Orthodontics

Adult Orthodontics

Want information about adult orthodontic treatment?

Numerous studies in the past 20 years have linked chrnoic (prolonged) malocclusions ("bad bites") with premature wear of the teeth, fractured teeth, bone loss, gum recession, poor esthetics, and worsening temporomandibular dysfunction (TMD).  Malaligned (crooked) teeth can lead to increased difficulty with oral hygiene and inturn lead to decay and gum disease. Fortunately, advancements in orthodontics have made treatment much more user-friendly, allowing adults to continue with their daily routines, singing, playing musical instruments, dining out, dating, and more.  In the US, one out of five orthodontic patients is an adult.

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Dr. Y, Irvine CA, dentist


Can Orthodontic treatment accomplish the same results as they do in children?

Yes.  The physiology of tooth movement in adults is the same as in children.   There are differences, including; 1) lack of jaw growth, 2) denser bone, 3) possible medical conditions or medications that interfere with tooth movement, and 4) possible periodontal disease.  On the other hand, adult orthodontic patients tend to be more cooperative with appliance maintenance and oral hygiene which helps maintain steady progress during the orthodontic treatment.

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Dr. Y, Irvine CA, dentist

How does adult treatment differ from that of children and adolescents?

Since adults do not grow and they often have other dental requirements, the orthodontic treatment is usually only part of the treatment plan.  Also, certain bite problems are skeletal and may require more invasive treatment, including temporary anchorage devices, implants or even jaw surgery.  Adults are not growing and may have experienced some breakdown or loss of their teeth and the bone that supports the teeth. Orthodontic treatment may then be only a part of the patient's overall treatment plan. Close coordination may be required among the orthodontist, oral surgeon, periodontist, endodontist and family dentist to assure that the treatment plan is managed well.  Below you will find the most common attributes that differentiate adult orthodontic treatment from that of children.
Jaw Growth: The width a jaw stops growing between 2-4 years of age, the forward growth of the maxilla (upper jaw) stops at approximately 9 years of age, while the lower arch can continue to grow forward until age 16 in females and 19 in males.  The final growth vector is the vertical, in females continuing until approximately age 16 and in males 19.  Since adults can present with skeletal discrepancies, ranging from mild to severe problems, the treatment in certain instances requires surgery in conjunction with the orthodontic treatment.
Gum or bone loss (periodontal breakdown): Periodontal disease is quite common in adults and involves the loss of bone and gums around the teeth.  In many cases it is inherited, while in others it is acquired due to poor oral hygiene, certain medical conditions or medications.  Part of the presentation of periodontal disease is mild to severe inflammation of the gums which can affect the comfort and speed of orthodontic treatment.  It can be localized to a certain tooth or generalized, involving all the teeth at differing severities.   
The initial stages of periodontal disease begin with gingivitis (inflammation of the gums), with continued poor oral hygiene and possible exacerbating medical conditions can develop periodontitis, which involves the supporing bone and the periodontal ligament that supports the tooth within its socket.  Gingivitis is often reversible, periodontitis in many cases is not and requires more invasive procedures. 
Fortunately, proper occlusion helps present the progression of periodontal disease. 
For some individuals, their dentist or periodontist may need to perform special treatment before, during and/or after orthodontic treatment. Regular follow-up by both the general dentist and periodontist for some patients is required during the orthodontic treatment to help maintain good oral hygiene and healthy bone and gums. 
Worn, damaged or missing teeth: Worn, damaged or missing teeth can make orthodontic treatment more difficult. Teeth may gradually wear and move into positions where they can be restored only after precise orthodontic movement. Damaged or broken teeth may not look good or function well even after orthodontic treatment unless they are carefully restored by the patient's dentist. Extra space resulting from missing teeth that are not replaced may cause progressive tipping and drifting of other teeth, which worsens the bite, increases the potential for periodontal problems and makes any treatment more difficult.

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Dr. Y, Irvine CA, dentist

I have painful jaw muscles and jaw joints - can an orthodontist help?

One of the problems commonly associated with jaw muscle and jaw joint discomfort is bruxing, that is, habitual grinding or clenching of the teeth, particularly at night.  Bruxism is a muscle habit pattern that can cause severe wearing of the teeth, and overloading and trauma to the jaw joint structures. Chronically or acutely sore and painful jaw muscles may accompany the bruxing habit. An orthodontist can help diagnose this problem. Your family dentist or orthodontist may place a bite splint or nightguard appliance that can protect the teeth and help jaw muscles relax, substantially reducing the original pain symptoms. Sometimes structural damage can require joint surgery and/or restoration of damaged teeth. Referral to a TMJ specialist may be suggested for some of these problems.

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Dr. Y, Irvine CA, dentist

My family dentist said I need to have some missing teeth replaced, but I need orthodontic treatment first - why?

Your dentist is probably recommending orthodontics so that he or she might treat you in the best manner possible to bring you to optimal dental health. Many complicated tooth restorations, such as crowns, bridges and implants, can be best accomplished when the remaining teeth are properly aligned and the bite is correct.

When permanent teeth are lost, it is common for the remaining teeth to drift, tip or shift. This movement can create a poor bite and uneven spacing that cannot be restored properly unless the missing teeth are replaced. Tipped teeth usually need to be straightened so they can withstand normal biting pressures in the future.

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Dr. Y, Irvine CA, dentist

My teeth have been crooked for many years - why should I have orthodontic treatment now?

It’s never too late! Orthodontic treatment, when indicated, is a positive step—especially for adults who have endured a long-standing problem. Orthodontic treatment can restore good function.  And teeth that work better usually look better, too. A healthy, beautiful smile can improve self-esteem, no matter the age.

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Dr. Y, Irvine CA, dentist

Is orthodontic treatment affordable?

Patients are finding that braces are more affordable today than ever.  The cost of orthodontic treatment will depend on many factors, including the severity of the problem, its complexity and the length of treatment.  Your orthodontist will be glad to discuss the cost with you before treatment begins.  Most orthodontists have a variety of convenient payment plans.  Often there are combined plans available for parents and children who have treatment at the same time. In addition, many dental insurance plans now include orthodontic benefits.  Dollar for dollar, when you consider the lifetime benefits of orthodontics it is truly a great value.

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Dr. Y, Irvine CA, dentist

I am pregnant and want to begin orthodontic treatment.  Is this OK?

Pregnancy brings on bodily changes that can affect the mouth.  Soft tissues such as gums become much more susceptible to infection. The possible need for x-rays during the pregnancy is not advised.   Discuss this question with your medical practitioner/physician and orthodontist before you start orthodontic treatment.

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Dr. Y, Irvine CA, dentist

What is enamel stripping?  I have never heard of this.  Is this something new?  Is it safe?

This procedure goes by many names: enamel stripping; interproximal reduction; slenderizing; reproximation and selective reduction.  The goal is to remove some of the outer tooth surface (enamel) to acquire more space for your teeth.  The procedure has been used in orthodontic treatment since the 1940s and has been shown to be safe and effective.  Some studies among patients who have had this procedure show that it neither makes teeth more susceptible to tooth decay nor does it predispose patients to gum disease. 

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Dr. Y, Irvine CA, dentist

I see ads for perfect teeth in only one or two visits to the dentist.  Will that give me straight teeth? 

Crooked teeth should be evaluated by an orthodontist so that the most appropriate treatment plan can be suggested.

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