Malocclusion

Malocclusion - What it is

People have their teeth straightened for a variety of reasons. These include:

Improving facial appearance
Improving speech and/or chewing function
For dental health

Dental health is the most important reason to have braces made as poorly aligned or crooked teeth are difficult to keep clean. They often give rise to decay and gum problems. For most people, orthodontic treatment with braces is an elective procedure. It is rare that teeth will be lost if treatment has not started.

There is no age limit for orthodontic treatment – adults can benefit from it too. There are alternative solutions to orthodontic problems. These are prosthodontic treatments using tooth veneers, crowns, bridges or dentures or no treatment at all. The orthodontist will discuss the risks and benefits of each alternative with you.

Malocclusion - Causes and Risk Factors

Although many cases of malocclusion are inherited, there are some conditions or habits that may alter the alignment of the teeth. These include:

prolonged use of a pacifier or bottle feeding in early childhood
thumb sucking in early childhood
injuries that result in the misalignment of the jaw

Malocclusion - Treatments

There are many different types of braces, each suited to a particular type of problem. The best type of brace for you will be advised by the orthodontist depending on your teeth and your personal needs.

1. Fixed Braces

Fixed braces are small attachments called ‘brackets’ that are attached to the front of each individual tooth with a special adhesive, linked together by orthodontic wires. These attachments can be made of metal or a tooth-coloured material like porcelain (ceramic). Manyteenage patients choose vibrant colours to customise their metal braces.

Self-ligating braces incorporate features (innovative ways of holding the wire in place) to help the teeth move more smoothly and so make treatment quicker.

Fixed braces treatment for malocclusion available at National Dental Centre Singapore.

2. Invisible Aligners

Clear aligners are clear removable braces which gradually straighten teeth when worn all the time. They are virtually unnoticeable and are good for less severe cases. These aligners are usually worn full time and removed when eating and brushing. The aligners move your teeth gradually and are changed every two weeks until its completion.

Invisible braces treatment for malocclusion available at National Dental Centre Singapore.

3. Lingual Braces

Lingual braces are fixed braces which are attached to the back of the teeth rather than the front. This means they are truly invisible so you can continue to smile with confidence throughout treatment.

As lingual braces are not visible, they are ideal for adults or older teenagers who are concerned about the appearance of traditional fixed braces. Lingual braces are invisible when the patient smiles.

Your orthodontist is the best person to recommend the bracing system best suited to your lifestyle and malocclusion.

Lingual braces treatment for malocclusion available at National Dental Centre Singapore.

Retainers After Treatment

After your orthodontic treatment is finished, you will need retainers to hold your teeth in their new positions. Your orthodontist will prescribe the retention plan that is best for you. To avoid the risk of late crowding in adult patients, it is often prescribed that they usually sleep with their retainers on for the rest of their lives, if they want their teeth in perfect alignment.

Orthodontic Treatment : How Long Does It Take?

Orthodontic treatment with fixed braces generally takes two to three years. The braces are fixed permanently on the teeth until the completion of treatment. You need to visit your orthodontist regularly (four to eight weeks interval) for treatment follow-up. For a successful outcome, you need to maintain good oral hygiene by brushing regularly, especially after every meal and snack. To do that, do remember to bring a travel toothbrush with you when you are not at home and avoid eating hard, sticky foods.

Orthodontic Treatment: What are the Outcomes of Treatment?

Outcomes of braces/orthodontic treatment can be measured through objective assessment of the degree of improvement achieved using the Peer Assessment Rating (PAR). PAR is a widely accepted orthodontic index that is designed to evaluate improvement in alignment and positioning of teeth and jaws.

Scores are assigned to the pre- and post-treatment states, reflecting the deviation from an ideal alignment and bite for the patient. The difference in pre- and post-treatment scores will indicate the degree of improvement. A higher percentage difference reflects a higher degree of improvement in alignment and bite. As patient outcomes may be influenced by many factors, it has been recommended that 75% of completed cases should exhibit an improvement greater than 70%[1].

In NDCS, PAR is tracked on a yearly basis based on a sampling of cases. Results show that at least 90% improvement is achieved in 100% of completed cases evaluated. Year-on-year average is tabulated below.