Are you looking to have your crooked or overlapping teeth straightened and improving your smile? Teeth irregularity tends to worsen with age. Over the years, teeth wear down from use, the muscles of the tongue, cheeks and jaws become weaker as we age, gums recede and the jaw bones become less flexible, lip muscle tone declines, and collagen fibres in the gums weaken; these and other changes in the mouth result in a changing environment for the teeth. The teeth start drifting slowly out of position, affecting the adjacent teeth and opposing teeth in the other jaw. The drifting process gets accelerated if there is gums disease, arising from diabetes, hormonal changes, and other causes. Small changes over many years results in crooked teeth. Irregular teeth are difficulty to clean; food impaction, ugly food stains, and dental caries can develop.
Fortunately, your teeth can be re-aligned at any age by applying gentle forces to your teeth over a period of time, from a few weeks to a couple of years depending on the degree of irregularity and type of malocclusion (misalignment). The forces applied must be gentle, to avoid damage to the gums, and the nerves within the teeth. The forces may be delivered to the teeth through metal wires, flexible plastic, metal screws, rubber bands, or by muscles in the jaw.
The orthodontist will plan the most appropriate and efficient way to deliver the forces to straighten the crooked teeth, by selecting the best dental braces to suit your problem, whether you are a teen or an adult.
The cost of orthodontic treatment depends on the degree of severity of the malocclusion, the duration of the treatment period, the amount of time and effort put in, the types of orthodontic braces used, and the level of expertise required to carry out the treatment. Everyone’s tooth shape and arrangement, bone structure, muscle development and face form is unique, hence the choice of dental treatment for every individual needing braces varies accordingly. Prices range from $450 to $8800. An inexpensive solution can be found to suit your budget and financial requirements. Deferred payment and instalment plans are available. If needed, we will help you with the insurance claims for your dental expenses.
In Singapore, orthodontic treatment may be carried out by a general dentist or an orthodontist. An orthodontist is a dental specialist who has completed a few more years of specialized dental education in the field of orthodontics.
Different types of braces have their advantages and disadvantages. Dr. David Lee, an orthodontist with many years of experience, would be able to advise you on the most suitable type of brace for your condition, taking into account your budget, time constraints, age, occupation, eating habits, oral hygiene, the amount of bacterial plaque or tartar build-up, the health of your gums, severity of tooth irregularity, and other factors, including the latest clinical research findings. You will be shown how to care for your braces using special tooth brushes, dental floss, inter-proximal brushes, and other cleaning aids, and given advice on how to prevent cavities or stains.
Metal braces are the most commonly used type of fixed braces because they are robust, accurate, economical, and dependable. Strong as they are, metal brackets sometimes do break as a result of hard foods or trauma. Stainless steel brackets do not rust or corrode, and they are kinder on the tooth enamel. They are malleable, so they can absorb some degree of excessive force. They can be made thin, and sharp corners or angles can be machined into the bracket for a more accurate movement of the teeth, without them breaking or chipping. When it is time to remove the braces from your teeth, metal brackets can be intentionally deformed to break the cement bonding the bracket to the enamel, making the debonding process less uncomfortable. Some metal brackets have little hooks attached (for elastics to be applied), and these can be bent to suit your anatomy should they scratch your cheeks or tongue; you cannot do that with ceramic hooks. Recent advances in bracket design include self-ligating brackets (such as Damon, Quick & In-Ovation brackets) that do away with elastic modules (tiny rubber bands) that wrap around each bracket, inadvertently leading to increased friction and hygiene issues.
Ceramic braces cost more, but they are more aesthetic, being less visible. Ceramic brackets are more difficult to manufacture, involving more processing and expensive tooling. They are more brittle and can chip off when heavy stress is applied, for example when thick rectangular wires are used during the later stages of treatment. Because of the weaker material used, ceramic brackets have to be made thicker and bulkier to withstand the loads placed on them. Hence they are usually larger in size, compared to metal brackets.
