How to correct malocclusion in an adult

• Signs of correct bite
• Types of malocclusion
• Why do you need to correct your bite?
• Until what age can a bite be corrected?
• Ways to correct a bite

• Aligners
• Trainers
• Veneers
• Bracket system
• Types of braces

• Which braces system should you choose?
• How long does it take to correct a bite?
• How to care for braces?

Malocclusion occurs in almost 80% of the Russian population. In a third of cases it requires orthodontic treatment. And it’s not just a matter of aesthetics - if you are often bothered by headaches, earaches and dizziness, then perhaps it’s a malocclusion. An orthodontist deals with the correction and prevention of malocclusions.

The most common misconception about bite is related to age. Many people think that it can only be corrected in childhood, but today, with the advent of new technologies, this can be done at any age.

In this article we will look at the causes and types of malocclusion and why it needs to be corrected. We will also tell you about treatment methods and dispel the most common fears. Orthodontist Olesya Milagina comments on current issues of orthodontic treatment for us.

Signs of correct bite

To begin with, we will show what a normal bite looks like and list the signs by which you can understand that it is normal.

• The main distinguishing feature of a correct bite is the tight contact of the upper and lower jaws when they close. The upper front teeth cover the crowns of the lower ones by a third, that is, the lower incisors come into contact with the palatine tubercles of the upper ones. There is no distance between the upper and lower chewing teeth, and during chewing they are in constant contact.
• Correct bite affects the harmony of facial proportions: the lower and upper jaws are symmetrical.
• There are no speech defects.
• Food is comfortable to bite and chew.
• There is no discomfort or clicking in the jaw joint.

Prevention

Prevention of disorders begins as early as a one-year-old child. It is necessary to ensure that the baby does not suck a finger or other foreign objects so that proper closure is formed. Only orthodontic pacifiers should be used.

For an older child, preventive measures include:

• treatment of carious lesions;
• prosthetics of teeth lost prematurely;
• prevention of the development of rickets.

It is necessary to take your child for examination to an orthodontist in a timely manner in order to promptly identify closure disorders and resolve the issue of correcting it.

Violation of occlusion is a defect that threatens not only cosmetic defects, but also the development of a large number of serious diseases. Parents should, if they have the slightest suspicion of the development of this anomaly, take their child for examination to an orthodontist.

Types of malocclusion

How can you tell if your bite is wrong? Essentially, these are all deviations from the norm that nature has established.

Malocclusion occurs:

• distal - the upper jaw is pushed forward more than the lower jaw;
• mesial - the lower jaw is pushed forward more than the upper jaw;
• deep - the upper teeth overlap the lower ones by more than half their length;
• open - most of the teeth of the upper and lower jaws do not meet;
• cross - the left and right sides of the upper dentition protrude forward unevenly, and the upper and lower teeth meet with cutting edges.

Diagnostics

Only a qualified specialist can determine the degree of jaw curvature. This does not require high-tech equipment - the doctor just needs to look at the position of the dentition in several positions.

But, in order to decide which method to use to correct a particular defect, the orthodontic patient will have to undergo a series of examinations, including:

• clinical examination;
• X-ray examination;
• intraoral photographs and facial photographs from various angles;
• measuring the size of the jaws, dentition and teeth;
• assessment of the condition of the muscles of the maxillofacial apparatus;
• deviations in the position of the tongue during swallowing are examined.

In addition, a number of other examinations that are important for making a diagnosis are carried out, which make it possible to accurately and qualitatively determine the degree of neglect of the case.

In particularly difficult situations, radical measures may be required, such as removing several units and even surgery.

Why do you need to correct your bite?

