Orthodontics

Orthodontics is a branch of dentistry that diagnoses, prevents and treats dental and jaw disorders. Orthodontics aims not only to correct the teeth aesthetically, but also to improve healthy chewing, speech and respiratory functions by positioning the jaw and teeth correctly.

Orthodontic treatments provide relief from many problems such as crowded teeth, incompatibility between the upper and lower jaw, tooth gaps, teeth clenching and jaw joint disorders. These treatments include different methods such as braces, clear aligners (such as Invisalign), jaw expanding appliances and orthognathic surgery. Orthodontics is a treatment area that can be applied not only for children and adolescents but also for adults. Orthodontic treatments started at an early age help to guide jaw development, while orthodontic treatments performed in adults ensure that the teeth are placed in the correct position and dental health is maintained in the long term.

Orthodontic treatment involves the application of various appliances and treatment methods to correct irregularities in the jaw and tooth structure. Conditions such as crowded teeth, incompatibility of the upper and lower jaw, bite disorders (malocclusion), excessive gaps between teeth and irregularities in jaw development can lead to both aesthetic and functional problems. Disturbances in the jaw structure not only affect the appearance of the teeth, but can also cause problems in basic functions such as chewing, speaking and breathing.

Such structural disorders can worsen over time and lead to serious health problems such as tooth wear, jaw joint disorders (TMJ), gum disease and tooth loss. For example, food debris can accumulate between crooked teeth, which can lead to tooth decay and gum infections. Likewise, a mismatch between the upper and lower jaw, especially if there is a severe malocclusion, can negatively affect a person's chewing function and lead to pain in the jaw joint, jaw locking or headaches.

Various orthodontic treatment methods can be applied to correct these disorders in the jaw and tooth structure. Methods such as traditional braces, transparent aligners (such as Invisalign), lingual braces, jaw expanding appliances, functional orthodontic appliances and orthognathic surgery (jaw surgery) are determined and applied according to the patient's condition. While such disorders can be corrected more easily in childhood and adolescence, the treatment process may be longer in adults as the teeth and jaw bones become harder.

How is Orthodontics Treated?

Orthodontic treatment consists of a series of methods applied to ensure the correct alignment of the teeth and jaw, correct crowding, guide jaw development and eliminate bite disorders. The treatment process is shaped depending on the age of the individual, the degree of defects in the tooth structure and whether the jaw development is complete or not. Orthodontic treatments initiated during childhood and adolescence usually give faster and more effective results because the jaw bones are still in the developmental stage. In adults, on the other hand, since tooth movements occur more slowly, the treatment period may take a little longer and in some cases, additional interventions such as jaw surgery may be required. Orthodontic treatments are applied using different methods such as traditional metal or clear braces, clear aligners (such as Invisalign), jaw expanding appliances, functional appliances and orthognathic surgery. The patient's compliance with the treatment, regular check-ups and attention to oral hygiene are among the factors that directly affect the duration of treatment. A properly planned and regularly followed orthodontic treatment provides great benefits not only in terms of aesthetics, but also in terms of chewing function, speech and general oral health. The orthodontic treatment process consists of several stages:

1. Examination and Diagnosis

Before starting orthodontic treatment, the orthodontist performs a detailed evaluation of the teeth and jaw structure. In this process

• An intraoral examination is performed.
• Panoramic and cephalometric x-rays are taken.
• Digital scans and measurements are taken.
• A personalized treatment plan is created by analyzing the tooth and jaw structure.

2. Determining the Treatment Plan

• Depending on the condition of the patient's orthodontic problem, the treatment method to be applied is determined.
• Clear aligners (Invisalign) may be preferred for mild disorders.
• Metal or transparent braces can be applied for moderate and severe crowding or bite disorders.
• Jaw expanding appliances can be used in patients with jaw incompatibility.
• In severe jaw disorders, jaw surgery (orthognathic surgery) may be required.

2. Orthodontic Treatment Methods

Orthodontic treatment can be done with different methods according to the needs of the patient.

