The practice of orthodontics involves the design, application, and control of corrective appliances, commonly called braces, to treat and correct these problems. The technical term for crooked, crowded or protruding teeth is malocclusion, which means bad bite.

The specialists who treat malocclusions are called orthodontists. An orthodontist is a trained dentist who has successfully completed at least two additional academic years of continuous advanced studies in an orthodontic program of a dental school or institution approved by the American Dental Association. This advanced training includes such diverse studies as embryology, genetics, human growth and development, cephalometrics, biophysics and mechanical engineering. Only dentists with this advanced education can announce that they are orthodontists, and only these specially trained dentists have the knowledge, training and experience to properly evaluate and treat malocclusions.

A Brief History of Orthodontics

The diagnosis, prevention and treatment of dental and facial irregularities, now called Orthodontics, dates back to ancient Greece and Rome. It wasn’t until about 1830 that a French dentist named Lefoulon began to call his work with crooked teeth orthodontisie. Throughout most of that century, appliances used to move teeth, while becoming more refined, worked on individual teeth, with no attempt to treat the teeth and mouth structure as a unit.

Dr. Edward Angle is generally considered the father of modern orthodontics, based on his development in the late 1880s of a system for creating classifications of and terminology for diagnosing irregularities. After founding an orthodontics school in St. Louis at the turn of the century, he and others founded the American Society of Orthodontists, which later was called The American Association of Orthodontists (AAO). By the mid-1920s, major colleges and universities across the country offered advanced training in orthodontics.

Causes of Orthodontic Problems

There are two causes of malocclusions. Most malocclusions, including crowding, spacing, extra or missing teeth, cleft palate and certain irregularities of the jaws and face, are inherited. Acquired causes include thumb or finger sucking, tongue thrusting, breathing restrictions by tonsils and adenoids, accidents involving the teeth and face, dental disease and premature loss of primary or permanent teeth. Many of these problems also affect facial appearance. Most people do not have naturally straight teeth; in fact, the AAO estimates that up to 75% of people could benefit from orthodontic care and about 4.5 million people in the United States are wearing braces or other appliances to achieve a beautiful smile and healthy teeth.

Consequences of Untreated Orthodontic Problems

Untreated orthodontic problems may cause tooth decay, diseased gums, bone destruction, joint problems and loss of teeth. (More adults lose their teeth because of gum disease than because of decay.) Protruding teeth are more susceptible to accidental chipping and other forms of dental injury. Sometimes, the increased cost of dental care resulting from an untreated malocclusion far exceeds the cost of orthodontic care.

Malocclusion also may exert harmful effects on an individual’s overall health, causing speech defects, psychological and emotional disorders. A pleasing appearance is a vital asset to one’s self-confidence and self-esteem. Often, self-consciousness disappears as orthodontic treatment brings teeth, lips and face into proper position.

When to Visit an Orthodontist

Most malocclusions can be improved at any age. The AAO recommends that a child have the first orthodontic examination by age seven. An important consideration is at what age the greatest improvement can be achieved in the least amount of time and at the lowest cost. The best age will vary from patient to patient; a complimentary consultation will help determine if and when treatment will become necessary. Since the orthodontist knows what to look for based on training and experience, parents should not rely on their own judgment or that of friends regarding whether their children need braces.

Contrary to what was previously believed, treatment for adults is possible at any age. In fact, today, one out of every five patients is an adult. Problems such as any of the following – spaces between the teeth, protrusion of teeth, tipping of teeth into a space that was not kept open after premature extraction or loss of a tooth, and teeth that have moved into abnormal position – can be helped by orthodontics. While the lack of growth in adults may slightly limit the benefit of orthodontics, most adults who undergo treatment see a visible improvement.

The health aspect of orthodontics is often the primary consideration for adult treatment. Crooked teeth can put extra stress on supporting tissue. Failure to correct the problem might cause weakening of support tissue, thereby causing gum disease, loss of teeth and eventual need for dentures.

Cost of Orthodontic Treatment and Insurance Options

Fees for treatment can vary widely, depending on the severity of the problem and length of the treatment time. Geographic location also plays a role.

Orthodontic coverage is being included in more insurance plans each year as employers and unions realize that orthodontic care is an important health concern of workers. The American Association of Orthodontists welcomes prepaid orthodontic care because it encourages better dental health care through increased availability. Because the quality and cost of orthodontic insurance varies greatly, the AAO has developed a nationwide program to counsel companies and unions on the health benefits of orthodontic care, as well as help them get the best possible benefits at the lowest premium costs. In recognition of the increasing number of adults aware of the benefits of orthodontic treatment, the AAO believes there should be no age limit for orthodontic coverage.

While orthodontic treatment may involve several years of treatment, payment usually can be extended over the years required for care. The orthodontist welcomes the opportunity to discuss fees on an individual basis.

Types of Treatments

Although some people think of metal braces as the only way to fix malocclusions, improvements in technology have enabled the creation of innovative, new types of braces, as well as vast improvements in metal braces. In addition, updated thinking about when and how to treat means that people of just about any age can benefit from orthodontic treatment.

Custom-made appliances (known more commonly as braces) are designed by Dr. Andolino and his team to address the needs of each individual. They may be removable or fixed (cemented and/or bonded to the teeth). They may be made of metal, ceramic or plastic. Whatever their composition, braces move teeth through their supporting bone to a new, desirable position by applying light, continuous forces in a carefully controlled direction.

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