1. Increased abrasion, caries and tooth loss.
   Normally, when chewing, the load is evenly distributed across all teeth. When there is a malocclusion, the load on some teeth increases, while on others there is practically no load. On teeth that “work for two,” the enamel wears off faster, chips appear, and the teeth themselves become loose. Teeth that are “resting” are more vulnerable to caries.
2. Gum diseases.
   With an incorrect bite, the teeth can be tilted inward or, conversely, turned toward the lips. Eating or even normal conversation can injure the inside of the cheeks and tongue. The gums also suffer: the volume of tissue gradually decreases, exposing the roots of the teeth.
3. Diseases of the temporomandibular joint.
   Incorrect positioning of the incisors over time leads to displacement of the jaw joints relative to each other. The pathology is accompanied by muscle spasms, bruxism, crunching and clicking while eating or talking.
4. Diseases of the food tract.
   The bite is responsible for chewing and swallowing, and defects in the bite disrupt this process. Poorly chopped products are an additional burden on the gastrointestinal tract, which provokes gastritis, enterocolitis and problems with stool.
5. Breathing problems and ENT diseases.
   The accumulation of bacteria in the mouth during an open bite can cause sinusitis, sinusitis, otitis media, and sore throat.
6. Communication problems and complexes.

For 60% of patients, braces are aesthetics; for the remaining 40%, it is either the functionality of the masticatory apparatus, or a solution to a problem with the temporomandibular joint, or a preparatory stage before prosthetics.

Reasons for development

Why does a child develop malocclusion? The causes of its occurrence are divided into congenital and acquired.

Causes of congenital malocclusion:

• infections affecting the fetus;
• maternal diseases complicating the development of the fetus;
• maternal abdominal injuries;
• negative effects of poisons and drugs;
• trauma to the baby's facial bones during childbirth;
• congenital shortening of the frenulum of the tongue and lips.

Unlike congenital ones, acquired closure disorders are caused by diseases and bad habits.

These reasons include:

• pacifier abuse;
• the baby constantly sucks and chews objects (pencil, finger);
• bad habits (biting your lip, propping up your chin);
• lack of prosthetics, teeth falling out prematurely;
• Consequences of rickets before the age of one year;
• pathologies of ENT organs, with impaired nasal breathing (deformation of the nasal septum, enlarged adenoids);
• endocrinopathies;
• diseases of the musculoskeletal system;
• pathological posture in sleep;
• extensive caries of molars;
• injuries to the facial part of the skull;
• malignant tumors of the facial bones;
• purulent-necrotic processes of the jaws (osteomyelitis, periostitis);
• early or delayed eruption of teeth.

Often the formation of closure defects is caused by several reasons. They need to be identified in order to determine the optimal tactics for correcting the defect.

Ways to correct a bite

Today there are four ways to correct a bite and one way to carefully disguise the problem.

• Aligners
• Trainers
• Bracket systems
• Surgical intervention

We have listed these methods in order from easiest to most difficult. You must understand that each case is individual, and depending on this, the doctor will select the optimal bite correction system. You can hide an unaesthetic bite with the help of veneers - we will also talk about them.

Aligners

Removable aligners that are created from dental impressions. The most modern way to correct a bite, which is suitable for the treatment of simple disorders.

After drawing up a treatment plan, the patient receives 3–5 sets of aligners of varying stiffness. The mouth guard is designed to last for two weeks, and then it needs to be changed to the next one, and so on until the final result. The course of treatment lasts on average 4–8 weeks.

Aligners need to be worn 24 hours a day, and this may not be comfortable for everyone. They are not suitable for deep bites. The mouthguard is designed so that it is “one step” ahead of the current position of the teeth in the dentition. Therefore, after putting it on, pressure is felt, which is evenly distributed throughout the jaw. Aligners consist of an elastic transparent material, so they are invisible to others, unlike braces.

Trainers

Removable silicone mouth guards for two jaws, which help correct a simple bite or consolidate the result. You need to wear the trainer during sleep and during the day for up to 4 hours.

Veneers

The characteristics are similar to crowns, but they are installed only on the front surface of the tooth in the form of a thin plate on a special dental glue.

Veneers can be composite, ceramic or zirconium. The first two types last about 10 years. Products made of zirconium dioxide with external porcelain coating - up to 15 years.

Veneers eliminate defects that arise as a result of cracks or damage to the integrity of teeth. A visually straight dentition is formed.

For the patient, the result of orthodontic treatment is aesthetics, and for the doctor, it is functionality. If your teeth are just crooked and your bite is perfect, you can get veneers or crowns. In other cases, you cannot do without braces: veneers do not correct the position of the teeth, but only mask their external imperfections.