1. Orthodontic Treatment with Braces

Braces are one of the most commonly used methods in orthodontic treatment. They are used to straighten crooked teeth, correct bite disorders and align teeth.

Types of braces are as follows:

Metal Braces:

• The most durable and effective orthodontic treatment method.
• Brackets made of stainless steel are adhered to the front surface of the teeth and aligned by applying pressure to the teeth with the help of a wire.
• It is widely used for children and young patients.

Clear or Ceramic Braces:

• They have a more aesthetic appearance than metal braces.
• It is often preferred by adult patients because it is close to tooth color.
• They are slightly more sensitive than metal braces and treatment time may be longer.

Lingual Braces (Internal Braces):

• Placed on the inside of the teeth, invisible from the outside.
• It is aesthetically advantageous, but the process of getting used to it may be longer because the tongue touches it.
• They are generally suitable for adults.

2. Transparent aligners (Invisalign and Alternatives)

• Clear aligners are an aesthetic orthodontic treatment option that can be attached and removed from the teeth.
• They are invisible and ideal for those with aesthetic concerns.
• They can be removed while eating, so dental hygiene is easier.
• It is used in mild and moderate orthodontic cases.
• The aligners are changed at regular intervals to gradually straighten the teeth.

3. Functional appliances and jaw expansion devices

Some orthodontic problems can affect not only the teeth but also the jaw structure. In such cases, special appliances are used to guide jaw development.

Removable appliances: Usually used in children and can be worn and removed at certain times.

Jaw Expanders (Palatal Expanders): It is used to widen the upper jaw in patients with jaw stenosis.

4. Orthognathic Surgery (Jaw Surgery)

• In severe jaw disorders, jaw surgery is combined with orthodontic treatment.
• It can be applied if the upper or lower jaw is positioned forward or backward.
• Braces or clear aligners may be required before and after treatment.
• The orthodontist and maxillofacial surgeon work together to create a treatment plan specific to the patient.

3. Orthodontic Treatment Duration

The duration of orthodontic treatment depends on the severity of the patient's problem, age and the method used.

• Treatment of mild crowding and interdental space: 6-12 months
• Intermediate braces treatment: 12-24 months
• Jaw disorders and advanced orthodontic cases: 18-36 months
• During the treatment process, the patient should go for regular dental check-ups and take good care of their braces or aligners.

4. The Process After Orthodontic Treatment: Reinforcement (Retainer Use)

After the orthodontic treatment is completed, reinforcement treatment is applied to prevent the teeth from returning to their old state.

Retainer (Reinforcement Appliance): These are transparent plaques or thin wire-shaped appliances used after braces are removed.

• It helps the teeth to maintain their new position.
• It can be worn continuously for the first few months, then only at night.

5. Things to Consider After Orthodontic Treatment

Pay Attention to Dental Hygiene: During and after orthodontic treatment, it is important to keep your teeth clean by flossing and using an interdental brush.

Keep Regular Checkups: Even after the orthodontic treatment is over, regular dental check-ups will keep your teeth healthy.

Avoid Hard and Sticky Foods: Sticky foods such as hard candies, chewing gum, caramel sweets should be avoided while using braces or braces.

Continue to Use Reinforcement Appliances: The use of retainers should not be neglected to prevent the teeth from returning to their old positions.

Which Problems Does Orthodontic Treatment Cover?

1. Crowded and Cramped Teeth (Malocclusion)

It is a condition where the teeth do not line up properly.

• If the jaw structure is small and there is not enough space for the teeth to fit properly, crowding occurs.
• Crowded teeth increase the risk of caries and gum diseases by making teeth cleaning difficult.
• It can be aesthetically disturbing and can lower a person's self-confidence.

Treatment Method: Metal or transparent braces, transparent aligners (Invisalign), if necessary, tooth extraction to create space in the jaw structure.

