Articles

stock photo young couple at beach with beautiful smile

When it comes to getting a great smile, extreme makeovers have captivated the nation's imagination. The problem: They're just that—they're extreme.

For most American adults, careful orthodontic and dental treatment can create a beautiful, healthy smile. Forget the treatments you've been seeing on TV reality shows, which appear to create a speedy change and high-quality result. Things aren't always as they appear.

The long-term effects of those treatments can be periodontal problems and tooth decay, followed by a lifetime of intense maintenance and a variety of unintended consequences. If teeth are too big or too small, an extreme makeover might recommend veneers. With veneers, the teeth are literally filed down - an irreversible process. Under ideal circumstances, veneers last between 10 and 15 years. For someone in their 20s, veneers will have to be applied between three and four times. Each time the veneers are changed, the tooth structure is further reduced, potentially leading to severe problems.

As an alternative, patients are turning to orthodontics rather than the more invasive cosmetic dentistry treatments. For example, by aligning and bleaching the teeth, patients can enjoy the same aesthetic results they would get with veneers. As a result, their teeth look more natural, are healthier and are ready to last a lifetime. There are many orthodontic options available in the market today, at a wide range of prices and suitable for a myriad of dental challenges. And best of all, most new technologies work behind the scenes. Only you and your orthodontist have to know.

A Taste of the Technologies

These days, getting your teeth straightened doesn't mean you must sport a mouthful of metal for years to come. Major recent advances in orthodontic technologies have made it possible to straighten teeth, without the aesthetic distractions of traditional braces. Each treatment choice has its pros and cons, since not every technology will work for every patient.

Ceramic Braces - Ceramic braces are placed on the front of the teeth, as with traditional braces. But because they are ceramic, they "blend in" with your smile. This option costs slightly more than typical braces but they come with some potential pitfalls. First, the brackets fracture more easily than their metal counterparts, causing more maintenance. In addition, the ceramic material introduces some friction in the brackets, which can slow down treatment. For example, if the upper front teeth cover the lower teeth, ceramic brackets can wear grooves on the inside surfaces of those upper teeth.
Invisalign - With these systems, a series of thin aligner trays are worn over the teeth. The trays are ideally worn between 20 and 22 hours per day, removing them only for eating and for dental hygiene. Because the patient can take out the trays, these systems work well for people with periodontal health issues, as well as for vegetarians and others who eat a great deal of food items that are not "braces-friendly". Aligners also work well for short treatment plans that run between four and nine months, treating mild to moderate crowding or spacing of teeth.

Understandably, there are several drawbacks to tray-based systems. First, aligners are not effective for major tooth movements. They simply cannot provide the precision orthodontists need to create the best results in all cases. In addition, if the patient fails to wear the appliances for the required 20 to 22 hours per day, they may regress all the way back to square one. This lack of wearing can make treatment extend for months and months beyond the original projections. Because of this, tray-based systems are not the best option for patients who require more than 12 months of treatment.
Traditional Lingual Braces - These braces have been available for many years. As with standard braces, they employ metal brackets. These brackets are uniform in dimension, meaning they are not customized to fit the teeth of each patient. They are worn on the back of the teeth and are virtually invisible. The technique can create precise, high-quality results from a clinical perspective. At times the brackets near the tongue may be slightly uncomfortable and can mildly, but temporarily affect speech.
Incognito - A relatively new technology, Incognito are attached to the backs of the teeth. Unlike traditional lingual braces, they are 100 percent custom-fitted using digitized models of the patient that are then fitted with virtual brackets in a computer software program... The customized brackets are then printed in wax and cast in a dental gold alloy. A robotic arm then bends an extremely accurate archwire. As a result, the wires fit into the brackets more precisely, resulting in better tooth movement. For patients, there are fewer speech problems and less discomfort than with traditional lingual braces. This is my preferred method - hands down. And patients who have had both traditional lingual braces and Incognito choose the Incognito method every time.

Dentist or Orthodontist?

An increasing number of dentists are offering teeth alignment as part of their menu of services. Many are touting Invisalign, since the dentist simply takes impressions of the teeth and sends these molds off to a lab where the alignment trays are created. This poses a question - can dentists really provide the same care as an orthodontist?

You as the patient, must decide... Most general dentists who offer teeth alignment technologies such as Invisalign participate in a training course that only lasts for a day and a half. In that time, it is absolutely impossible for dentists to gain the expertise that an orthodontist earned over two to three years in specialized training.

Why does this matter? Because straightening teeth is not just about aesthetics. It's about dental health. For the treatment to be successful the teeth must be aligned properly to ensure a functionally accurate bite with strong roots and healthy gums.

When treatment complications arise, a dentist must be able to recognize the negative implications. If that occurs, the general dentist is then compelled to refer the patient to a skilled orthodontist to correct the problem. Therefore, why not go to an orthodontist to begin, thus ensuring the best possible results for the patient?

Of course, with so many options available today, each potential patient should weigh the pros and cons before making a functional and cosmetic smile-changing decision. Above all, do not underestimate the importance of long-term dental health.

Andolino Orthodontics

Articles