Misaligned Teeth & Braces

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Misaligned Teeth & Braces
Misaligned Teeth & Braces
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Misaligned teeth & braces

It is estimated that around 40 percent of children and adolescents suffer from misaligned teeth, which, if left untreated, can have a long-term effect on quality of life and health. Many misalignments are perceived as annoying, mainly for aesthetic reasons. Most of the time, parents and their children come to the orthodontist. But more and more adults want to catch up on orthodontic therapy they missed in their youth. The difference lies in the fact that in adulthood only misaligned teeth can be corrected, but no undesirable developments in jaw size and position. The child's growth phases must be used for their therapy…

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  • diagnosis
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  • Correction methods
  • Fixed braces
  • Splint therapy / aligners
  • Whom can I ask?
  • How are the costs going to be covered?

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Incorrect dentition can affect both the position of the teeth and the relationship between the upper and lower jaw. With specific measures, the development of malformations in children can be prevented at an early stage. Pre-existing misalignments can ideally be corrected in childhood and sometimes also in adulthood using various methods.

diagnosis

A precise treatment plan must be drawn up prior to any orthodontic treatment. It is the result of extensive analyzes of individual findings that lead to a comprehensive diagnosis. This includes the collection of diseases, family history and habits (pacifier, thumb sucking, etc.) as well as a physical examination inside and outside the mouth, followed by a jaw model analysis. After taking an impression of the upper and lower jaw and holding the bite position using a wax template, models are created from hard plaster, based on which the type and extent of the malocclusion can be determined and measurements can be carried out.

In the case of forced bites (deviations of the lower jaw during the jaw closure due to disruptive tooth contacts) or extensive misalignments in the permanent dentition (especially in adults), a special instrumental functional analysis is also required. X-ray examinations and photo diagnostics (face and mouth photos) are also carried out.

Avoidance of misaligned teeth

Orthodontic early treatment is used when treatment measures to prevent or eliminate habits that damage teeth or in the case of anomalies of the teeth or jaws have to be taken before the age of nine.

It is rarely necessary to start treatment before the age of four. Early treatment focuses on getting rid of habits, as this may make subsequent orthodontic measures superfluous.

The harmful habits include:

  • Thumb or finger sucking, chewing on fingernails, pens, etc.,
  • Dummy,
  • wrong swallowing pattern,
  • Cheek biting and sucking,
  • Lip sucking, pressing, biting,
  • certain speech disorders,
  • habitual (habitual) mouth breathing.

The measures for eliminating habits are diverse and range from bitter substance-containing nail polishes from the pharmacy to prevent thumb sucking and so-called oral atrial plates (individually made devices for the space between lips and teeth) against finger sucking, incorrect swallowing patterns or mouth breathing to speech therapy (speech therapist). If getting used to the habit is not enough to reverse the influence on teeth and jaws, early treatment measures with specially made orthodontic appliances are necessary. In addition, myofunctional therapy (MFT; synonym: orofacial muscle function therapy) can be useful. The chewing, tongue, lip and cheek muscles should be retrained through special exercises,In order to, in the ideal case, effect a correction of tooth position, bite position and jaw anomalies or to influence them favorably.

Correction methods

Not all misaligned teeth can be recognized at first glance by the layperson. Therefore, three orthodontic examinations - at the age of four, eight and twelve years - should be performed. The timely treatment of certain misaligned teeth reduces the treatment time and ensures a stable treatment result.

The typical age for starting orthodontic treatment is between the ages of nine and eleven - for girls, who are usually ahead of boys in development, often after the age of seven. A correction of misaligned teeth is still possible in adulthood. After a detailed recording of the findings, diagnosis and determination of the treatment goal, the treatment method and the necessary aids and equipment can be determined by the orthodontist. A basic distinction is made between removable and fixed appliances (braces), which are sometimes used in combination. Determine the type,Extent and direction of the intended tooth movement (tilting or physical movement) and the objective of influencing growth changes, which treatment apparatus can be used.