Lingual braces (invisible braces) cost even more, and are completely invisible, being bonded onto the inner surfaces of the teeth (facing the tongue). They were designed for cosmetic purposes, and are more difficult for the orthodontist to adjust. They are also more difficult for the patient to keep clean since they are less accessible and less visible. Even so, we have special tooth brushes and tools that will help you clean the braces, whether they are regular or invisible braces.
Clear aligners are transparent, barely noticeable plastic shells or trays that fit over the teeth. They are removable, so there is no problem with tooth brushing and eating, and there is very little risk of getting tooth decay. They are contoured to fit the tooth anatomy, so they are very comfortable and do not affect your speech. They can be removed for the special occasions when you don’t want anything stuck on your teeth, like when you go for a job interview. There is no problem with brackets accidentally breaking off or scratching your cheeks or giving you ulcers. A series of aligners can be made to gently guide your teeth into the desired position, moving less than a millimeter at a time. The number of aligners required depends on the degree of severity of mal-alignment of the teeth.
Invisalign aligners are proprietary clear aligners manufactured by Align Technology Inc. It was launched in the U.S. in 1999, and since then, over 2 million people have been treated with this technology. Align Technology spent a lot of money on marketing and advertising, and only became profitable in 2003. Over the years, they introduced changes to the material and design of the aligners, resulting in more efficient and more effective delivery of forces to the teeth. Specific tooth movements (such as twisting, tipping or rotation), can be programmed into the appliance by the orthodontist before they are manufactured. These planned movements can be visualized by the orthodontist using computer aided design software, and corrections can be made before actual fabrication of the aligners.
On your first visit, the orthodontist will take X-rays of jaws & skull, take measurements of your teeth, and assess the suitability of Invisalign for your treatment. Impressions will be taken of your teeth to produce a replica of your teeth. Your moulds will be sent to the laboratory for computerized designing and planning the tooth movements. Once the dentist finalizes the movements, and order is sent to proceed with manufacturing. In straight forward cases, the Invisalign aligners will be back in Singapore in three weeks, for you to start your first aligner.
Retainers are orthodontic appliances that keep the teeth in place, preventing undesired tooth displacement. Removable retainers have stainless steel wires embedded in plastic; the wire and plastic components restrain the teeth, preventing the teeth from drifting out of place. They also allow for some degree of desirable movement, for the settling of the occlusion that occurs soon after the braces are removed. A good settling of the upper and lower teeth will give you a good bite. Retainers are usually worn at night. They can be removed the next morning for cleaning. As they are easily cleaned, they do not cause any tooth decay.
Functional appliances are specially-designed removable braces for individuals with problems like excessively protruded teeth, overbite problems, or problems with jaw growth. These functional appliances are effective in correcting misalignment by improving biting and jaw position. Functional appliances are worn to help in the development of the jaw. They may also modify the development of the lips, cheeks & tongue. There are many types of functional appliances. Most of them are removable, although some of them are fixed onto the teeth, such as the Herbst appliance, Forsus appliance, MARA appliance.
Removable functional appliances are more hygienic and less likely to break or cause tooth decay. They connect the upper and lower dentition and jaws together by means of plastic and wires. They may be made as two separate pieces for the top & bottom jaws, or they may be fused together as a single piece that fits both the top & bottoms jaws in a certain position. The plastic or wires guide the tongue, lips, cheeks & jaws by stretching, shielding, or re-positioning, producing a more conducive environment for the tissues to grow & develop.
History of Orthodontics
Orthodontics is a special branch of dentistry that deals with malocclusions (abnormal positions of teeth). Orthodontics also deals with problems of jaw growth and misalignment. Orthodontics not only focuses on improving teeth alignment, but also on enhancing the facial appearance of the person, contributing to overall mental wellness.
Orthodontics was formerly known as orthodontia. The term was derived from the Greek word, orthos which means straight or proper, and dontos which literally means teeth. Orthodontics has been practised since the early times; archaeologists have discovered mummified people with metal brands wrapped around their teeth. Even Hippocrates and Aristotle in the 4th century BCE had postulated about ways to straighten teeth and manage other dental problems.
The father of modern orthodontics is Edward H. Angle. He started an orthodontic school in the 1900s in the U.S. and pioneered the use of ‘edgewise’ brackets that we still use today. He also invented several dental appliances.