What is orthodontics?
Orthodontics is the branch of dentistry that specializes in the diagnosis, prevention and treatment of dental and facial irregularities.

Who is a qualified orthodontist?

A Qualified Orthodontist is a post graduate specialist who after completing the basic five year degree in dentistry undergoes an additional THREE YEAR training program, to gain the expertise & knowledge to treat people with braces, and the Dental Council of India approved University & Dental College.

Specially trained dentists, with a post-graduate masters degree(MDS) in Orthodontics are THE MOST QUALIFIED INDIVIDUALS, to carry out orthodontic treatment.

It is similar to Gynecologists, who study for an extra three years to master delivering bundles of joys in all complicated situations, or, Pediatric Surgeons, who undergo an extra few years of training to specialize in the fine surgical skills needed to operate on the delicate structures of new born children, infants & small children.

How do I know whether the MDS doctor is a QUALIFIED ORTHODONTIST?

All qualified Orthodontists are M.D.S. – Master of Dental Surgery. (General dentists are B.D.S.) At the same time, not all M.D.S. doctors are Orthodontists. The M.D.S. doctors who have undergone training specifically, in the subject of Orthodontics, are ORTHODONTISTS. The Orthodontist can be a Resident Orthodontist or a Visiting Orthodontist. Resident Orthodontist is one who is available on all days at a particular place, to treat & take care of patients with the help of braces. The Visiting Orthodontist is one who is available on particular days of the month (generally once in a fortnight/month) at a particular place, for the same.

Why Braces?

For most people, a beautiful smile is the most obvious benefit of Orthodontics. Crooked and crowded teeth are hard to clean and maintain. This can result in tooth decay, worsen gum disease and lead to tooth loss. Other Orthodontic problems can contribute to abnormal wear of tooth surfaces, inefficient chewing function, excessive stress on gum tissue and the bone that supports the teeth, or misalignment of the jaw joints. These can lead to chronic headaches and face or neck pain.-After your braces come off, you'll feel more self-confident.

Does my child need Orthodontic Treatment (braces)? These warning signs indicate that your child needs to have Orthodontic Treatment:

• Crooked or overlapping teeth
• Protruding teeth
• Delayed eruption of permanent teeth
• Mouthbreathing habit
• Thumbsucking habit
• Difficulty in closing the lips
• Open bite, cross bite, deep bite
• Disharmony in jaw growth

When is the best time to start Orthodontics?

Your child is an individual with a special pattern of growth and dental development. There is usually a "best time" for a child to begin treatment for straightening teeth. Early diagnosis by the Orthodontist will determine the best time to begin.

When do I start to bring my child to an Orthodontist?

An early examination, at age 7, enables the Orthodontist to determine the timing and type of treatment your child needs. In some children, the best results are achieved in the growing years. In other children, the initial examination by the Orthodontist may not be followed immediately by treatment. The Orthodontist may want to monitor your child with periodic examinations to check on the eruption of permanent teeth, before recommending braces.

What kind of braces will my child wear / can my child get clear braces?

The Orthodontist will select the most appropriate type of braces to treat your child's particular problem. Braces may be fixed to the teeth or may be removable. Sometimes, your child will require both types of braces. Some permanent teeth may need to be removed in order to make space for lining up the teeth. The braces that are used are of three types namely metal braces; tooth colored / ceramic braces and lingual braces.

Metal braces

These are most commonly used; designed for patient comfort and clinical efficiency. They are -well accepted by patients.

Tooth colored / esthetic braces (ceramic, plastic)

These esthetically appealing braces are available in translucent material, to blend with teeth, or in a clear, transparent material that allows the natural color of the teeth to show through. But they are not for everyone. The ceramic material is very hard; harder than teeth and cannot be used in all circumstances. They are usually more costly. The plastic braces are not as durable as metal or ceramic and require additional care. However, the Orthodontist will recommend the proper type of braces for you.



Lingual Braces

These braces are placed on the back side of the teeth, hence are not visible when the patient smiles or talks. They are esthetically most pleasing but they take time to get used to. Careful patient selection is very important as lingual braces cannot be placed for all patients.

