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1. Introduction

The principle behind orthodontics is to use external force to rearrange the position of the teeth and make them straight. Uneven teeth will not only influence our looks but could also cause more serious problems, such as tooth decay, periodontal disease and temporomandibular joint disease. Orthodontic treatment is a safe and effective way to solve these problems for both children and adults.

2. Illustration of orthodontic procedures and introduction of dentists

Dr.Toshio Ishizuka

Graduateted from Dental Prosthesis at the School of Dentistry, Nagasaki University in Japan.
Over 20years of experience
General Dental diagnosis and treatment including orthodontic and implant treatment.

Dr. Sophia Wang
Active member in good standing of the International Congress of Oral Implantologists.
Active member in good standing of the Chinese Stomatological Association.
Active member in good standing of the Shanghai Stomatological Association.
Continued her study of orthodontics at the "Today is" Dental Clinic in the USA (2009).
An expert in prosthodontics and orthodontic treatments, as well as general dental diagnoses.
Highly skilled in reducing patient anxiety with her gentle and professional manner.

3. Frequently Asked Questions

1)What makes teeth become uneven?

Uneven teeth are generally caused either by congenital genetic factors or by acquired environmental factors, such as disease, poor oral habits, dental abnormalities during the developmental period, or malocclusions like overbite and underbite.

There are a wide variety of factors that can cause uneven teeth, (with heredity usually accounting for about 30%), including the following:

· Poor oral habits (such as finger sucking, lip biting, chewing only on one side, etc.)

· Being born with too many teeth

· Congenital missing teeth

· Premature loss of deciduous (baby) teeth

· Retained deciduous (baby) teeth

· Cleft lip and palate

· Endocrine factors

· Malnutrition

· Vitamin deficiency

· A communicable disease

· Facial hypertrophy psychosis

2)What can we do to help prevent uneven teeth?

Uneven teeth caused by genetic factors cannot be prevented, but potential deformities from acquired factors can and should be prevented. Parents should pay attention to the oral health of their children’s deciduous (baby) teeth, guiding and teaching them how to brush their teeth correctly for example. Secondly, parents need to correct any bad oral habits their children may develop as soon as they become aware of them, such as lip biting and finger biting, also can prevent some malocclusion deformities. Additionally, parents should prepare some chewy food when feeding their children, rather than making all their food too soft. Proper chewing is useful for stimulating healthy jawbone development, and this can also help to prevent uneven or lost teeth.

3)What’s the harm of having uneven teeth?

Firstly, having uneven teeth will be very detrimental to facial appearance, and can make people (both children and adults) feel frustrated and upset, resulting in a loss of self-confidence. Moreover, this loss of confidence may reducing the amount of time a person spends caring for their own personal oral health, which in turn could lead to a greater likelihood of cavities, gum disease and other oral diseases. If these health concerns are not treated in a timely manner, not only will our appearance and confidence suffer, but there is a real risk of adversely affecting our oral health and tooth functioning.

4) What are the different methods used for orthodontics?

The dental appliances (commonly called braces) used for orthodontics treatments can be divided into three categories: removable braces, functional braces, and fixed braces. The majority of clinical patients (approximately 80% to 90%) choose to use fixed metal (steel) braces. Also, if conditions allow, patients can choose to wear clear aligner style braces, which are nearly invisible, and will present a noticeably better appearance.

The most common types of braces are shown below:

5)How long do orthodontic treatments usually last?

Orthodontic treatments can be broadly divided into two phases: the treatment period and the retention period.

· The treatment period takes about one to two years. During this time, the patient must wear a fixed appliance (braces) and will need to see the dentist an average of every four to six weeks to have the braces adjusted. Later, once all of the teeth are in alignment the dentist will remove the fixed braces. However, the treatment is not finished yet.
· Next comes the retaining period, which generally can take over two years. Now that the braces have been removed, the patient will instead need to wear a retainer which, unlike the fixed braces, can be taken off by the patient. During the first six months, the patient should wear the retainer day and night - except when eating. After six months, the retainer should be worn every night, but not during the day.  One year later, the retainer only needs to be worn every other night, gradually extending the intervals between wearing the retainer.
This whole orthodontic treatment program will take years for treating and retaining, but with a little patience, the end result will be perfectly straight and aligned teeth.

6)Can adults also undergo orthodontic treatments?

