Dr Aida Nur Ashikin bt Abd Rahman   Orthodontist & Senior Orthodontic Lecturer, Faculty of Dentistry, Universiti Teknologi MARA (UiTM)                                                        

Orthodontic treatment is about straightening your teeth; it is about improving the harmony of your mouth and jaws using a prescribed appliance called braces. Braces help to improve the appearance of your teeth as well as your facial structure, boosting your confidence to flash that beautiful smile more often!

Know your braces

Fixed braces are the most common and sophisticated; they can be made from different materials, most commonly, silver-coloured metal (such as stainless steel, figure 1). For those who would prefer a more discreet style, there are the gold and tooth-coloured materials such as ceramic (figure 2) that would not show as much. These braces can also be tied by colourful rubber or a metal gate known as self-ligating braces (figure 3).

Figure 1: Metal braces

Figure 2: Ceramic braces

Figure 3: Self-Ligating braces

Braces are usually fitted to the outside of the teeth but, a more recent development has seen braces that are fitted to the back of or tongue side of the teeth (called lingual braces).

Figure 4: Lingual braces

Aligners are another type of braces. They are clear, removable mouthguard-style braces that straighten the teeth gradually (figure 6).

Figure 5: Aligner

Figure 6:  Removable bracers

Removable braces are also often used and are made of wire and plastic to allow simple, limited tooth movement.

Getting your braces

Many different factors need to be taken into consideration before deciding which type of brace is right for the individual patient.

Simple straightening can sometimes be carried out as quickly as 6 months, particularly if it is only the front 6 teeth. However, such relatively short treatment usually produces limited changes. This is not always a long-term solution as there is often not enough time to move the whole tooth, including its roots, into the right place. As a result, the teeth may move back to their original positions rather quickly once the braces are taken off!

It often takes between 1 or 2 years to get the teeth to bite in a better way, in sync with the jaws and lips. It may take even longer for more difficult problems, involving regular review visits to the orthodontist every 4-8 weeks. Some cases may require a combination of braces and orthognathic or jaw surgery, the latter usually carried out by a maxillofacial surgeon or a plastic surgeon.

A good orthodontist will discuss all the possible types of braces that can be used for your problem, together with the risks and benefits of each one. He or she may also advise on the different ways to improve your teeth, such as simple straightening or full bite correction.

Beware of counterfeits

Currently there are many untrained individuals offering fake braces or fixing un-prescribed braces as a beauty accessory. Many people take up these offers because the cost is far lower than getting the braces done by qualified orthodontists.

This is actually a worrying trend, as braces, when produced and affixed by untrained individuals, may lead to dangerous consequences that can affect the health. A main concern is chemical poisoning from the metal, adhesives or even the rubber used to make the braces.

The leached metal from non-prescribed metal may cause allergic reactions. It can also give rise to changes to the cells of the mouth (called carcinogenic and mutagenic effects) that may lead to cancer. 

Another concern is the high disruptive force resulting from incorrect application of braces, which can cause unwanted movement to the wearer’s teeth.

There are possible complications that can arise even at the hands of an expert orthodontist, as our teeth are part of a complex biological system involving the gums, jawbones and facial muscles. Common complications such as gum disease, gum recession (when the teeth are pushed out of the jawbone due to the lack of space for all your teeth) and the teeth returning to their original position (called a relapse) once treatment is finished. These problems need to be tended to by a trained orthodontist. Can you imagine the problems that can arise when you place yourself in the hands of an untrained person?

Embrace the real deal

If you believe that you require braces to improve your appearance, always consult a qualified orthodontist or dentist. A thorough orthodontist or dentist will always:

• Ask you about your concerns.
• Outline all the different treatment options and their risks and benefits.
• Explain about the different types of braces.
• Estimate the duration of the treatment.
• Explain about retainers at the start of treatment, and the possible need for lifelong wear if the teeth are to stay in their new position.
• Explain how likely the teeth are to stay in their new position at the end of treatment (that is, the stability of the final result).
• At the initial stage, explain what other procedures may be required as part of the treatment.
• Allow you to take your time to decide if you want to go ahead.
• Give you a written treatment plan and fee estimate (if appropriate).
• Tell you how much orthodontic training they have had, if you ask (and you should!).

Last but not least, braces treatment should be carried out in a proper clinical setting, to minimise risks of infection. The clinic should use hygienic and properly sterilised equipment, as well as prescribed materials which have been tested and approved by the Ministry of Health.

Remember, you should also practice good oral hygiene throughout treatment, as this is essential to ensure a successful outcome.

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