Young children and adults rarely have orthodontic treatment. There's a lack of research into things like how many people need braces to prevent tooth problems or other medical problems and how many people wear them because they would like to have a more attractive smile. It’s not clear whether orthodontic treatment is really needed as often as it is recommended nowadays. But sometimes people wish to have orthodontic treatment for more minor misalignments because they don't like the way it looks. Orthodontic treatment is mainly done if the teeth or jaws are more than just a little misaligned – for instance, if the upper front teeth stick out over the lower front teeth by more than 3 millimeters, or if teeth at the side of the mouth don't touch each other when the person bites. A retainer may have to be worn for longer in some cases, depending on the type of misalignment. The active treatment and retention phases usually take about 3 to 4 years in total. The retainer may, for instance, consist of a wire glued to the back of the front teeth. After that, you use something known as a retainer to prevent the teeth from moving back to their original position. The active treatment phase, when fixed or removable braces are worn, lasts about two years. Sometimes children already have treatment with braces between the ages of 6 and 8 (early treatment). By that time the baby teeth have already been replaced by permanent teeth, but the jawbones are still growing. It is usually done between the ages of 12 and 16. The aim of this treatment is to correct the position of the teeth and align the upper and lower jaw to improve the bite. Sometimes both types of braces are used: Then you might wear removable braces at first, followed by fixed ones. Orthodontic treatment mainly involves wearing a fixed or removable braces in your mouth. Misaligned teeth and jaws are usually treated by an orthodontist. You sometimes have to go to see other specialized doctors too: For instance, if your airways are narrow as well, it’s a good idea to see an ENT (ear, nose and throat) specialist too. The teeth are first scanned and then a model of the teeth is made digitally. It is now sometimes also possible to make a model using computers. The resultant cast is used to make a model of the child’s set of teeth, and the treatment can then be planned based on the model. But the material hardens after about half a minute and can then be removed from the mouth. This can be unpleasant and make them gag. To make a plaster model (a dental cast), the child is asked to bite down on two special trays filled with a soft material. The orthodontist will usually take x-rays and make plaster models of the teeth too. He or she will ask about possible causes and see whether the child’s mouth opens and closes properly. The orthodontist will take a close look at the child’s teeth and mouth, and also examine the rest of their head. To find out whether misaligned teeth or jaws need to be treated, the child is usually referred to a specialist known as an orthodontist. But sometimes doctors or dentists are the first to notice, during an examination of the mouth. Parents often notice themselves that their child has misaligned teeth or jaws. But the psychological effects don’t only depend on how severe the misalignment is. A lot of people who have crooked teeth or an uneven bite feel less attractive or less confident – particularly if it affects their speech – and they might then avoid contact with others. Misaligned teeth and jaws can also affect your mental health, particularly in children and teenagers who are teased as a result. After a while the joints of the jaw might start hurting and the jaw muscles may tighten. The affected teeth may become wobbly, tooth decay may develop, and the teeth may be more prone to damage if you have an accident. Sometimes teeth dig into your lips or the gums opposite when you close your mouth, which can be painful. Severe misalignments can affect things like eating, drinking and speaking, or cause breathing problems. This will depend on the type of misalignment and how severe it is. Misaligned teeth or jaws can lead to a wide range of different problems – or sometimes cause no problems at all.
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