2. Open Bite: It is a condition where the upper and lower front teeth do not touch each other during closing. The habit of tongue thrusting, long-term use of pacifiers or bottles can cause this problem. Open bite can lead to chewing and speech disorders (for example, not being able to pronounce the letter "s" correctly).

Treatment Method: Functional appliances, braces, jaw surgery in advanced cases.

3. Deep Bite: It is a condition where the lower teeth are too far below the upper teeth. Deep bite can cause the lower front teeth to press on the palate and cause gum recession over time. It can cause pain in the jaw joint and tooth wear.

Treatment Method: Braces, orthodontic appliances, jaw surgery in some cases.

4. Crossbite: This is when the upper and lower teeth are misaligned, causing the teeth to close against each other. It can be caused by an incorrectly positioned jaw structure. It can cause jaw slippage and facial asymmetry.

Treatment Method: Jaw expanders, braces or clear aligners.

5. Spaced Teeth (Diastema): Excessive gaps between teeth can be caused by genetic factors or lack of teeth. It can lead to aesthetic concerns. It can cause food accumulation and gum disease.

Treatment Methods: Braces, clear aligners or dental veneers (laminate, composite bonding).

6. Underbite or Overbite Retardation / Forward Positioning: It is a condition in which the jaw is positioned forward or backward from normal.

The lower jaw is in front (Class III Malocclusion - Prognathism): A protruding jaw can disrupt facial aesthetics and cause incompatible closure of the teeth. If left untreated, it can lead to jaw joint disorders.

The lower jaw is behind (Class II Malocclusion - Retrognathia): A receding jaw can cause the upper teeth to appear more in front than normal and cause the appearance of "rabbit teeth". It can lead to aesthetic concerns and pressure on the jaw joint.

Treatment Method: Orthodontic appliances (functional appliances) are used for treatment in children. In adults, braces or clear aligner treatment can be applied. In severe jaw disorders, jaw surgery (orthognathic surgery) may be required.

7. Impacted Teeth and Missing Teeth: Some teeth, especially canines and wisdom teeth, may remain impacted. Impacted teeth can cause crowding by putting pressure on other teeth. Some people may have congenital tooth deficiency, which can cause aesthetic and functional problems.

Treatment Method: Extraction or orthodontic replacement of impacted teeth. Implant or bridge applications to replace missing teeth.

8. Temporomandibular Joint (TMJ) Problems

Symptoms can include severe pain in the jaw joint, clicking sounds, jaw locking and headaches. Jaw joint disorders can be caused by incorrect bite, stress, teeth clenching (bruxism) or jaw trauma.

Treatment Method: The jaw closure is corrected with orthodontic treatment. Special night plates are used for the jaw joint. If necessary, physical therapy and jaw exercises are applied.

What are Orthodontic Treatment Methods?

Orthodontic treatment consists of a series of methods applied to ensure ideal alignment of the teeth and jaw, correct crowding and bite disorders. These treatment methods are determined by the patient's age, the degree of defects in the structure of the teeth and jaw, and the duration of the treatment. Orthodontic treatment options ranging from traditional braces to clear aligners, from functional appliances to orthognathic surgery are planned individually.

Tooth crowding, bite disorders and imbalances in the jaw structure do not only create aesthetic problems; they can also negatively affect chewing function, cause jaw joint pain and lead to dental caries by making oral hygiene difficult.

Therefore, orthodontic treatments are of great importance not only for cosmetic purposes but also to protect oral and dental health.

1. Orthodontic Treatment with Traditional Braces

One of the most commonly used methods in orthodontic treatment is braces. Braces are small metal or ceramic pieces that are bonded to the teeth and connected to each other with archwires, allowing the teeth to move to the desired position. Braces are more commonly used in childhood and adolescence, but they can also be very effective for adult patients.

Metal braces are the traditional and strongest type of braces. Made of stainless steel, they provide the fastest straightening of teeth. Due to its high durability, it is one of the most preferred methods to correct large-scale orthodontic problems. However, more invisible alternatives are also available for patients with aesthetic concerns.