Technically, there are no age limits for orthodontic treatments, so long as the patient has healthy gums. In fact, over one-third of all orthodontics patients in Europe and the United States are adults.
Whether the patient is 60 years old or 12 years old, there is not much effective difference in how well or how quickly teeth can be realigned during an orthodontics treatment, although the speed may be a little slower for adults. Compared with orthodontic treatments for children, adult cases may be more complicated since adults are more likely to have some oral health issues such as cavities, tooth decay, gum disease, or missing teeth. Shanghai dental dentists should always deal with any oral diseases first before starting any orthodontics treatment.

7)Can orthodontic treatments be done for children younger than 12 years of age? When is the best time
to bring children to see a dentist?

The American Orthodontics Association has recommended that the best time to start a child’s orthodontic treatment is at seven years old since many issues needing correction often occur during this period. If these issues are discovered in time, early correction will be relatively easy. However, the case becomes more complicated after all of the child’s permanent teeth come in. If, after inspection, there is no need for corrective orthodontic treatment, the dentist can still give the parents some useful suggestions, such as what kind of dental problems the child may have and when is the best time to do orthodontics treatment.

8)Will patients suffer any pain from the orthodontics treatment?

Patients may feel a little bit sore or experience some discomfort for the first two to three days, caused by the body’s normal response to the initial orthodontic treatment. However, in general, any feelings of pain or discomfort should disappear quite quickly. During any orthodontic treatment, patients should abstain from eating any hard foods (like bones) or sticky foods.

9) Will teeth become loose after having orthodontics done?

While some people may worry about orthodontia causing older teeth to fall out prematurely, this view is unscientific and unfounded. In fact, orthodontic treatment is a slow process of realigning teeth with a gentle force. The side of each tooth has some mobility and will be slowly moved until the new bone structure on the other side of the tooth has regrown. This continues until all of the teeth are in their proper positions. The procedure is gradual, and the teeth remain steady and stable throughout. Professional orthodontic treatment will not cause any harm to the teeth or gums.

10) What are some things we need to pay special attention to?

After having worn braces for a long time, patients may feel that their teeth are sore and weak after removal. So they should eat soft foods, such as rice, porridge, etc., at first to avoid increasing any feelings of discomfort. Normal dining can begin again after one week, but 0sticky foods are not allowed for one or two years after starting orthodontic treatment. Ignoring this advice will not only increase the cost of the treatment and the number of visits to the dentist, but will also extend the amount of time needed for the orthodontic treatment.
In the meantime, patients need to take in enough calcium and vitamins during the period of orthodontic treatment.
Good oral hygiene is likewise very important. Patients must brush their teeth every morning, evening and after meals, and keep their braces and teeth clean. Otherwise, food debris could accumulate on the braces, allowing bacteria to grow, which could corrode the braces and cause tooth decay and swollen gums. We recommend using a child’s toothbrush with a small head and soft bristles. You should brush gently and slowly, for between three to five minutes. If you find brushing after each meal to be too inconvenient, you can at least rinse out your mouth with mouthwash after every meal.

4.Successful Orthodontics Cases

Case 1) Successful Orthodontics Case for a 5-Year-Old Girl With Underbite

This is a 5-year-old girl, with sunken face. Her chin tilted to one side when smiling. Her mother told that she had long expected to bring her daughter to dental doctor. Well, with so many worries, like worrying about whether her girl will cooperate, whether she will feel painful or whether her daughter can adapt to it and so forth, the treatment is put off. Now, seeing the more and more sunken and awry face of her daughter, she realizes the urgency of treatment.

After 7-month’s treatment in our iSMILE Dental Clinic, the underbite has been regulated properly. Now, both the girl and her parents are very happy because of her natural, confident and beautiful smile!

Before treatment:

After treatment:

Case 2) Successful Orthodontics Case for a 10-Year-Old Boy With Underbite
Boy, 10 years old, the central section of his face was sunken and his lower face was preumbonal. He was frequently confronted with the problems of being laughed at by his classmates for his appearance shape. Now, after one-year’s orthodontic treatment, his appearance shape has been greatly improved. We have been friends with our patient and he comes to see us frequently.

10 years old (before treatment)

12 years old (face and profile are maintained well)

18 years old (face and profile are still kept well)

Case 3) Successful Orthodontics Case for Adult With Underbite
Male, more than 20 years old now, his families showed less care to his underbite when he was still a kid since it didn’t affect his face actually. So, no treatment was given. Now, the underbite affects not only his face, but also his daily life, like eating. He chose us iSMILE Dental Clinic. The treatment is the combination of operation and orthodontic treatment. There is a preoperative treatment for over a year, then orthographic surgery, and orthodontics after the surgery to adjust the dental occlusion. Well, his tooth function has been greatly improved, and the front and side facial appearances are beautiful. He can smile confidently now…

Before treatment:

After treatment:

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