Lasers may help to reduce pain in orthodontic treatment: but more high quality research is needed

orthodontics-4Pain is usual during orthodontic treatment, especially when a brace is placed on the teeth. Later adjustments of the brace can also result in pain, sometimes lasting up to a week or more. This can make people stop their orthodontic treatment, meaning that the benefits are lost. Painkillers have been recommended to reduce pain, but an effective non-drug solution would lower the risk of side effects and help people follow the full course of treatment. Continue reading

Retaining tooth position after orthodontic treatment

Retention proceduresOnce people finish having their teeth straightened with orthodontic braces, the teeth will tend to get crooked again. Orthodontists try to prevent this by using different retention procedures. Retention procedures can include either wearing retainers, which fit over or around teeth, or stick onto the back of teeth, or by using something called ‘adjunctive procedures’. Adjunctive procedures either change the shape of the contacts between teeth, or involve a very small procedure to cut the connection between the gum and the neck of the tooth. This is an update of a Cochrane review published previously in 2006. Continue reading

Additional, non-surgical treatments for accelerating tooth movement in dental patients being treated with fixed braces

iStock_000063907725_SmallThroughout the world, orthodontic treatment is used to correct the position of teeth in adolescents and adults when they experience problems. Braces are orthodontic appliances made up of brackets glued to the teeth and then connected by wires in order to exert pressure on the teeth to move them and improve their positioning. Depending on the problem, the length of time for treatment may range from several months to several years. However, on average, most treatments take around 24 months. Accelerating the rate of tooth movement may help to reduce the length of time needed for a course of treatment and may reduce the unwanted effects of orthodontic treatment that can sometimes occur, such as tooth decay and the shortening of the tooth root. Several methods, including surgical and non-surgical treatments, have been suggested to accelerate orthodontic tooth movement. The evidence relating to non-surgical procedures to accelerate orthodontic tooth movement is assessed in this review. Continue reading

Surgery could speed up tooth movement in orthodontic treatment

OrthodonticsOrthodontic treatment (use of braces) is lengthy, typically taking over 18 months to complete, with brace adjustments required every six weeks or so. Usually brace treatment is carried out without the use of surgery. However, reduction of orthodontic treatment duration is highly desirable and special surgical procedures have been proposed to speed it up. This surgery may work by stimulating cells adjacent to the teeth or by reducing the resistance presented by the supporting bone and mechanically shifting teeth. These surgical procedures are relatively new and may carry additional risks compared to standard treatment. Continue reading

Breaking the habit: long-term dummy or pacifier use may be prevented by braces

PacifierOften babies and children develop a habit of sucking objects to comfort and calm them. They frequently suck dummies (known as pacifiers in the USA), fingers, thumbs or other items like blankets. Eventually, most children grow out of the habit, or stop due to encouragement from their parents. Some children, however, continue sucking as a habit. If they continue to do so as their adult teeth start to grow through (around the age of six), there is a risk that these adult teeth will grow into the wrong position causing them to stick out too far or not meet properly when biting. As a result these children often need dental treatment to fix the problems caused by their sucking habit. Possible treatments to help children break their sucking habits examined in studies in this review include the use of two different braces in the mouth; giving advice and incentives for changing behaviour (known as psychological advice/treatment); applying a bitter, nasty tasting substance to the children’s thumbs/fingers or combinations of these treatments. None of the studies included looked at barrier methods, for example the use of gloves or plasters or withdrawal of dummies. Continue reading

Orthodontic treatment for correcting posterior crossbites

Crossbite

Photo copyright Giorgio Fiorelli

Posterior crossbite is when the top back teeth bite down inside the bottom back teeth. It occurs when the top teeth or jaw are narrower than the bottom teeth and can happen on one or both sides of the mouth. The condition affects between 1% and 16% of children who only have their baby teeth. Most posterior crossbites (50% to 90%) remain even when the permanent teeth erupt. In a minority of children, the problem self-corrects.

In order to obtain a more comfortable bite, the lower jaw shifts to one side into a position that allows more teeth to come into contact. However, this shifting of the lower jaw may lead to tooth grinding, and this may lead to other dental problems including the tooth surface being worn away, abnormal growth and development of the teeth and jaws, and jaw joint problems.

Therefore, we need to find safe and effective treatments to correct posterior crossbites or expand the top back teeth, or both. One way of doing this is using orthodontic treatments. This can be more effective in children because the two halves of the roof of the mouth have not fully joined yet, so the top back teeth can be expanded more easily. Orthodontic treatments can also be used to treat posterior crossbites in adults, but they are more likely to need surgical treatments, which are not the focus of this review. Continue reading

Anchoring braces with dental implants or other surgical methods

shutterstock_126467393Orthodontic treatment is used to correct the alignment of teeth that are crooked or sticking out by moving the affected teeth. The teeth are straightened by using a brace. Sometimes there is unwanted movement of other teeth during the treatment. This is controlled by what is known as anchorage, or methods for stabilising these teeth. Conventionally, anchorage sites are inside the mouth (intraoral) using teeth for example, or alternatively outside the mouth (extraoral), using headgear devices attached to the head or neck. As an alternative to these conventional methods, surgical techniques have been developed to put dental implants into bone in the mouth to provide a firm structure for anchorage. This research reviews the evidence on these methods to find out which is most effective for anchorage in orthodontic treatment. Continue reading