OUR TREATMENT
We offer a range of orthodontic treatment options for people of all ages, including fixed and removable appliances based on the best science and technology available. Your comfort and concerns are a priority to us, as is achieving a great result as efficiently as possible.
For most people the best time to have orthodontic treatment is during early adolescence. By then most, if not all, of the permanent teeth will be present, and we can use the adolescent growth spurt to our advantage.
Early treatment is used if we think it will:
- Eliminate the need for further treatment
- Simplify treatment later
- Prevent damage to the teeth/gums
- Improve a child’s confidence if they are being teased about their teeth
It is generally a short course of treatment (6-8 months) aiming to address 1-2 issues only. Early treatment might include partial braces, removable plates, or fixed jaw expanders.
While there are only a few instances in which we recommend early treatment, we still love seeing kids between 8-10 years if possible. This allows us to meet your lovely children and they can grow comfortable attending our practice. We love seeing their wee personalities develop over the years as we review them. They’re more likely to appreciate our (pretty lame) jokes at that age too.
At these preliminary visits we are mostly screening for
- Missing teeth
- Impacted teeth
- Damage (usually soft tissue) resulting from a poor bite
- Early crowding
- Jaw/bite relationships
- Oral hygiene and caries experience
- Chalky teeth/enamel hypomineralization
- Habits which may be affecting the teeth/jaws
- Trauma
We can often give you an indication of the likelihood that treatment will be required long-term which gives you plenty of time to plan financially.
Having early treatment doesn’t always eliminate the need for a second phase of comprehensive treatment during adolescence so the benefit does need to be carefully considered.
The situations that may require early intervention include:
Cross-bite
Cross-bites usually involve either the back teeth – due to narrow upper jaw or the front teeth – due to a shorter upper jaw, longer lower jaw, or single displaced teeth. Cross-bites can cause the lower jaw to shift when closing due to interference from the opposing teeth – this is called a functional shift. Long-term issues if left untreated may include abnormal growth of the jaws or unwanted tooth wear.
Functional treatment
A common malocclusion is a smaller lower jaw relative to the upper jaw. This can result in the upper teeth appearing to stick out which can affect children’s confidence if they are being teased at school. Functional appliances are designed to position the lower jaw forward while restraining the forward growth of the upper jaw – essentially helping the lower jaw catch up and often eliminating soft tissue influences like a lower lip trap. These appliances instantly improve the profile, however, they still rely on favourable growth for the benefits to remain long-term. Therefore, they are best used during peak growth periods. Twin-blocks are an example of a functional appliance. They are very popular, effective, and simple to use. They consist of upper and lower removable plates worn for 9-12 months followed by a similar length period with braces and elastics.
Space maintainers
When deciduous baby teeth are extracted prematurely, the adjacent teeth often tip or drift into the space, complicating the eruption of the permanent tooth/teeth. A variety of space maintainers are available – they can be fixed or removable. If we place a space maintainer, we will continue to monitor your child until the permanent tooth/teeth have erupted to assess whether orthodontic treatment is still required.
It’s never too late to come and have a chat about creating the smile you always wished for. It is more common now than ever to meet adults who have made the decision to have orthodontic treatment. We appreciate that everyone is unique, with differing lifestyle demands, priorities and budgets. We can work together to find the best option for you.
Adult treatment can be more complicated due to previous dental work and pre-existing issues with gum recession and bone loss. There are also some medications that affect tooth movement. We will advise you whether any of these complications apply to you.
Collaborating with dentists and specialists to provide a full mouth rehabilitation can be challenging but also extremely rewarding. We welcome the opportunity to work with your dentist to care for you.
APPLIANCES
Braces have been used to correct malocclusions (bad bites) for over 100 years. They remain the most common and effective option for straightening teeth and correcting bite issues. These days they are much smaller and the wires we use apply much gentler forces to move the teeth, granting a more comfortable experience.
Metal Braces
Most people have metal (stainless steel) brackets which they jazz up with funky coloured o-rings. The brackets are bonded to each tooth at the first appointment and remain there until the end of treatment. At the adjustment visits it is usually just the wires and o-rings that are changed.
Ceramic braces
Ceramic brackets are essentially tooth-coloured and are therefore a more aesthetic, however, a slightly bulkier option. They are a great option for the upper front teeth in patients that are self-conscious about having metal braces. They are not suitable for lower teeth due to being more abrasive than metal braces. They cost a little extra but do not offer any functional advantage over metal braces. These tend to be the most popular with adults.
Aligners
Clear Aligner Therapy (CAT) is a great alternative for people that really don’t want braces but are motivated to improve their smile. Invisalign and Spark are examples of clear aligners. They are a series of custom-made, clear trays combined with tooth-coloured attachments bonded to your teeth, that slowly move your teeth as you change the tray every 1-2 weeks.
If you choose to explore this option, we upload a 3D scan of your teeth and a virtual outcome of what your teeth might look like is created using specialised software. Once we are happy with the proposed movements, the aligners are manufactured overseas and sent to us. We then place the attachments and give you the first few sets of aligners.
As with all appliances, CAT has strengths and weaknesses. There are a number of cases that are much less predictable with this system because we cannot control your treatment quite as precisely as we can with braces. There are, however, specific situations in which they are actually preferable.
The main benefits are:
- Because they are removed for eating there are far fewer restrictions on what you can eat
- It is much easier to clean your teeth, as the aligners are removable
- They are a discrete alternative to braces. They are not completely invisible but very close.
The main issue with CAT is that it relies entirely on patient compliance as they need to be worn 22 hours a day to be effective.
If you are interested in this option, feel free to come and see us to find out whether they would be suitable for you. Sometimes it is possible to combine aligners and braces which might be a good compromise.
Retainers
When braces are removed, retainers are required to hold the teeth in their new and improved position. The first year following orthodontic treatment is the most critical period in terms of retention. At Papamoa Orthodontist we take a “belt and braces” approach, providing you with both fixed and removable retainers. Wires will usually be bonded behind the upper and lower front teeth and removable upper and lower retainers will also be provided. If either retainer breaks it is important that you contact us immediately to arrange a replacement – particularly if it occurs during the first year. It is also important to clean around the fixed wire retainers well to prevent issues with the gums and calculus build up.
SURGERY
Sometimes the upper and lower jaws just don’t fit together. This is usually because one or both jaws are too big or small. In this case, we would be unable to achieve an acceptable result with braces alone and a combined surgical and orthodontic treatment will be recommended. In these cases, we need to wait until growth is complete – usually early adulthood, however, we would engage the input of and work together with an oral and maxillofacial surgeon early.