Invisible braces

The technology of invisible braces is used for minor tooth alignment. A series of clear removable aligners are used to straighten your teeth without metal wires or brackets. You wear each set of aligners for about two to six months, removing them only to eat, drink, brush, and floss. As you replace each aligner with the next in the series, your teeth will move - little by little, week by week - until they have straightened to the final position your Orthodontist has prescribed.

What will be the treatment cost?

The actual cost of Orthodontic treatment depends on the severity of the problem. Many Orthodontic problems require only limited treatment at relatively inexpensive fees. Your Orthodontic specialist will be glad to discuss fees and payment options with you before treatment begins. Treatment by an Orthodontist can be less costly than the additional care required to treat dental problems arising as a result of Orthodontic problems. Please consider the money spent on Orthodontic treatment as money invested on an everlasting beautiful smile.

What are Removal Appliances / plates?

Unlike conventional braces, which create pressure by being attached directly to the teeth, removable appliances are used in different ways. Some are intended to influence growth of the jaws in order to effect changes in facial structure eg. Functional appliances like "Activator", "Twin Block". Some are used to retain teeth in their corrected positions (retainer). Others, are used in conjunction with fixed appliances eg. "bite planes" and "thumb guards". Still, removable appliances are not right for all Orthodontic problems. Timing of such therapy is also very important. An Orthodontic specialist is trained to make the treatment decisions.

How long will my child need to wear braces?

In general, active treatment time ranges from one and a half to three years. The actual time will depend on the severity of the problem and growth of your child's face and mouth. Good oral hygiene, regular appointments and co-operation will help treatment to progress smoothly. For an adult patient most Orthodontists agree that the treatment will usually take from 10 to 20 percent longer as the adult's bone structure is denser and firmly set, so a slightly longer response time to tooth movement can be expected.

Will I need to have any permanent teeth removed when I get braces?

If the teeth are very crowded, and they are protruding very far, sometimes removing teeth is an excellent choice for a patient. Typically, most Orthodontists choose to extract two upper back teeth (premolars) and two lower back teeth (premolars) to accomplish the goals of treatment. Alternative extraction approaches may be indicated depending on the nature of the case.

How important is co-operation?

Successful Orthodontic treatment requires good cooperation between your child and the Orthodontist. The Orthodontist provides the expertise and braces to straighten teeth but your child must follow instructions carefully, so that the teeth can move properly and on time.

Always remember Effort on your part = Good Result.

Is it harder to take care of your teeth when you are wearing braces? Yes. It is normally more difficult to take care of the teeth because the braces are more difficult to clean around. However, it only takes 3 to 4 minutes several times per day to keep them perfectly clean.

Does it hurt when you stick (glue) the braces on or take them off?

It does not hurt to place the braces on or to take them off. Special instruments are used to minimize discomfort.

Do braces harm teeth or gums?

If you follow the instructions for the care and maintenance of the braces, keep your appointments, and brush your teeth regularly, you should not have any problems whatsoever.

What is a retainer?

A retainer is a simple, removable plate that is fitted to your teeth to hold them in their corrected position after the Orthodontist removes the fixed (bonded) braces that were used to straighten your crooked teeth. Initially-patients are advised to wear the retainer full time for a period of 6 months; subsequently there is a gradual phasing out with reduced wear time.

Is it true when braces are removed the teeth get crooked again?

There are usually some minor changes following Orthodontic treatment. These changes are normally insignificant in comparison to the original malocclusion.

Will it hurt?

Discomfort has to result when we loosen a tooth for movement. This usually last up to about 48 to 72 hours after braces are placed. Each succeeding adjustment will mean some minor discomfort for a day or two.

Can Orthodontic treatment help stop thumb sucking habit?

Habits such as thumb sucking, tongue thrusting, lip posture and mouth breathing, and functional problems, such as mandibular displacement, which is often associated with anterior or posterior crossbites, are usually treated as early as possible. Habit appliances are designed in many different ways and are used until the harmful habit has stopped.

