally quite discreet and attached to the palate, serving to stretch the palate when required.
Furthermore, we use night braces (posterior or cervical and anterior or mask) to move the upper jaw forwards or backwards.
Another option is to used fixed braces in the shape of a band round the first permanent molars on either side, and a wire which connects said bands. These are the so-called transpalatine bar and lingual bar.
These are normally used to ensure that the permanent molars which grew in at 6 years of age do not move forward in the event of extracting a temporary molar, or when the temporary teeth are changing for their permanent versions.
In some very rare cases we may use brackets before all of the permanent teeth have grown in.
Orthodontic treatment in adolescents and adults
Once all of the permanent teeth have grown in, we can use fixed braces.
We fix what are known as «brackets» and «bands» to the teeth, made in either metal or transparent material.
We insert a wire or metallic arc to these brackets, which is held in place using an elastic or metal ligature enabling us to guide the movement of the teeth. Said brackets are fixed to the visible wall of the teeth using special adhesive. Some treatments require the extraction of a tooth which cannot find its space in the mouth, or of a canine which is buried or stuck in the bone. Sometimes in adult patients, upper or lower jawbone surgery is required to achieve their movement during treatment. The choice of treatment is made according to the objective we wish to achieve and to the wishes of the patient.
Dental hygiene and orthodontics
Brackets and their wire complicate dental hygiene.
Por ello, a fin de evitar la inflamación de las encías o el descubrimiento de alguna caries, a la hora de retirar el aparato, el cepillado deberá ser minucioso, tres veces al día, después de cada comida. Si se pica algo entre horas, conviene también un cepillado.
No se deben comer chicles, u alimentos muy duros, para evitar que salten los brackets.
Para la inmensa mayoría de los pacientes, la ortodoncia es llevadera, y no significa grandes problemas.
This means that, to prevent gum inflammation or the discovery of tooth decay on removing the brace, the patient must brush their teeth very carefully, three times a day, after every meal. It is also advisable to brush the teeth after eating between meals.
The patient must not chew gum, or eat very hard food, to prevent the brackets from coming loose.
For the immense majority of patients, orthodontic treatment is tolerable and represents no major problems.
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