Orthodontic treatments can be divided into three distinct phases:
- Interception and treatment of decompensation: this step is to correct oral habits, maintain space for permanent teeth and make a palatal expansion to correct the lack of space or to extract teeth. These treatments are not necessary for all patients; we begin this phase at the age of 7-8 years old, only in patients who require correction of the dento-alveolar relation which could lessen the need of skeletal correction.
- Orthopedic treatments: for the alteration of the skeletal environment, it is the phase of the devices that allow us to control bone growth in adolescents. In most cases, this phase starts before puberty (11 years of age for girls and 14 years of age for boys).
- Comprehensive treatment: the last phase is when we put the ‘braces’ or any other system of invisible orthodontics to align all the teeth.
These phases are often continuous in time, with a phase leading immediately to the next one. Some cases are much more complex and may require surgery, but we do not want to go into details, since our goal is to inform you of treatment options.
The best time to begin orthodontic treatments always depends on the patient. Between the ages of 6 to 8, we can begin to predict the pattern of the dento-skeletal growth of the patient. This is when we plan the future steps. If the patient has an obvious lack of space, we try to correct the problem immediately so that the next steps are easier or even unnecessary.
For example: an 8 year old child who still sucks his/her thumb may prevent the normal development of the palate due to the pressure of the finger and create a deep palate, a lack of space and overlapping adult teeth in the future. To counter this, we can make a device that will firstly fix the bad habit while expanding the palate.
In a matter of 6 to 9 months, this treatment will bring the patient to the ideal position for him to growth as he should without needing braces or surgery in the future. In other cases, the patient may not need treatment until the age of 12-13 or even later if we determine that the he or she would respond better to a treatment when his or her oral hygiene habits improve.
There are so many variations between patients that we cannot predict the best time to start treatment without seeing the patients. We recommend an orthodontic evaluation of the around the age or 7, to discuss the facial growth and the different treatment plans. We review our patients every 6 months and reassess the situation after each visit in order to begin treatment at the optimal time.
Nowadays adults are beginning to reconsider the possibility of straightening their teeth. Therefore, as the demand increased, the market adjusted. There are now a multitude of dental realignment systems that are almost invisible. These systems are first and foremost brackets of porcelain or plastic (the color may change a little during treatment).
There are also lingual braces that are less used because the treatment is very complicated for the dentist and we can have more aesthetically pleasing and functional results with other systems.
Recently, a new system of housing has been made available on the market: the Damon-type brackets (Damon 2, 3, Mx, Q). Currently, only the brackets on the front teeth are transparent. The reason we classify them as invisible orthodontics is that treatment time is reduced by about 30% to 50%. So the treatment is slightly compromised on the aesthetic side by the little wire between the boxes, but the patient completes the treatment in 9 to 16 months. The system does not use elastics to hold the boxes to the wire but rather a small door, it takes away the resistance and also reduces the number of appointments required to complete the treatment.
Since early 2011, we use the Insignia system which allows us to accelerate the treatment time by using individualized orthodontic brackets and wires. Imagine a 3D virtual model of your teeth where the dentist can move each tooth individually in three-dimensions to get the optimal result. It is a system that allows precise control of the orthodontic treatments from the beginning until the end to maximize the effectiveness of the treatment.
The ideal occlusion of each patient is modeled in a 3D virtual program which then makes it possible to manufacture brackets and wires tailored to the planned final position of the teeth determined by the dentist. With its computer-aided bracket placement system, this new revolutionary process allows a more beautiful finish and requires fewer adjustments (and therefore fewer visits) during the treatment.
Lastly, there’s the gamut of transparent-shelled devices, best known as Invisalign, which consist of a series of retainers made from semi-rigid plastic replaced every two weeks that allow small-scaled movements. Other systems such as MTM, Red-White-Blue, etc… are also available. These barely visible retainers allow patients to have an excellent oral hygiene and can be removed during meals. Unfortunately these treatments are limited to small movements compared to ordinary brackets but they are perfect for minor corrections in adults.