What are Orthodontic Headgears?

Orthodontic headgears are a very important part of the treatment for patients with disproportional jaw growth. Headgear creates Special Forces that guide the growth of the face and jaws. Regular use of headgear achieves the best results.

Is it too late for me to start Orthodontic treatment?

There is no age limit for Orthodontics. Teeth and tissue are essentially the same in both adults and children. Orthodontists can successfully straighten teeth regardless of your age. However, certain types of problems cannot be treated with braces alone. Some may require a combination therapy of jaw surgery and braces.

What are removable dentures ?

Removable dentures replaces one or more missing teeth with appliances that the patients themselves can remove and wear such as complete dentures and partial dentures.

What is a fixed denture ?

Fixed dentures is a prosthetic appliance permanently attached to remaining teeth, which replaces one or more missing teeth with restorations that the patient cannot remove on his own, such as veneers, crowns, bridges, and implants.

What is a crown?

It is a cemented extra coronal restoration that covers, or veneers, the outer surface of the clinical crown. It restores the damaged portion of the tooth along with its function. It protects the tooth from any further damage.

What are complete dentures?

Complete dentures are prosthetic appliance that replaces a complete set of upper and lower missing teeth and its supporting structures for maintaining esthetics, function and muscular tonicity.

What is the difference between conventional dentures and immediate dentures?

Conventional dentures are dentures that are made and placed after the remaining teeth have been removed and the tissues have healed. Immediate dentures are dental appliances that are placed immediately after the removal of the remaining teeth . The patient does not stay without teeth at all. It is useful for patients who are esthetically conscious.

What is an over-denture?

An over-denture is a dental appliance which is tooth supported over remaining natural teeth or implants, replacing lost or missing natural dentition and associated structures. It receives partial support and stability from the modified natural teeth.

What are metal dentures?

Metal or cast dentures may also be used to replace some or all missing teeth. Its main advantage is that its lighter than a conventional denture. They are much thinner. As it is made of metal it has a good thermal conductivity and the patient can have better perception of temperature.

What are flexible dentures?

Flexi-dentures are a relatively new development in denture materials. The teeth are attached to a slightly flexible gum coloured denture base which extends to make the clasps. They provide a metal free alternative to the partial denture equation.Stability and retention come from the very close fit of the denture, and the flexible gum colored clasps that extend from the denture to tightly grip the natural teeth. Like acrylic dentures, they are a 'mucosal borne denture'- meaning they get support from sitting on your ridges.

Indications:
• Where the mouth is unlikely to change
• Great for a single missing tooth at the side or back (premolars/molars)
• In patients where muscle control is compromised but not dexterity- for putting them in and taking them out
• Where allergy to metal or metal free denture desired
• As a thinner more grippy alternative to acrylic dentures when many teeth have been lost.
What do dentures feel like?

For a few weeks, new dentures will feel awkward until you become accustomed to them. They might feel loose until the cheek and tongue muscles learn to hold them in position. It is not unusual to feel minor irritation or soreness. The patient needs to see his or her dentist for regular fit adjustments to relieve any soreness. The patient needs to see his or her dentist for adjustments to relieve any sore areas.The tongue also has to adapt to the changes to master speech with new dentures.

Are you able to eat with dentures?

Eating with dentures will take a little practice. You should start with soft foods that are cut into small pieces. As you become used to chewing, you can return to your normal diet.

Are there foods you should avoid if you wear dentures?

There are only a few eating restrictions for denture wearers. Avoid biting down directly on crunchy or hard foods, like whole apples, hard pretzels, crusty bread, or large sandwiches. They can break because of the angle where the denture comes into contact with the hard surface.

Biting is limited only by the stability of the dentures.-Factors which decrease stability of a denture are: Insufficient bone structure (shrunken bone ridges covered by gum tissue), old or worn dentures, and a dry mouth.

If you wear dentures, are dental adhesives necessary?

