Orthodontics is a specialty of dentistry that deals with the correction of
“bad bites,” or problems with the way your teeth fit together.

What is a bad bite?

Your upper and lower teeth should fit together nicely when you bite, like the two halves of a zipper or the pieces of a jigsaw puzzle. When this does not happen, malocclusion (the technical term for a bad bite) occurs.

Malocclusion does not only affect appearance. It also makes chewing difficult, affects swallowing and speaking, and causes uneven wear of teeth. Because of this, your teeth can become prone to cavities, and you run a higher risk of developing gum disease and bad breath.

What are the different kinds of bad bite?

Ideally, your front teeth should overlap slightly when you bite, and the biting edges of your lower teeth should touch the inner surfaces of your upper teeth. There are, however, cases in which the upper front teeth come down too far, called a deep overbite. In other cases, the lower jaw may be too large or too small, resulting in an underbite or a crossbite.

What causes teeth to seem crooked and malaligned?

The following are the most well-known explanations why teeth appear crooked:

Teeth may come in too early or too late.
The teeth must develop in an orderly manner and at a particular period. But this does not always occur. A permanent tooth that grows ahead of schedule may take up the space of an upcoming tooth. Therefore the upcoming tooth will appear crooked. A permanent tooth that comes in too late may not have enough space it needs to grow properly.

The permanent teeth are not proportional to the jaw size.
When the size of your teeth do not match the size of your jaw, problems may occur. There may be gaps between the teeth when the jaw is too large. Conversely, very small jaws may pack the teeth too tightly causing them to appear twisted, rotated or crowded.

Occurrence of extra teeth.
The existence of extra teeth can assume the space which rightfully belong to other teeth. Thus, an exact number of teeth can prevent crowding of the teeth.

Molars are not in their proper position.
The tips of the teeth should fit into the triangular spaces between the teeth on the opposite side. When the upper and the lower teeth do not fit together like lock and key, particularly in the molar area, the teeth that come before and after it would be misaligned.

Absence of some teeth.
Teeth that are congenitally missing will cause the nearby teeth to move or rotate into the extra space.

You may have had a bad habit.
The habit of thumbsucking, mouth-breathing and tongue-thrusting can cause damage to permanent teeth by pushing the upper front teeth out and the lower front teeth in. These bad habits, often (but not exclusively) practiced by children, result in what is called an open bite.

Accidental tooth loss.
Traumatic injuries on the face have a substantial effect on the growth and development of the teeth and jaws. Trauma leading to tooth loss may alter a good bite.

What are the preliminaries to orthodontic treatment?

Before orthodontic treatment, the orthodontist begins by examining the teeth, jaws and face of the patient as well as the presence of a bad bite. Certain diagnostic tools like head and teeth x-rays, facial photos of teeth and plaster study models, may be employed to help the orthodontist develop a treatment plan suited to the needs of the patient. The treatment objectives are then laid out to the patients/parents. Furthermore, the appliances to be used will be discussed by the doctor and the treatment time and cost will also be estimated.

When are braces really needed? Are braces just for good looks?

Braces are not just for good looks. Patients normally seek out an orthodontist because they feel that their teeth are crooked, or maybe they are not happy with their smile. Orthodontics offers an opportunity for improved appearance that results in improved self-esteem but the most important reason for orthodontics is dental health.

Orthodontics brings about proper occlusion of the teeth, meaning your teeth fit together properly and work effectively as a unit. When teeth are correctly aligned, decay is less likely to occur. Crowded, overlapping teeth are food traps and are extremely difficult to brush and floss properly. Orthodontic treatment also relieves the extra strain on gums and bones caused by teeth that do not meet properly. Such strain may lead to gum or periodontal disease that may cause tooth loss. It also provides better and more stable alignment of the jaws to prevent temporomandibular joint problems.

Good alignment of the teeth promotes the efficient function of the mouth. Better chewing brings about good digestion. Thus, orthodontic treatment leads not only to better dental health but also to better nutrition and general health. In some types of cases, speech difficulties may be corrected by proper alignment of teeth.

