If you are considering straightening your teeth with adult braces, then chances are that you are totally confused by the systems available, and have no idea what the best treatment for you is.
Teeth straightening for adults has become very popular in the last 5 years for one reason - general dentists have started to do the treatment. Previously, you had to go and see a specialist, and this put a lot of people off. Systems like Invisalign started the big shift, and more recently systems like 6 month smiles, C-Fast and Quick Straight Teeth have become very popular due to the speed of treatment which is offered.
I hope to help you cut through all the hype with these systems, and help you make the right decision when it comes to choosing the right treatment option.
Broadly speaking, adult braces can be split into three categories, you can have fixed braces on the outside of your teeth, fixed braces on the inside of your teeth, and removable braces which include the invisalign type of braces.
After treating many, many patients in all systems, I can say that any fixed brace will always give you a better result, and quicker result than a removable brace. Removable braces also struggle to move the whole tooth, so if there is a space that needs closing, removable braces will tip teeth into the space, where as a fixed brace will move the tooth, and keep it upright, which gives you a better end result
Any brace system works on the simple fact that if you put a force on a tooth, then the position of that tooth will move, (simple, right?). I would also forgive you in thinking that the harder the force, the quicker things will move, but this is the exact opposite of what happens, in fact putting too much pressure on the tooth can slow it down, and even cause some permanent damage to the tooth. The reason for this is that too much pressure kills the bone around the tooth!
So now, I hope your thinking: “If the new braces like six month smiles don’t put too much pressure on the teeth, then how do they achieve quicker results?” The answer to this is that its all just clever marketing - all systems which have a bracket and wire system will move teeth at pretty much the same rate, the difference is in what is done in terms of the treatment. If you do less treatment, then the results will be quicker!
With almost all adult focussed systems (also known as STO: Short Term Orthodontics), like the ones mentioned above, the aim is to just straighten the front teeth - and hardly change the back teeth, and the bite. This is fine, in most cases, and even if you had a comprehensive brace treatment, this would be the first thing which is done. The difference between this and comprehensive treatment is that comprehensive treatment will aim to achieve an improvement in the bite relationship, and in theory, the end result should be more stable… I will come back to this a little later.
Can everyone be treated with STO braces? No. I think that most people can be treated with STO, and the end result will be a dramatic improvement in a short period of time, however it is not for everyone.
So how do you know if its a good option for you? Ultimately, the best answer for this will be given by a dentist, or an orthodontist who has experience in this treatment. Here are a few things that STO will struggle with:
1. Reducing an overjet
Overjet is how far in front the top teeth are, in relation to the lower teeth, an example of a large over jet is:
If this is something that you are looking to improve, then you might need to look at removing two upper side teeth so that there is room to move the front teeth back. STO will not do this.
2. Severe crowding.
Crowding is the term us dentists use to describe how much tooth overlap there is. To get an idea of crowding, it's easier to look at a birds eye view of the teeth.
In this photo, you can imagine, the horseshoe shape of the dental arch needs to expand so that the teeth have enough room to line up straight. If the crowding is beyond a certain point, then there may not be enough bone to straighten the teeth out, and there is a risk that the teeth are slightly moved out of the bone- this sounds worse than is actually is, but it can cause gum problems at a later date. Again, in these situations, it's usually a better idea to remove some teeth to make some room.
3. Open bites
Open bites are where the front teeth do not overlap, when the back teeth touch, as in this photo:
Open bites can be closed, but they are usually beyond what short term orthodontics can do.
Saying all of this, Short Term Orthodontics is a great solution for most adults, I would estimate about 70-80% of adults would be suitable for this treatment, and combining the dramatic results with short treatment times, its definitely worth asking your cosmetic dentist about it.
Keeping your teeth straight
About half the patients I treat have had brace treatment as a teenager- so why do they need it again?! Its all to do with something called retension.
When a tooth is moved, then it will want to move back to its original position once the brace is removed. To stop this happening most children will be given a clear retainer which looks similar to the invisalign brace. The problem is that they don't were it!
For this reason, I advise having a thin metal wire permanently placed to the back of your teeth, so its not visible, and this stays on forever. In addition, I advise a removable retainer to be worn every night for the first 6 months. All this is because my patients go through a lot of treatment to get the smile they want, and often want to do everything possible to keep the results!
In theory, you could remove the retainers after several years, and the teeth should stay where they are, but most people get used to the retainers after a few days, and it does not bother them to keep wearing the retainers.
Recently I have seen orthodontic systems advertised to dentists saying that "minimal retension needed." I do not believe any STO system can be made with "minimal retension," they all need the same amount of retention.