What is Orthodontics?

Orthodontics is a branch of dentistry specializing in treating imbalanced bites, formally known as malocclusion.

Malocclusions occur when the teeth are not positioned correctly in the upper and lower jaws. Misaligned teeth can lead to an ill-fitting bite, such as an excessive overbite or an underbite.

Orthodontists provide fixed and removable appliances that correct misaligned teeth and/or jaws. The goal is to realign the teeth and create new, beautiful smiles over time.

Types of Orthodontic Treatment

Irregular, crowded, and protruding (buck) teeth have caused issues for people for hundreds of years. The 21st century brought advances in dental technology that allowed the orthodontic specialty to develop.

Modern treatment involves orthodontic appliances to straighten misaligned teeth and correct malocclusions. The types of orthodontic appliances available for children and adults include:

• Braces or clear aligners, sometimes called "invisible braces"
• Headgear (used in combination with braces)
• Fixed or removable space maintainers
• Permanent or removable retainers, depending on your preference and needs
• Temporomandibular joint (TMJ) splints and other jaw repositioning appliances for children with jaw irregularities
• Jaw surgery, also called orthognathic surgery

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

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?

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. 

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. 

There are three different classes of malocclusion, referred to as class I, II, and III:

Class I Malocclusion

The most common type of malocclusion is class I. In a perfect bite, the upper teeth should slightly overlap the lower teeth. In a class I malocclusion, 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. 

Normal Occlusion (Class I Occlusion) 

Normal occlusion (the contact between upper and lower teeth) refers to the “ideal” positioning of teeth. The molar relationship is appropriate, and there is no crowding or spacing.

In a "perfect" bite, the teeth sit in a straight line. Having normal occlusion without previous orthodontic treatment is rare.

What Causes Malocclusion?

Malocclusion is commonly caused by genetics. Most people aren’t born with normal occlusion.  

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 — such as 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) 

What Are The Different Types Of Orthodontic Appliances?

Orthodontists specialize in correcting malocclusion-related problems using orthodontic appliances.

Contemporary treatment types include:

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

Orthodontic specialists recommend both fixed and removable appliances to improve teeth alignment and fix a patient’s incorrect bite:

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. Foods and drinks high in sugar, such as candy and soda, should also be avoided because of the increased risk of cavities. 

Types of fixed appliances include:

Braces

Braces, including 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. 

Braces realign teeth, close gaps, and fix an incorrect bite within 18 months to 3 years.

Space Maintainers

Space maintainers are often used for children who lose a tooth early or from dental 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. 

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, or brushing.

Removable appliances correct minorly crooked teeth or prevent children from sucking their thumbs. A few common treatments include:

Clear Aligners

Clear aligners are thin, plastic trays formed specifically to 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. They are sometimes also used to prevent sleep apnea.

Headgear

Headgear fixes a child’s overbite. It moves 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. 

Does Dental Insurance Cover Orthodontics?

Some insurance plans may cover certain orthodontic treatments. Insurance carriers such as 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.

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.