Orthodontics is the branch of dentistry that corrects teeth and jaws that are positioned improperly. Crooked teeth and teeth that do not fit together correctly are harder to keep clean, are at risk of being lost early due to tooth decay and periodontal disease, and cause extra stress on the chewing muscles that can lead to headaches, TMJ syndrome, and neck, shoulder, and back pain. Teeth that are crooked or not in the right place can also detract from one’s appearance. The benefits of orthodontic treatment include a healthier mouth, a more pleasing appearance, and teeth that are more likely to last a lifetime.

Why orthodontics matters (beyond aesthetics):

• Oral hygiene: Straight teeth are easier to brush and floss effectively.

• Tooth longevity: Properly aligned teeth distribute bite forces evenly, reducing wear and fracture risk.

• Gum health: Crowded teeth create hard-to-clean areas where periodontal bacteria thrive.

• Digestion: Proper chewing breaks down food more effectively.

• TMJ health: Correct bite reduces muscle strain and joint pain.

Types of orthodontic treatment:

1. Traditional metal braces:

• Stainless steel brackets bonded to teeth, connected by archwires.

• Elastic ties (colors available).

• Treatment time: 18–30 months.

• Most effective for severe crowding, rotation, and complex bite issues.

2. Ceramic braces:

• Tooth-colored or clear brackets.

• Less noticeable than metal.

• Slightly more fragile and expensive.

• Treatment time similar to metal.

3. Clear orthodontic aligners (e.g., Invisalign, ClearCorrect):
Clear orthodontic aligners can straighten a dental patient’s teeth without the wires and brackets of traditional braces. The aligners consist of a sequence of clear, removable trays that fit over the teeth to straighten them. Each tray must be worn by the patient for a specified amount of time — usually around 20 hours a day for two weeks — before the patient can progress to the next tray. In most situations, the aligners can straighten teeth in anywhere from six to 18 months.

Clear orthodontic aligners are suitable for patients with mild or moderate crowding, or minor spacing issues. They may not be appropriate for patients with severe crowding or spacing. While the aligners can correct a mild malocclusion, patients with severe underbites, overbites, or crossbites may require more advanced orthodontic treatment.

Unlike traditional braces, the trays can be removed for brushing, flossing, and eating. Because the trays are clear, patients can undergo this type of orthodontic treatment without the usual discomfort associated with regular braces.

Lingual braces (hidden behind teeth):

• Brackets attached to the back (tongue side) of teeth.

• Completely invisible from the front.

• More difficult to clean and adjust.

• Higher cost and longer treatment time.

Malocclusion types (bite problems):

Statistics:

• The American Journal of Orthodontics and Dentofacial Orthopedics (2018) reports that 75% of adults could benefit from orthodontic treatment, yet only 20% currently seek it.

• Approximately 4 million people in the U.S. wear braces at any given time (1.5 million adults).

• Clear aligner treatment has grown by 500% over the last decade.

Treatment duration by age:

• Children/teens: 12–24 months

• Adults: 18–36 months (bone remodeling is slower)

• Mild cases with aligners: 6–12 months

Retention (critical phase):
After active treatment, retainers (fixed or removable) must be worn indefinitely to prevent relapse. Without retention, 50–70% of patients will experience significant relapse within 10 years.

References:

• Proffit, W.R., et al. “Contemporary Orthodontics.” 6th ed., Elsevier, 2018.

• Buschang, P.H., et al. “Clear aligners: a review.” Am J Orthod Dentofacial Orthop, 2015.

• Little, R.M. “Stability and relapse of mandibular anterior alignment.” Semin Orthod, 1999.