Today's dentures have been significantly improved through advances in both dental and materials technologies. As a result, dentures that fit properly usually do not require adhesives to secure them. When you are just getting used to dentures, adhesives may be advised, but otherwise should not be necessary.

A loose denture is a sign that it doesn't fit your mouth correctly. When first getting used to dentures, you may notice them slipping when you laugh, smile, or cough, which is caused by air getting under the base and moving it. The more you wear dentures, the better you will be able to control their movements in these situations.

How do I clean the dentures?

Maintaining oral hygiene is very important. Plaque on the denture can cause irritation to the gums along with bad mouth odour. Rinsing the denture with water after every meal is very important. The denture should be left in a cleanser overnight for killing microorganisms. Toothpastes should not be used on the dentures.

What are the procedures possible to improve my smile?

In many cases, a cosmetic dentist will implement a combination of several of the following procedures to give you that perfect smile.

Teeth Whitening - Whitening of the teeth is performed for patients who desire a brighter smile. Teeth whitening can be performed to reduce discoloration and staining, or simply to provide the patient with whiter, brighter teeth. Teeth enamel discoloration can be caused by staining, aging, or chemical damage to teeth. Some of the more common causes of teeth discoloration are medications, coffee, tea or cigarettes. People who drink significant amounts of cola soft drinks can experience similar staining. Damage to the root may also contribute to discoloration.

Aside from staining, there are other factors that can affect the color of a tooth. Genetics can play a role. Some people have naturally brighter enamel than others. Disease can also be a factor and certain medications can cause a discoloration of a tooth. If you suspect that there is an underlying medical cause for your tooth discoloration, be sure to inform your cosmetic dentist. We at the Orthodontic and Dental Centre have kept pace with technology and have very recently installed a state of art Tooth Whitening machine, to give you a pearly white smile.

Tooth Contouring and Reshaping - Tooth reshaping, or contouring, is one of the few instant treatments now available in cosmetic dentistry. Dental reshaping and contouring is a procedure to correct crooked teeth, chipped teeth, cracked teeth or even overlapping teeth in just one session. A _ little reduction and a little addition of tooth-colored laminate can create a beautiful smile when performed by a cosmetic dentist, with no discomfort to you. Tooth reshaping, or dental contouring, is commonly used to alter the length, shape or position of your teeth.

Dentures - Dentures often solve a host of dental problems. A dental bridge is a false tooth, known as a pontic, which is fused between two porcelain crowns to fill in the area left by a missing tooth. The two crowns holding it in place_are attached onto your teeth on each side of the false tooth. This is known as a fixed bridge. This procedure is used to replace one or more missing teeth. Fixed bridges cannot be taken out of your mouth as you might do with removable partial dentures.

In areas of your mouth that are under less stress, such as your front teeth, a cantilever bridge may be used. Cantilever bridges are used when there are teeth on only one side of the open space. Bridges can reduce your risk of gum disease, help correct some bite issues and even improve your speech. Bridges require your commitment to serious oral hygiene, with which they can last for many years.

Dental Fillings - Today's dental fillings are more than the typical metal fillings of our childhood. Dental fillings are now color matched to the rest of your teeth for a great smile. Composites are the solution for restoring decayed teeth, making cosmetic improvements and even changing the color of your teeth or reshaping the teeth. Bonding will lighten any stains you may have, close up minor gaps and can be used to correct crooked teeth. Basically, bonding will cover any natural flaws applying a thin coating of a plastic material on the front surface of your teeth.

Cosmetic Gum Surgery - A "Gummy Smile" or a "Long Tooth Smile" are corrected through gum surgery.

What is root canal treatment?

Root canal treatment is necessary when the soft inner tissue, or “pulp,” of the tooth becomes inflamed or infected. This may happen as a result of deep decay, repeated dental procedures on the tooth, or an injury to the tooth. Root canal (Endodontic) treatment removes the damaged pulp. Then the tooth’s canals are cleaned and filled to help preserve the tooth. In a few cases, however, root canal (nonsurgical Endodontic) treatment alone cannot save the tooth. In such a case, we may recommend surgery.

