The length of orthodontic treatment varies depending on the severity of the problem. Treatment can be as short as 3-6 months or as long as 3-4 years. Most cases require treatment for one and a half to two years. Severe problems, especially in children where growth modification is required, may take longer. On the other hand, in some adult cases where the goal of treatment is primarily improving the alignment of the front teeth for esthetic reasons or to improve teeth position to facilitate other dental procedures, orthodontic treatment may last 6 months or even lesser.
Since the treatment is customized for each patient, we would be able to give you a fair idea of the duration of the treatment at the initial consultation appointment after a proper checkup. Due to differences in bone density and metabolism, teeth move faster in some individuals and slower in others. Patients cooperation is perhaps the most important factor determining treatment duration and results. Patients who follow instructions diligently and keep regular appointments normally finish treatment faster and with better results compared to irregular and uncooperative patients.
Cost of Orthodontic Treatment :
Several factors influence the charges of orthodontic treatment. These include the severity of the problem, the estimated duration of the treatment, the type of the appliances required and the treatment and appliance options selected by the patient. Esthetic options like ceramic braces and invisible braces (braces placed on the inside surface of teeth – lingual braces) and clear aligners cost more than metal braces. The various treatment and appliance options and the cost involved will be discussed in detail during the initial consultation and diagnosis appointments.
Need of extracting teeth for Orthodontic Treatment
Certain orthodontic problems occur because there is not enough space in the jawbones to accommodate all the teeth in ideal positions. These include crowded (malaligned) and protruded teeth. There are a number of methods by which we can create space to correct these problems without extracting teeth. However, for certain severe problems adequate space can only be created by extracting certain permanent teeth. The space created by tooth extraction is used to move the other teeth into proper positions (retract protruded teeth and align crowded teeth). The teeth usually preferred for extraction are the premolars. Extraction of front teeth are avoided except in rare circumstances.
Modern appliances and techniques have to lead to a reduction in the number of orthodontic cases being treated with tooth extraction compared to 20-30 years ago. In our practice the majority of the cases are treated without permanent tooth extraction. Extractions are opted for in some cases only after a thorough diagnosis and treatment planning wherein it is ascertained that the desired results for that particular patient can be achieved only if certain permanent teeth are extracted. The procedure of tooth extractions is done under local anesthesia and is usually painless. Mild discomfort may be there for a few days after the extraction but significant pain is usually not experienced. Dental extractions do not have any relation to weakness or damage to the eyes or any other part of the body.
Maintenance of corrections after Orthodontic Treatment
Once the desired corrections have been achieved, it is time to take off the braces. However, the bone, muscles and soft tissue need some time to adapt to the new position of the teeth. So it is important to hold the teeth in their corrected position for a certain period of time after active treatment to stabilize the correction. This phase of treatment is called retention and the appliances used are called retainers.
The duration of retention after orthodontic treatment depends on several factors such as the type of malocclusion, its severity and etiology and the condition of the teeth, gums and the jawbones. Most malocclusions would require a period of 4-6 months of full-time wear of retainers which is followed by gradually reducing the use of retainers and their discontinuation after one and a half years to two years. Some malocclusions do not require any retention! On the other hand, certain malocclusions require a long term retention protocol to maintain the results.
Retainers are of two types – fixed and removable. Traditionally, removable retainers consisted of a plate with wires which is visible, and are still used today in certain situations. With technological advances, we have been also providing our patients with a transparent removable retainer without wires which is comfortable and virtually invisible when worn over teeth.
A fixed retainer is a segment of a special wire which is usually bonded to the inside surface of front teeth. This is extremely comfortable, totally unobstructed and invisible. However, it requires proper oral hygiene care by the patient. This can be kept in the mouth as long as necessary and is especially useful in cases where long term retention is required.
It is extremely important to follow the orthodontists instructions regarding the wear of retainers. Not wearing retainers/ wearing them irregularly, can lead to teeth shifting towards their original position and loss of the results achieved. Retainers normally do not affect the day to day activities of the individual and are extremely important to maintain the great smile and profile achieved by orthodontic treatment.
It must be understood that teeth retain the ability to shift their position throughout the life of an individual, irrespective of whether they have had orthodontic treatment or not. Some minor changes in tooth position can happen after orthodontic treatment and retention , but they are usually minimal compared to the original problem.
Pain during Orthodontic Treatment
At the start of the treatment, patients may have some discomfort due to two reasons. Firstly, the soft tissues on the inside of the lips and cheeks are normally used to the relatively smooth surface of the teeth. Braces may feel uncomfortable and ‘tend to poke’ a bit initially. This feeling usually lasts a few days and then gradually disappears as patients get accustomed to the braces. Secondly, tooth movement is produced by applying gentle pressure on them. Teeth may feel a bit ‘sore’ with some discomfort on biting and chewing at the start of treatment. This also subsides in 2-4 days. At certain subsequent appointments, adjustments in the braces/wires can cause discomfort but this is usually minor and only for a short duration. Most of the orthodontic treatment is painless and discomfort, when it occurs, is rarely so significant so as to disturb the day to day routine of the patient.