If you or your child need braces, it's good to know that there are a number
of alternatives and advances when compared to 'traditional' metal
braces. Braces are more comfortable and easier to maintain than ever
before, and there are near invisible options you can now choose from
including ceramic braces. "Traditional" stainless steel braces are smaller than ever, and are still usually the most efficient and cost-effective method of aligning teeth.
The wires we use now are often made from newer materials such as copper-nickel-titanium, and they offer excellent flexibility, lower forces and so are much gentler than stainless steel wires.
Ceramic braces are like metal braces, but are made of porcelain, so they are more transparent and tooth coloured, and the braces themselves usually blend in with your teeth and can be close to invisible.
Children or teenagers who have crowded teeth due to a narrow maxillary dental arch
may require some expansion. An expansion appliance is placed on the teeth in the upper jaw to make sufficient space for the teeth. An expansion appliance can be removable (slow maxillary expansion appliance) or it can be cemented in place for more rapid results (rapid maxillary expansion).
While braces are ideal for children over ten years old, palatal expansion is often used a few years earlier while the jaw is still developing.
A palatal expansion appliance is often used for three to six months after the initial fitting, and the appliance is adjusted daily or weekly, depending on the type.
After a few weeks, little gaps between the front teeth may be apparent and this the sign that the jaw is expanding correctly. The expander is then left in for a few months to ensure your child is comfortable and the widening remains. We will of course, keep a close eye on progress and please call us on (08) 8945 4844 if your child has an expansion appliance, and you've any questions.
A simple removable appliance may be used to fix a simple problem from the age of 6 to 7 onwards. An example is an anterior cross bite, where a top front tooth bites behind the botton front tooth. ie the bite is "back to front". Treatment with this type of appliance usually only takes 3 to 4 months if the appliance is worn properly.
Slow maxillary expansion appliances come into this category, as do devices to help stop thumb or finger sucking.
Retainers are used in all patients to hold the teeth in their new position. Teeth are most likely to move in the first 12 months after braces, and while the patient continues to grow.
Retainers can either be fixed or removable. Removable retainers can be made of hard coloured or clear acrylic (Hawley appliance) and look like a plate, or be made of thin heat moulded plastic and look like a thin mouthguard.
A bonded retainer is a thin wire that is fixed and bonded behind the teeth, where it can't be seen. It can remain in place for several years.
Removable retainers need to be worn for 8 to 12 hours a day every day (usually at night) for at least 12 months. Patients will be seen at least once every 6 months.
Over time the retainer wear can be reduced to a few nights a week, before stopping altogether. The longer patients wear retainers, the more stable the result will be in the longer term.
In some children and teenagers, especially those with a small lower jaw, it may be possible to modify forward jaw growth either to make more space for the teeth, or to improve lower jaw growth in a favourable way. This can done with the use of functional appliances which may be a type of removable appliance. Many of these appliances incorporate an expansion device to make the jaw wider.
One of the most popular and best tolerated is the "Clark Twin Block". It enables the child to open and close normally but in a forward position, to encourage forward growth of the lower jaw, but perhaps also repositioning forwards of the jaw joint.
Not all growth issues can be corrected with functional appliances, but sometimes their use can reduce the need for braces or even jaw surgery.
These appliances only work in growing children.