Is orthodontic treatment expensive?

Expensive is relative. First, we have to consider the average length of treatment, which is usually 24 months. So if we divide the cost by the number of treatment visits, the cost will be reasonable.

Another consideration is the use of imported dental materials (the braces, wires, elastics, etc.) and equipment. In spite of this, orthodontics treatment in the Philippines cost only about one-third that of the average price in the U.S. and other Asian Countries. Lastly, we have to emphasize the lifetime benefits derived from orthodontic treatment. It does not only give you a super smile but it also improves self-confidence and dental health.

How often are the visits?

In general, active orthodontic treatment time may range from one to three years. The actual time depends upon the complexity and severity of the problem, and on the cooperation of the patient and his parents. After the braces are removed, a patient is required to wear retainers to assure that the teeth remain in alignment. In the beginning of treatment, appointments are more frequent until the appliances are in place. The first or second appointments usually require one or two hours for cementing the appliances into the mouth and instructions. After the initial long appointments, visits may vary from the three to six week intervals. Routine adjustments may take only about thirty minutes, as long as there are no loose, broken, or lost appliances.

Can an ordinary dentist put in braces?

Any dentist can “attach” braces. However, make sure that the orthodontist who treats your child has necessary qualifications. Check these three important matters:

How did the orthodontist train?
It is important to check on the orthodontist's training. The Association of Philippine Orthodontists recommends that orthodontic training consists of either a university-based, two-year graduate program or a clinically-oriented preceptorship program accredited by the Philippine Board of Orthodontics (PBO) with successful completion of the PBO Examinations.

Did he/she finish many cases?
Anyone can move a tooth or start a treatment. But to finish a corrective orthodontic case properly is a completely different matter. It is always a good idea to check some of the orthodontist’s finished cases.

Is he/she certified by the Philippine Board of Orthodontists?
The Philippine Board of Orthodontics, organized in 1980, by the Association of Philippine Orthodontists, is an autonomous accrediting body, duly recognized by the Board of Dentistry of the Professional Regulation Commission. In 1989, the specialty board became the accrediting body for orthodontic specialists. The board tests the qualifications of dentists who practice orthodontics, and confers certificates upon those who meet its requirements.

Are there dangers when braces are badly put?

Braces that are not properly placed may cause harm to the patient; therefore you need to go to a dentist with the proper orthodontic training. Some detrimental effects of improper treatment are shortening of the roots of the teeth, gum problems, death of tooth nerves, and excessive mobility of the teeth leading to tooth loss.

Do braces hurt?

Discomfort may result when we loosen a tooth for it to move. This usually lasts for two to three days after adjustment. The discomfort will depend on the individual’s pain threshold and age. As treatment progresses, discomfort may slowly diminish as the patients get used to having braces.

Are braces hard to maintain?

Generally, braces are simple to maintain and will not hamper your lifestyle. You will have to make a conscious effort to keep your teeth and orthodontic appliances or braces clean. In time, the cleaning becomes second nature. You will also have to stay clear of sticky and hard foods that may dislodge or break the braces.

Can older people still wear braces?

Orthodontic treatment is not just for kids anymore. More and more adults are realizing the benefits of orthodontic care. There is no age limit for orthodontic treatment. As long as the teeth, gums and supporting bones are healthy, teeth can be aligned. Poorly aligned teeth can lead to tooth decay, gum disease, excessive tooth wear, and poor self-image, lack of confidence and sometimes, even severe headaches and facial pain. Properly aligned teeth improves appearance, are easier to keep clean, and last longer. Adult treatment will usually take longer than teenage treatment. An adult’s bone is denser and more firmly set, so slightly longer response time to tooth movement can be expected.

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This is a public service by the Association of Philippine Orthodontists (APO). The APO is a specialty organization founded in 1980 to promote and encourage high standard of excellence in orthodontic treatment and education. It created the Philippine Board of Orthodontics, which is recognized by the Board of Dentistry of the Professional Regulations Commission, to accredit orthodontic specialists in the Philippines.