Ceramic braces have a more aesthetic appearance than metal brackets because they are produced in a color close to the color of the teeth. They are a more attractive option, especially for adult patients. However, they can be more fragile than metal braces and the treatment time may be slightly longer.

Since lingual braces are attached to the back surface of the teeth, they are not visible from the outside. Although they are aesthetically advantageous, the application process is complicated and the treatment time may be slightly longer. In addition, since it comes into contact with the tongue, it may initially cause some change in the patient's speech habits.

2. Orthodontic Treatment with Clear Aligners (Invisalign and Alternatives)

Transparent aligners are a modern orthodontic treatment method developed as an alternative to traditional braces. These custom-designed aligners are transparent devices that gradually straighten the teeth by applying a specific force to them. Invisalign, one of the most popular clear aligner brands, is custom-made for the patient by digitally scanning the teeth, and the aligners are replaced every two weeks to ensure that the teeth are in their ideal position.

One of the biggest advantages of clear aligners is their aesthetic appearance. Unlike traditional braces, they are almost unnoticeable from the outside because they are transparent. This is an important reason for preference, especially for adult patients. It is also easier to maintain dental hygiene as they can be removed while eating or brushing teeth.

However, for clear aligners to be effective, patients need to be disciplined. It is essential to wear the aligners for at least 20-22 hours a day. If patients do not wear their aligners long enough, the treatment time may be prolonged or the desired results may not be achieved. Furthermore, clear aligners may not be sufficient for some complex orthodontic cases and traditional braces may be a more appropriate option for patients with severe dental crowding.

3. Treatment with Functional Appliances and Jaw Expanders

Some orthodontic problems are caused not only by the alignment of the teeth but also by defects in the jaw structure. In such cases, the jaw structure is corrected by using functional appliances and jaw expanders before or in conjunction with braces treatment.

Functional appliances are usually used in growing children and are designed to correct problems such as a receding lower jaw or a forward position of the upper jaw. These appliances help guide jaw development by retraining the patient's jaw muscles.

Palatal expanders are used to widen the jaw in patients with upper jaw stenosis. They are particularly effective when applied in childhood, because children's jaw bones are still developing. Such devices allow the jaw to expand, allowing the teeth to line up more evenly and can prevent other health problems that may develop due to breathing problems.

4. Treatment with Orthognathic Surgery (Jaw Surgery)

Some severe orthodontic cases cannot be corrected with braces or clear aligners alone. If the upper or lower jaw is severely anteriorly or posteriorly positioned, jaw surgery called orthognathic surgery can be performed to enable the patient to have a functionally healthy chewing and speaking ability.

Orthognathic surgery is usually combined with orthodontic treatment. First, the patient receives preparatory treatment with braces or clear aligners. Then, the maxillofacial surgeon surgically corrects the patient's jaw structure, followed by orthodontic treatment. This process aims to correct the jaw alignment by making permanent changes to the bone structure.

This type of surgery is performed not only for aesthetic concerns, but also to address functional problems such as jaw joint disorders, severe bite problems and breathing difficulties. Jaw surgery is usually recommended for adult patients, because it is not appropriate to perform surgical intervention in children and adolescents before growth is complete.

5. Use of Retainers after Orthodontic Treatment

After the orthodontic treatment is completed, reinforcement treatment is applied to keep the teeth fixed in their new position. Since teeth tend to move over a period of time, it is necessary to use a retainer to prevent the teeth from returning to their original position after orthodontic treatment. Retainers can be applied in two different ways:

Fixed retainer: It allows the teeth to be fixed with a thin wire glued to the back of the teeth.

Removable retainer: They are in the form of transparent plaques and can be worn and removed by the patient.

Retainer treatment is usually applied for a period of time ranging from 6 months to several years. If patients do not use retainers, the teeth may return to their old position over time and all the results of orthodontic treatment may be lost.

