What is Orthodontics?

Orthodontics is a branch of dentistry specializing in treating imbalanced bites, formally known as malocclusion. Malocclusions occur when the teeth are incorrectly positioned in the upper and lower jaws.

Irregular, crowded, and protruding (buck) teeth have caused issues for people for hundreds of years. Misaligned teeth can lead to an ill-fitting bite, such as an excessive overbite or an underbite.

The 21st century brought advances in dental technology, allowing the orthodontic specialty to develop. Orthodontics aims to provide fixed or removable appliances to correct misaligned teeth and/or jaws.

What Do Orthodontists Treat?

Orthodontists specialize in correcting malocclusions. The World Health Organization (WHO) considers malocclusion one of the most important oral health care problems. Up to 93% of children and adolescents experience some form of malocclusion.⁵

Malocclusion simply means the misalignment of teeth. The clearest sign of malocclusion is when the teeth are crooked or stick out.

Types of Malocclusions

A normal occlusion (the contact between upper and lower teeth) refers to the “ideal” positioning of teeth. In a "perfect" bite, the teeth sit in a straight line.

Having normal occlusion without previous orthodontic treatment is rare. There are three different classes of malocclusion, referred to as class I, II, and III:

• Class I malocclusion ⁠— The most common type of malocclusion where the molar relationship is correct, but there is crowding or spacing in the front teeth
• Class II malocclusion ⁠— A class II malocclusion, or overbite, occurs when the upper teeth and jaw severely overlap the lower teeth and jaw
• Class III malocclusion ⁠— A class III malocclusion, or underbite, occurs when the lower jaw is pushed forward, and the lower teeth and jaw overlap the upper teeth and jaw

What Makes Orthodontists Different?

Orthodontists are different than general dentists. A general dentist cares for overall oral health, while an orthodontist corrects teeth and jaw misalignment.

Orthodontists also specialize in correcting malocclusion-related problems using orthodontic appliances. These appliances can correct malocclusions by:

• Closing gaps in teeth
• Straightening teeth
• Correcting bites
• Aligning teeth tips

Types of Orthodontic Treatment

Modern treatment involves various orthodontic appliances to correct malocclusions. The types of orthodontic treatments available for children and adults include:

• Traditional braces or clear aligners
• Headgear (used in combination with braces)
• Fixed or removable space maintainers
• Permanent or removable retainers
• Jaw surgery (orthognathic surgery)
• Temporomandibular joint (TMJ) splints 

The treatment you’ll need will depend on your malocclusion and preferences. 

What Are The Different Types Of Orthodontic Appliances?

Depending on your condition, an orthodontic specialist may recommend a fixed and removable appliance to improve your teeth. The different types of orthodontic appliances include:

1. Fixed Appliances

Fixed orthodontic appliances are attached to the teeth for a certain period of time. How long treatment takes depends on the severity of each patient’s alignment issues.

While wearing a fixed appliance, dentists recommend avoiding sticky or crunchy foods. These are difficult to remove from fixed appliances.

You should also avoid sugary foods and drinks like candy and soda. These foods can increase the risk of cavities.

Types of fixed appliances include:

Braces

Braces realign teeth, close gaps, and fix an incorrect bite within 18 months to 3 years. Traditional metal and clear braces are made of individual brackets (attached to each tooth) and metal wires. Small rubber bands (ligatures) wrap around each bracket to hold the appliance together.

Space Maintainers

Space maintainers are often used for children who lose a tooth early or from tooth decay. A space maintainer keeps the space from the missing tooth available for the permanent tooth to grow into. There are fixed and removable options available.

2. Removable Appliances

Unlike fixed orthodontic appliances, removable appliances do not attach to the teeth. The patient can remove them at any time.

These appliances must be taken out before:

• Eating
• Flossing
• Brushing

Removable appliances correct minorly crooked teeth or prevent children from sucking their thumbs.

