Most people considering orthodontic treatment have had information from a variety of sources about orthodontic appliances, treatment progress, retention time, etc. This information may come from dentists, friends or acquaintances who have had treatment or from different websites. The information is sometimes valid, but too often it can be erroneous, incomplete and misleading.
In this first column of our “Ortho Blog” on “Orthodontic Myths“, we will try to demystify 5 common myths for which we often have questions.
1- “Spindles”: it must hurt to work!
Many believe that it must “pull” or hurt for the teeth to move. This is a myth!
- In the past, when metal “rings” were used on each tooth and only very rigid stainless steel wires were available, the devices exerted greater forces on the teeth, creating more discomfort and pain for patients.
- Now, new technologies such as self-ligating cases and flexible wires that we use allow us to have straight teeth with a minimum of inconvenience.
- However, it is normal that at the beginning of treatment, during the installation of the devices and during subsequent yarn changes, there should be some discomfort that may last a few days.
- If significant pain persists unreasonably, talk to your orthodontist.
- However, the notion of pain is so deeply rooted in people’s minds that there are still patients who complain about not having pain because they think that, without pain, their teeth will not move! Remember, “it doesn’t have to hurt for it to be effective”!
- In addition, the pain threshold varies from person to person so that the same procedure can be very sensitive in one person while another will hardly feel it.
- The illustration on the right shows the “pins” that were the standard used until the mid-1970s. Each tooth had a fitted and cemented ring, which required creating space between the teeth and was very uncomfortable during installation. The very rigid wires had to be bent and curved to provide flexibility. The width of the rings gave these devices the nickname “railway rails“!
- All these disadvantages have now disappeared with modern orthodontic appliance versions.
➡ Learn more about sensitivity, pain and discomfort during orthodontic treatment.
2- The tighter it is, the more efficient and faster it will be.
- Some people believe that if the tension in orthodontic appliances is higher, teeth will move faster. They even ask us to “tighten” the devices to speed up the treatment!
- In practice, it is sometimes the opposite that must be done. The teeth respond to the forces applied to them but these forces must be optimal. If they are too strong, they can destroy the tissues around the teeth (bone, gum, ligament, periodontium, etc.) that will have to regenerate before the tooth moves and this takes longer.
- If the strength is ideal, the tissues will respond optimally and the tooth will move faster. This is a known principle in orthodontics and we always evaluate the forces we apply to the teeth (threads, elastics, springs, chains, etc.) so that they are adequate.
- The same applies to rubber bands; use only those prescribed for you.
3- Orthodontic wires must be changed at every visit.
- The wires used in orthodontics are not ordinary wires. Each type of yarn has a particular role to play during processing.
- The first wires used are superelastic alloy wires (nickel copper and titanium) with shape memory. They can be bent, twisted, deformed and they will try to regain their original shape by bringing the teeth back with them.
- The initial wires are round, small in diameter and flexible, which allows them to have larger deformations because it is at the beginning of the treatment that the teeth are the most crooked.
- As the teeth align, the diameter of the wire will be increased and eventually rectangular wires will be used to better control the three-dimensional teeth.
- Once the teeth are properly aligned, more rigid alloys (stainless steel or titanium-molybdenum) can be used to finish the cases.
- There is therefore a logical sequence in the change of threads from the beginning to the end of a treatment. A complete treatment may require only 4-5 wires per arch to make all corrections.
- However, the wire can be removed at each visit to make modifications if necessary (shape, fold to move a tooth) without being changed.
➡ Learn more about orthodontic wires (bows).
4- Only “braces” can correct my teeth
- Although fixed braces, commonly referred to as “braces”, are the standard in orthodontics because they are the most versatile and effective appliances available, there are many devices and technologies available today that can correct malocclusions.
- There are clear cases that are much more aesthetic and “lingual” pins that are placed on the inner surface of the teeth and that are practically invisible.
- It is even possible to align the teeth without braces using transparent plastic shells (Invisalign/ClearCorrect). It must be realized, however, that these alternative technologies do not allow all types of malocclusion, especially the most complex ones, to be corrected as well.
- To find out if your case could be corrected by this type of appliance, consult an orthodontist.
5- My spaces will close as soon as I have my “pins”.
- It all depends on where the space is located and the position of the teeth to be moved to close the space.
- Many people find a gap between the anterior teeth (diastema) unsightly and would like to close it as soon as possible.
- It is sometimes possible to correct a space early in the treatment by adding an elastic ligature. Such a space closure can be very fast (a few weeks).
- Sometimes, it is preferable to wait until the teeth are diverted or straightened if they were severely tilted because these movements require the presence of space to be performed.
- In fact, if no space is present at the beginning, it is sometimes necessary to create some to align the teeth. It is also possible that small spaces may appear during processing. This is sometimes a side effect of the mechanics used to make other movements.
- In some cases, it is advisable to keep spaces between teeth at the end of the treatment. This may be necessary because of the size of the teeth between the two arches, which means that a space must be present if a good gearing is to be obtained between the posterior teeth. This space is often located at the back of the upper canines.
- Another situation where a space is voluntarily left is when the upper lateral ones are smaller than they should normally be to be in aesthetic harmony with the adjacent teeth. One or more spaces are left between a few teeth so that the dentist can widen narrow teeth and optimize aesthetics.
- Several examples of restorations to widen incisors are illustrated in the “restorations” section.
- If you are concerned about the presence of spaces during your treatment, discuss this with your orthodontist.
➡ To learn more about space closure in orthodontics and see examples.