Orthodontic treatment differs according to each individual's dental structure and needs. There are many different methods available, from traditional braces to clear aligners, from jaw expanders to jaw surgery. If you think you have crowded teeth or a problem with your jaw structure, you can consult an orthodontist to determine the best treatment plan for you.

How Long Does Orthodontic Treatment Take?

The duration of orthodontic treatment varies depending on the age of the patient, the severity of the disorders in the tooth and jaw structure, the treatment method chosen and the patient's compliance with the treatment. It can usually last between 6 months and 3 years. Mild crowding can last 6-12 months, moderate cases 12-24 months, and more complex jaw disorders can last 2-3 years. In children, the treatment progresses faster as jaw development continues, while in adults it may take a little longer as tooth movements are slower.

The patient's regular use of transparent aligners (such as Invisalign), proper care of braces and orthodontic controls directly affect the duration of treatment. If the brackets break, the wires break or the orthodontic elastics are not used regularly, this can prolong the treatment process. In addition, in advanced cases such as malocclusion, the treatment period may exceed 24 months if jaw expanding appliances, functional orthodontic treatments or jaw surgery are required.

After the treatment is completed, retainers are used to maintain the teeth in their new position. The duration of retention usually varies from 6 months to several years. In some patients, the retainer can be worn at night for life, as the teeth have a high tendency to move. If the retainer is not used regularly, the teeth may return to their original position and the treatment may be wasted.

As a result, mild cases can last 6-12 months, while moderate and severe cases can last 1.5-3 years. It is critical for patients to keep regular check-ups, use orthodontic appliances according to the instructions and pay attention to oral hygiene in order to shorten the duration of treatment. Before starting orthodontic treatment, it is the best approach to consult an orthodontist to learn the estimated duration of treatment for each individual.

What Should Be Considered After Orthodontic Treatment?

After the orthodontic treatment is completed, certain rules should be observed to ensure that the teeth maintain their new position and the treatment is a long-term success. After the use of braces or clear aligners has ended, there is a risk that the teeth will return to their old positions. Therefore, it is necessary to follow important steps such as reinforcement treatment (retainer use), paying attention to oral hygiene, continuing regular dental check-ups and regulating eating habits.

1. Use of Retainers

When orthodontic treatment ends, teeth may tend to return to their old position for a period of time. In order to prevent this, reinforcement treatment (the use of retainers) is necessary. Retainers are appliances that help stabilize the teeth after orthodontic treatment.

Retainer Types:

Fixed Retainer: It is in the form of a thin wire glued to the back surface of the teeth. It is invisible and provides long-term protection. Since it is permanently attached, there is no risk of forgetting it.

Removable Retainer: It is in the form of a transparent plaque and can be inserted and removed by the patient. Especially recommended for use at night. Easy to clean, but regular use is essential.

Things to Consider When Using Retainers:

• It should be worn 20-22 hours a day for the first few months.
• It can then only be used at night.
• It should be used regularly for the period specified by the doctor.
• Care should be taken to clean it, it should be washed with water and disinfected with special cleaners.

If the retainer is not used regularly, the teeth may return to their old position and the entire orthodontic treatment process will be wasted. Therefore, the use of retainers is as important as orthodontic treatment.

2. Taking Care of Dental Hygiene and Oral Care

When braces or clear aligner treatment is over, even though the teeth have settled into their new positions, it is necessary to pay more attention to oral hygiene. This is because, just as extra attention should be paid to oral care during the braces process, these habits should continue after the treatment.

Recommendations for Dental Care After Orthodontics:

• Brushing teeth at least 2 times a day (morning and evening).
• Flossing, because flossing reduces the risk of caries by cleaning the interface.
• Using special mouthwash or fluoride mouthwash recommended by your dentist.
• Visit the dentist every 6 months for scaling and professional care.
• If fixed retainers are used, special attention should be paid to removing plaque and tartar accumulated on the inside of the teeth.

Failure to pay attention to oral hygiene can lead to problems such as tooth decay, gum disease and tartar formation. This may cause the healthy tooth structure obtained after treatment to deteriorate.