During the treatment, frequent controls are necessary in order to be able to check the progress of the treatment and the therapy concept and to change them if necessary. The so-called retention phase follows after the active correction of a misaligned tooth. The tooth position achieved is fixed in the jaw by means of equipment that is not visible from the outside until it no longer changes even without external influence. Depending on the success, this phase takes a few months, sometimes significantly longer. Since it often deteriorates between the ages of around 18 and 20 years, it is often recommended to at least extend the retention phase beyond this time. The duration of therapy depends on the extent of the misaligned teeth and is approximately two to three years.

Fixed braces

In contrast to the removable appliances, the multibracket appliance is firmly connected to the teeth and can only be removed again by the orthodontist. The fixed appliance consists of ring-shaped bands with welded locks and tubes (only on the rear malt teeth) and brackets (on the molars and front teeth), which are glued directly onto the teeth using a special adhesive. The highly elastic, thin wire arches used in the bands and brackets correct the misalignment of teeth through precisely metered forces; In addition, auxiliary parts (e.g. elastic bands, springs, devices to be used by the patient) are used as required.

Since misalignments are usually caused by a combination of tooth misalignments (e.g. lack of space, strong tooth rotations, displacement of individual teeth) and jaw misalignment (e.g. anterior tooth step due to the back of the lower jaw), a combined removable / fixed correction often results. Fixed appliances are mainly used in the permanent dentition in the treatment of misalignments in young people and especially in adults. Partially fixed appliances are often used in combination with removable appliances during the mixed dentition phase.

Benefits:

  • There is practically no tooth misalignment that cannot be remedied with fixed appliances.
  • The treatment time is shortened compared to removable braces.
  • Cooperation on the part of the patient is only necessary to a limited extent or can be completely excluded by appropriate construction of the equipment.
  • Fine adjustment of the toothing is possible by precisely positioning the teeth in the ideal position.
  • Speaking is not hindered (exception: fixed appliances inside).

Disadvantage:

  • Difficult oral hygiene requires great discipline on the part of the patient - if the oral hygiene is poor, fixed braces cannot be used.
  • In some cases, there are restrictions on food intake (avoidance of sticky foods; be careful with hard foods such as popcorn, nuts, bread crusts, etc.).
  • The oral mucosa can be irritated at the start of treatment.
  • With the appropriate predisposition, roots can be shortened.
  • Aesthetic impairment: can be improved by using tooth-colored brackets made of plastic or ceramic if the tooth movements are not too extensive; When using the lingual technique, a special technique with brackets attached to the inside of the teeth, there are no aesthetic impairments.

Splint therapy / aligners

Aligners® (e.g. Invisalign®, Alphalign®, etc.) consist of a series of transparent orthodontic splints that can invisibly correct misaligned teeth. Treatment is done by wearing a series of these transparent splints. Aligners® are made from a thin, transparent film in accordance with the orthodontist's specifications using a modern, computer-aided special process. As a result, the teeth can be straightened without wires etc. Depending on the initial findings, between twelve and 50 splints are required for one treatment. The Aligner® must be worn 22 hours a day and changed every two weeks so that the teeth move in increments of 0.15-0,Straighten 25 mm per aligner up to the end position specified by the orthodontist.

Whom can I ask?

The prevention, detection and treatment of misalignments of the jaws and teeth is the task of orthodontics, a branch of dentistry. In Austria, every dentist is authorized to provide orthodontic services. Some dentists have specialized in orthodontic services, have completed extensive additional training and have many years of experience in this field.

How are the costs going to be covered?

The health insurance carriers assume the costs for treatment on the basis of removable devices for three years, in justified cases even longer after the application has been submitted. The health insurance provider must obtain the assurance that the costs will be covered at the beginning of the treatment and at the beginning of each additional year of treatment (usually by the practitioner). In addition to the tariff agreed between the health insurance carriers and dentists for this service, patients (in the case of children and adolescents usually by their parents) have to pay a subsidy to the contract tariff. Since 2015 the possibility exists in more severe cases (IOTN 4 and 5;Index for assessing the need for orthodontic treatment) to get fixed treatment free of charge from certain contract dentists ("free braces"). In lighter cases or for all other treatments that are not carried out on the basis of removable devices, a cost subsidy is granted.

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