How many times do I need to come for a root canal treatment?

The number of visits are dependent upon the extent of the infection. Usually in the first visit, the infected area is opened and cleaned; in the second the canals are enlarged for filling material to be filled & in the third visit the filling is done. With newer technologies it is now possible to do the RCT in a single visit if the infection is limited.

Is RCT painful?

The RCT is done after giving local anesthesia to ward of any pain.

Who performs Endodontic surgery?

All dentists receive training in Endodontic treatment in dental school. However, because Endodontic surgery can be more challenging than providing nonsurgical treatment, many dentists refer patients needing surgery to Endodontists. Endodontists are dentists with at least two additional years of advanced education and training in root canal techniques and procedures. In addition to treating routine cases, they are experts in performing complicated procedures including surgery. They often treat difficult cases-such as teeth with unusual or complex root structure or small, narrow canals.

Why would I need Endodontic surgery?

Surgery can help save your tooth in a variety of situations.

Surgery may be used in diagnosis. If you have persistent symptoms but no problems appear on your x-ray, your tooth may have a tiny fracture or canal that could not be detected during nonsurgical treatment. In such a case, surgery allows your Endodontist to examine the entire root of your tooth, find the problem, and provide treatment.

Sometimes calcium deposits make a canal too narrow for the instruments used in nonsurgical root canal treatment to reach the end of the root. If your tooth has this “calcification,” your Endodontist may perform Endodontic surgery to clean and seal the remainder of the canal.

Usually, a tooth that has undergone a root canal treatment can last the rest of your life and never need further Endodontic treatment. However, in a few cases, a tooth may not heal or may become infected. A tooth may become painful or diseased months or even years after successful treatment. If this is true for you, surgery may help save your tooth.

Surgery may also be performed to treat damaged root surfaces or surrounding bone.

Although there are many surgical procedures that can be performed to save a tooth, the most common is called apexectomy or root-end resection. When inflammation or infection persists in the bony area around the end of the root of your tooth after a root canal procedure, your Endodontist may have to perform an apexectomy.

What are implants?

A dental implant is a small "anchor" made of titanium. It is inserted into the jawbone to take the place of your missing tooth root. It is the closest replacement to the natural tooth. After osseointegration, or when the surrounding bone has attached to the implant, a replacement tooth is secured to the top of the implant. The new tooth looks, feels, and performs just like your natural teeth.

Why do I need implants?

Dental implants can be used in a variety of situations, whether you need to replace a single missing tooth or many teeth. They can even be used to replace a full denture. As anchor points, implants can also securely attach a partial denture or bridge.

If your mouth has insufficient bone structure, dentures will be more difficult to retain. Your dentist may advise the placement of implants. These are placed in the bone and retain the denture with small, precision attachments.

Can an implant be given to me?

If you're healthy enough to have a tooth extracted, you're probably healthy enough to have an implant - whether your missing teeth are the result of injury, disease, or decay. General good health and adequate bone in the jaw are the key requirements. Your dentist can tell you if implants are right for you.

How long does it takes to get implants and how is the procedure done ?

The dental implant process involves basically three steps that take place over a time period that averages from 3 to 9 months. The typical process will include:

Initial implant placement: This procedure is performed in your dentist’s office under either a local or general anesthesia. Your doctor places the small Dental implant into your jaw. Over the next several months, bone will attach to the surface of the implant anchoring it into position.

Repositioning of the gums: with the help of a minor surgery a gingival former is placed on top of the implants so that the gums can grow around it. This results in an esthetic tooth replacement.

Implant prosthetic attachment: During this phase, your dentist painlessly attaches a dental prosthetic "post" to the implant. A simple impression will be taken and over the next few days an artificial tooth will be created for a functional natural restoration.

Since dental implants look and feel like natural teeth, they enhance your appearance. More importantly, the securely attached implant gives you the confidence of eating what you like, speaking easily and clearly, and freedom from embarrassment. And, by following a regular routine of careful oral hygiene and regular checkups, your implants can last for many years.

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