Adult orthodontics is one of my favourite areas within dentistry, because here patients decide for treatment of their own accord, without exception. Therefore, the treatment takes place in a good atmosphere, even though it usually takes relatively long (1-2 years almost without exception). There is no revolt against the treatment and we always have a shared goal. It is important to emphasize that just like in childhood, there is a special significance of thorough planning, so there is no excuse, we need more X-rays (known as OP or panoramic X-ray and full x-ray) and plaster models and photo documentation for the sake of completeness.
Most of the treatments is solved with fixed braces, unfortunately it is rarely sufficient to wirk with removable devices, the so-called invisible orthodontic appliances. Although it is hard to believe, such a procedure often requires greater discipline and co-operation than the one with fixed appliances. Other dental problems, of course, have to be taken care of before we start the treatment – such as tooth decay or gingivitis. There is no age limit, I had the pleasure of having a 76-year-old patient once as well.
And what do we gain with this long treatment? The often very serious problems caused by irregular teeth cease to exist or don’t even develop, and it will be worth again to send a broad smile to the world.
Orthodontics for children
It turned out that adult orthodontics is one of my favorite areas – it is therefore not surprising that working with children is the other one. This one is, however, a much more difficult task. It is hard to imagine a situation where a 7-year-old youngster himself would be walking into my office and ask for a treatment to start in order to reach the the proper chewing function and aesthetics. This is a very hard task, because young humanoids do not believe in what neighbours tell them, nor what relatives or ads. The dentist should give it all to establish good relations and mutual agreement to the full, it is not enough to be professionally prepared and to be maximally polite. They must know all the current tale heroes of that age, football stars, and not only the ones of Barca, but Real as well, and Monster High dolls also, and so on, and so forth. In addition to that, kids grow up, and I should recognise another person every six months on the check-ups. It’s not easy, that’s why I love it. Childhood possibilities of aligning teeth also vary on a very large scale. As the bones continue growing and reshaping, it is possible to influence the development into the right direction with a variety of orthodontic appliances. This isn’t only true for the jawbones and teeth – if we are lucky, we can even get to the muscles affecting development at an early stage, so we’ll have a better starting position.
Until the child is 6, we primarily speak of preventative orthodontics. Early detection and care in many cases prevents the development of more serious dental abnormalities. In most cases I try to solve the issue with a removable brace made of resilient material, that also affects the muscles in the above mentioned way. These are called trainers in the official terminology.
In the early mixed dentition period (between 6-12 years) the most important task is to help the correct replacement of primary teeth. Aim is to ensure the normal development of permanent teeth. During this time it will be visible if we have to count with more or less teeth during the development – normally, the ideal number would be 32. Often canines don’t want to participate in the process and remain stubbornly in the upper jawbone in a variety of acrobatic positions. There are many things to pay attention to in this period as well.
In the late mixed dentition period bone development is approaching completion – this is usually 16 years for girls and around 18 for boys. Of course, this differs by person, but usually this is the time when the era of fixed braces starts. Please note that orthodontic appliances do not respect prom balls, summer festivals and end-of-school photo shoots, so it’s worth addressing the issue in time! 🙂
Primary task of conservation is to cater for cavities and replace damaged tooth parts with foreign substances. If the decay reaches the pulp, then it already means treating it.
I translate: if you get a hole in your tooth, you should go to the dentist asap, otherwise it will be a root canal treatment. Fillings are made through light polymerisation process at the dentist’s. To make Star Wars fans happy, we call this technique the lightsaber method. Here, after cleaning the hole caused by the cavity, filling material is applied into it which then gets irradiated with a photopolymerisation lamp. The light solidifies the layers of filling. With this method the shape and colour of the tooth will look natural. Yeah, the dark side lost!
Root canal treatment removes dead or infected pulp, and the root canals will be filled after cleaning and disinfection. Thus the pain can be eliminated, the retention of the tooth ensured, and further infections prevented. Today, this seemingly torturing, agonizing series of treatment can actually be done without causing any pain. Still, the force be with us! 🙂
Children’s dentistry is a separate universe. Although it is not my area of expertise, it happens many times, that caring parents bring the small ones to try the elevator (the chair) and the laser sword (the polymerization lamp). Of course there are better days when it’s a real joy to play, but I don’t deny it, sometimes there is a little crying, because we can’t camouflage everything to make it seem a bouncy castle. An injection will never be your friend. As with orthodontics, I find it very important that kids get honestly informed about everything so they won’t have bad memories after. If it doesn’t go the first time, then both parent and dentist need to be very patient. And we’ll succeed for sure next time. Or next time…:)
If tooth tissues are irreversibly damaged, missing parts need to be restored to regain full functionality and aesthetics.
Translation: If a large part of a tooth is missing above the gum or worst case, the tooth had to be removed, it is not only ugly, but also makes proper food processing, chewing, eating difficult.
In my experience, it often happens that a back tooth is missing, which is not visible in the shop window, and therefore the majority of patients leaves it like that. In the long run, this also puts the dentist into a difficult situation because the longer the tooth is missing, the harder it can be to replace it. Adjacent teeth can lean towards the gap, opposite teeth can protrude as the poor ones think they should assist in chewing.
If the tooth is broken, it is also worth visiting a professional as soon as possible, so there is still a chance to avoid root canal treatment, or the tooth to break off to such an extent where we can’t avoid extraction.
Prevention, prevention, prevention! Almost nothing can be more important than that.
On the one hand, it is the dentist’s responsibility to provide comprehensive information to the patient. On the other hand, it is the patient’s fault if they do not entirely meet:
- Controls every half year.
- Regular professional oral hygiene treatment – her maiden name is plaque removal.
- Electric or “analog” toothbrush?
- What kind of toothpaste to use?
- Mouthwash? Irrigator?
- How to floss?
During my work I place great emphasis on the “targeted disclosure” of these pieces of information, and I would like to have a deeper look into these topics also on my website from week to week