Bracket system

Braces are small clasps that are attached to the teeth with a special composite glue. A metal arch is placed in the grooves of the braces - the most important element of the braces system. The arch has the shape of a regular dentition. She pulls her teeth, setting them in the correct position. In order for the bracket system to successfully complete its work, it is important to periodically change the arches to more elastic ones.

The doctor fixes the arch on the braces with special rubber bands - ligatures. Depending on the task at hand and the required force that will act on each tooth and jaw as a whole, the orthodontist can choose metal or elastic ligatures. The latter have a clear advantage - when they are changed, you can get rid of the bacteria accumulated under them.

Increased salivation in the first days after installation is a good reaction of the body. The tongue contains sensory neurons that, when food appears in the mouth, send signals to the brain to turn it into a food bolus. When braces are put on your teeth, at first the brain perceives them as food. This is the body’s reflex that there is something in the mouth, which means it needs to be treated with saliva in order to then swallow it. After some time, the salivary glands will get used to it.

Does it hurt to wear braces?

The first days are unusual, but not painful. But if braces scratch your lips and cheeks, you shouldn’t tolerate it. “ Make an appointment with your orthodontist. Sharp elements can be corrected with special materials and filled with special wax

“, our expert advises.

The same applies to tooth sensitivity: sign up for a diagnosis. It is possible that areas of demineralization have appeared. Depending on what the teeth react to, further treatment will depend.

Types of braces

Braces are classified according to the following criteria:

• material (metal, plastic, ceramic and sapphire);
• technique (classical and self-ligating, without ligatures);
• Place of installation (on the outer surface of the teeth - vestibular, on the inner surface - lingual).

Metal braces

Despite the fact that these are the oldest braces systems, they are still popular, and not only because they are the cheapest. Their main advantage is the minimal friction force between the groove and the arc, the magnitude of which largely determines the duration of the entire treatment.

The only negative is that such braces are noticeable on the teeth. However, modern designs differ from their ancestors - they are smaller and more convenient.

Plastic braces

Second after metal ones in the price range. Since plastic itself is not strong enough, the design has metal grooves. Their disadvantage is that such braces are stained by coffee, tea and other coloring products. They are also more fragile than others. However, plastic braces come in a variety of colors and shapes and are therefore popular in pediatric orthodontics.

Ceramic braces

More expensive, but stronger than plastic ones. The color matches the color of the teeth, which makes them almost invisible. Their disadvantage is higher friction between the arch and the bracket slot, which can increase the duration of treatment.

Sapphire braces

Artificial sapphires are used to make them. They are transparent and shimmer beautifully in certain lighting. This design will appeal to those who are sensitive to aesthetics.

Combined braces

Consist of several materials. In the smile area it can be ceramics or sapphires, and in the chewing area it can be metal.

Lingual braces

They are attached to the inside of the teeth and are invisible to others. Their main disadvantage is their high cost. Also, at first they may interfere with diction, but after 2-3 weeks the language adapts and the problem goes away.

When are orthodontic plates used?

Braces are not used on baby teeth, but parents and especially a dentist can notice malocclusion in a child at the age of 6-7 years. One of the most common methods of orthodontic treatment during this period is plates. They are a removable structure that consists of metal fasteners and a plastic base. The plate is fixed on the teeth, pressing the plastic part against the upper palate and prevents their further curvature. There are plates equipped with a special screw, which expands the area of ​​the plastic element. These models are used to enlarge the jaw. The period of wearing the plate can be from 3 to 15 months, depending on the purpose of its use.

The great advantage of the plate is that it is a removable structure that can be removed, cleaned and does not impede oral care.

Sometimes, instead of braces, you can use trainers, structures made of flexible silicone material. Most often, trainers are prescribed to adolescents to stimulate or, conversely, slow down the growth of the jaw, correct its shape, and the width of the palate. For adults, the orthodontist may prescribe trainers to reduce pressure on the bite of the maxillofacial muscles and maintain the effect achieved by other treatment methods. The functionality of trainers goes beyond bite correction. They are used to wean from bad habits (thumb sucking), to form correct breathing through the nose and for other purposes. They can be used when, for some reason, orthodontic treatment with braces or plates is contraindicated for the patient.