Common removable appliances include:

Clear Aligners

Clear aligners are thin, plastic trays formed specifically for your teeth. You wear each aligner for up to 3 weeks; this moves the teeth a fraction of a millimeter at a time. Many people, especially adults, prefer clear aligners to fix crooked teeth because they are removable and nearly invisible.

Retainers

Retainers keep teeth in place after orthodontic treatment (braces) is complete. Since jawbones are living and changing tissues, retainers are necessary to ensure teeth stay straight. There are also permanent options available.

TMJ Splints & Jaw Repositioning Appliances

Repositioning the temporomandibular joint, which opens and closes the mouth, incorporates splints (jaw repositioning appliances). Splints stabilize the connection between teeth and joints.

Temporomandibular joint (TMJ) splints and other jaw repositioning appliances are used for children with jaw irregularities. They are sometimes also used to prevent sleep apnea.

Headgear

Headgear fixes a child’s overbite by moving the jaw bones and teeth backward. It also keeps the front teeth from sticking out. Headgear can slow the growth of the upper jaw, giving the lower jaw time to catch up. 

What are the Benefits of Orthodontic Treatment?

Studies show that oral health directly affects quality of life.⁴ Improving the alignment of your teeth and your bite reduces your risk of oral health issues.

Most people can benefit from orthodontic treatment, though some more than others. The advantages of seeking orthodontic treatment include:

• Reduction in cavities, gum disease, and other dental issues
• Decreased pain from headaches or TMJ disorder
• Improved esthetics of your smile
• Increased ease of cleaning your teeth
• More comfort in chewing and speaking

Are There Any Risks in Orthodontic Treatment?

The risks associated with receiving orthodontic treatment are minimal. You are most at risk for damage if you end your course of treatment earlier than recommended.⁵

Moving teeth too fast can also result in resorption, in which the roots of the teeth become shorter or damaged. The benefits of treating severe malocclusion can far outweigh the risks.

Who Shouldn't Have Orthodontic Treatment?

Although most people will benefit from orthodontic treatment, some people may not qualify for treatment. These include people with serious dental issues like:

• Gum disease (periodontal disease)
• Extensive tooth decay
• Cavities

Placing fixed or removable appliances on diseased teeth can negatively impact oral health. If you have any of these conditions, see a dentist first for treatment.

Does Dental Insurance Cover Orthodontics?

Some insurance plans may cover certain orthodontic treatments. Insurance carriers like Delta Dental and Humana offer discounts for braces, Invisalign, and retainers with certain plans.

If you have orthodontic benefits, your dental insurance will pay the same amount for Invisalign or other aligner therapy as it would for braces. However, you should check with your provider to determine the best option for your specific situation.

What Causes Malocclusion?

Malocclusion is commonly caused by genetics. Most people aren’t born with straight teeth.

Differences in teeth and jaw size cause crowded teeth, gaps, and an incorrect bite. There may not be enough room for both to grow properly.

Other common reasons for malocclusion include:

• Birth defects ⁠— Examples include a cleft lip and palate
• Childhood habits ⁠— Tongue thrusting, thumb sucking, excessive pacifier use, or prolonged bottle feeding
• Teeth abnormalities ⁠— Impacted teeth, lost teeth, or extra teeth
• Failed procedures ⁠— Improper placement of dental crowns, cavity fillings, retainers, or braces
• Jaw injuries and problems ⁠— Jaw fractures, cancers, tumors, dislocations, temporomandibular joint dysfunction (severe pain when moving the jaw)

Summary

Orthodontics is a dental specialty that treats misaligned teeth and bad bites. It uses orthodontic appliances to realign crooked teeth, reposition your jaw, and correct uneven spacing.

Common orthodontic appliances include braces, retainers, and headgear. Both children and adults can receive and benefit from orthodontic treatment.

However, people with extensive tooth decay, cavities, or gum disease don't qualify for orthodontic treatment. Lastly, some insurance plans may cover some of the cost of treatment.