Comprehensive orthodontics is an effort to correct the dentition to an ideal arrangement. This is in contrast to limited orthodontics or “Short Term Orthodontics” also known as “Six Months Orthodontics” where the objective is to rather quickly straighten just the upper or lower front teeth. The latter is somewhat of a compromise usually done on adults and can also be a wonderful alternative to multiple crowns or veneers.
Comprehensive treatment is best accomplished when the individual is rather young, as one’s adult teeth have finished erupting, typically age ten to twelve. This is because the bones are still growing and this growth can assist the orthodontic process making it faster and more stable. Since comprehensive orthodontic treatment can last, at times, longer than two years, young people generally have more time and can tolerate the length of treatment easier. Adults, too, can have comprehensive care but because they are “no longer growing” different approaches are at times necessary.
Several steps are commonly done prior to comprehensive treatment. First, there are certain x-rays that are necessary for proper diagnosis. One is a panoramic x-ray which allows the doctor to see all the teeth, any missing or extra teeth, the bone, and check for disease. The second necessary x-ray is one of the side of the head which is analyzed for bone growth and jaw relationships. This helps us answer why the teeth do not fit together well or look good: are the teeth just crowded, spaced or misaligned or are the bones that hold the teeth in place not aligned well or are too narrow? Also commonly done are color photographs and moulds of the teeth (that become plaster models) to assist in evaluating teeth arrangements, size of teeth, and so on. Finally a consultation is important to discuss with the parents and or patients the treatment, risk, benefits and limitations of treatment.
As with all orthodontic treatment, retainers are commonly necessary. Retainers, as the name implies, retain the newly moved teeth in their desired positions. These retainers are generally for long term use: years in fact. Retainers can be removable, made of clear plastic material or pink acrylic. Alternatively, they can be permanently bonded to the inside of the lower front teeth and occasionally, if there is room to the inside of the upper front teeth. Retainers are an important final step in preserving one’s new smile.
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