Which braces system should you choose?

The least expensive and most proven option is metal braces. Plastic ones are also inexpensive, but they are inferior in strength to metal ones. If aesthetics are more important to you, opt for more expensive ceramic, sapphire or lingual braces.

As for “internal” braces, their only difference from all others is the aesthetic factor. One of the inconveniences is that such braces change the diction, they are more difficult to care for and they are not suitable for everyone. You need to have an almost perfect bite: just “uneven teeth.”

Treatment prognosis

Correcting malocclusion with the help of braces, mouth guards, crowns, special plates and other mechanisms ultimately leads to the patient's jaw being straightened and facial features acquiring more correct shapes.

The duration of wearing orthodontic accessories depends on the severity of the pathology and the age of the patient. Of course, it is much easier to correct a child’s bite, since his bone tissue is in the process of formation.

With an adult patient, the situation is somewhat different - the bones are already formed, which means that the recovery process will take longer.

How long does it take to correct a bite?

Each case is individual, so without visiting a doctor it is impossible to say how long treatment will take.

The minimum treatment takes a year for the bone to grow and the teeth not to come back. The result needs to be stabilized. Patients often tell me after two months of wearing braces: “I want to take them off, everything is already straight for me!” But this is appearance. The jaw bones must anchor the teeth into their new position.

The duration of treatment also depends on the patient. The orthodontist puts a certain force into the braces, which weakens by the next visit. That is why it is important to strictly visit the doctor once a month so that you do not have to prolong the course of treatment.

My teeth began to loosen. Something is going wrong?

Loose teeth after installation should not scare you. The teeth will be in motion throughout the treatment period. Essentially, we move our teeth: somewhere the bone dissolves, somewhere it appears. Six months after treatment, the teeth will return to normal.

The purpose of braces is to change the position of hard and soft tissues adjacent to the tooth. But this is not enough to correct the bite. Teeth may move back apart some time after braces are removed if a retention device is not in place. After correction, retainers must be installed to keep the teeth stable in their new position. If this is not done, the effect of wearing braces will gradually disappear.

Complications

If anomalies are not corrected, then not only the baby’s appearance suffers. The consequences of impaired occlusion are numerous somatic pathologies.

What does the anomaly affect:

• diseases of the digestive tract develop;
• widespread caries;
• formation of dental plaque;
• inflammatory processes in the oral cavity;
• poor posture;
• respiratory disorders;
• disruption of the process of chewing food;
• previous tooth loss.

The baby develops articulation disorders, and the pronunciation of sounds suffers.

How to care for braces?

Caring for braces requires care and discipline. We talked about it in more detail in a separate article. After installing braces, the doctor will tell you how to live now. We will indicate the most important things.

1. Always have brushes and a single-tuft brush on hand.
2. Add a waterpik to your arsenal.
3. If you are not sure that you have brushed your teeth well, use an indicator tablet. After brushing your teeth, the tablet must be dissolved in your mouth. The areas where plaque remains will turn blue. These areas need to be cleaned again.
4. Avoid very hot and very cold drinks. Braces, like enamel, do not like sudden temperature changes.
5. To prevent braces from coming off, follow a diet. Eliminate nuts, toffees, seeds, and flour from your diet. Apples and other hard fruits should not be bitten off, but cut into small pieces and placed on the chewing teeth.

Lower jaw advancement with Herbst apparatus

The Herbst apparatus consists of two rods attached to a brace system. The bars hold the lower jaw in an extended state, allowing the muscles to rebuild their work. The Herbst appliance does not interfere with opening your mouth, talking, or eating. Patients quickly get used to this design in the mouth.

The patient walked with the Herbst apparatus for 9 months.

Dental hygiene

During the process of orthodontic treatment, as well as before installing braces and after removing them, the patient underwent professional teeth cleaning, during which plaque (Air Flow cleaning) and tartar were removed. A set of special products was selected for home hygiene, and training was provided on how to brush teeth with braces. Thanks to a careful approach to dental hygiene, there were no cases of caries or gum inflammation during orthodontic treatment.