3. Regulating Nutrition Habits

After orthodontic treatment is completed, some changes in eating habits should also be made to maintain the health of the teeth. Some foods that should be avoided during braces treatment should also be consumed carefully after treatment.

Foods and Habits to Avoid:

• Hard foods (ice, hard candy, hard nuts such as hazelnuts, almonds) can cause fractures in the teeth by putting too much pressure on the teeth.
• Sticky and sugary foods (such as caramel, chewing gum, Turkish delight) can increase the risk of caries by sticking to the teeth.
• Carbonated drinks and acidic drinks (cola, energy drinks) can damage tooth enamel and cause sensitivity.
• The habit of clenching or grinding the teeth (bruxism) can lead to tooth wear and fracture.

Recommended Foods:

• Calcium-rich foods (milk, yogurt, cheese) protect dental health.
• Vegetables and fibrous foods (such as carrots, apples) contribute to oral hygiene by cleaning the tooth surface.
• Drinking plenty of water helps to maintain the acid balance in the teeth.
• Paying attention to eating habits ensures that teeth remain healthy and orthodontic treatment maintains its long-term effect.

4. Continuing Regular Dentist Check-ups

It is very important to go to the dentist regularly after the orthodontic treatment is completed. After the treatment, the condition of the teeth should be checked at least every 6 months by visiting an orthodontist or dentist.

What to look out for during regular check-ups?

• It is checked whether the teeth have returned to their old positions.
• Retainer (reinforcement appliance) use is evaluated.
• Gum health is reviewed.
• Scaling may be performed.

While these checks ensure that the teeth remain healthy, they also help to diagnose possible problems early. Even if patients do not experience much pain or discomfort, regular check-ups should not be neglected.

5. Things to Consider to Prevent Teeth Regrowth

After orthodontic treatment is completed, there is a risk of the teeth returning to their original position. For this reason, many patients should take precautions against the risk of relapse after orthodontic treatment.

Suggestions to Prevent Teeth from Returning to Their Former Position:

• Retainer use should be continued for the period recommended by the doctor.
• Special night plates should be used for patients who have the habit of clenching and grinding their teeth.
• Cheek and tongue pushing habits should be abandoned.
• Extra attention should be paid to oral hygiene after orthodontic treatment.

Especially the first 6 months are the period of getting used to the new position of the teeth and during this period, the teeth are more likely to return to their old state. Therefore, patients should pay extra attention to the use of retainers during this period.

After the end of orthodontic treatment, certain rules should be followed in order to stabilize the teeth, maintain oral hygiene and ensure the longevity of the new smile. Regular use of reinforcement appliances, attention to oral hygiene, correction of eating habits and regular dental check-ups help the teeth to maintain their ideal position after treatment. After the orthodontic treatment is completed, it is critical for patients to keep up with daily oral care and follow the doctor's recommendations for a long-term healthy and aesthetic smile.

What is the Difference Between Orthodontist and Dentist?

Orthodontists and dentists are specialists in the field of oral and dental health, but their areas of expertise are different. Dentists provide general oral care services such as cavity treatment, fillings, extractions, root canal treatment, gum disease, dentures and teeth whitening. Orthodontists, on the other hand, focus on the correction of crowded teeth, jaw alignment and treatment of bite disorders.

In order to become an orthodontist, after graduating from dental school, 3-4 years of orthodontic specialization training should be taken. In this process, the focus is on advanced treatments such as braces, clear aligners, jaw appliances and orthognathic surgery. General dentists cannot always perform orthodontic treatment; however, they can perform basic orthodontic procedures. For advanced cases such as jaw malocclusion and crowding, an orthodontist should be consulted.

Treatment processes are also different. While dentists offer short-term treatments, orthodontic treatments can last between 6 months and 3 years. Orthodontists provide long-term treatments that gradually straighten teeth and require regular check-ups. In addition, orthodontists also take into account aesthetic concerns, ensuring the correct alignment of the teeth and improving facial aesthetics.