ORTHODONTICS - DR SERENA BALDI

ORTHODONTICS

Orthodontics is not only for aesthetic purposes, but its main and primary role is to keep your mouth healthy and fully functioning.

As well as realigning teeth, we also and most importantly deal with developing and restoring bone value between jaws and dental arches, which is needed so that you chew your food properly, and also for voice and aesthetics.

We recommend seeing an orthodontist from an early age. A child around the age of five or six is at the right age in which any diseases may be intercepted and dealt with using the most appropriate interceptive orthodontic treatments.

ORTHODONTICS FOR CHILDREN

We can divide children's orthodontic treatments into 2 phases:

Interceptive orthodontics
Interceptive Orthodontics: This refers to the set of procedures to prevent or correct malocclusions and oral disharmonies in children, which are used to avoid possible aggravations related to growth and simplify any subsequent treatment, if necessary.

This means that we 'intercept' any possible issues at the right time which are usually of a skeletal nature, as well as any abnormal functions which may be caused naturally or come from specific behaviours (such as using a dummy for too long) that not only affect teeth, but may also affect swallowing, breathing, vocal functions and posture.

Such procedures are aimed at correctly aligning the arches so as to create the space necessary for tooth eruption and any further alignment needed and also to stop the muscles from interfering so that the patient doesn't have to go through the same problems again. In order for the interception treatment to be effective, the child needs to be seen at the right time, and more specifically before full growth (before the age of 12 years old). Dr. Serena Baldi recommends the child's first visit between 4 and 5 years old. When necessary, the actual treatment will be carried out between the ages of 6 and 8 years old, which is when the bones of the roof of the mouth are still forming and the teeth are mixed (meaning there are still a few baby teeth together with adult teeth).

We usually look at implementing Interception Treatment to sort out:
- incorrect occlusion between the upper and lower teeth. This can produce an underbite or crossbite, an openbite, overbite, mandibular prognathism (protuding lower jaw). As previously mentioned, these can be caused either by genetics or through a certain behaviour, for example, using a dummy, sucking the thumb or low lip interposition.
- incorrect teeth alignment, for example dental crowding. This is when teeth overlap due to lack of space.
- losing baby teeth early or late eruption of adult teeth.
- the size of teeth are not in proportion with the mouth, jaw, etc.
These issues are usually solved with dental braces such as palate expanders, removable braces, and myofunctional appliances) as well as specific re-education exercises if necessary.

Actually for any existing correlations between the developing jaw bones, teeth alignment, perioral muscle and tongue functions, and posture, the orthodontics may look towards working closely with a speech therapist and osteopath at this stage.
Orthodontic treatment

On the other hand, the second phase, the actual orthodontic treatment, generally begins during the final teething stages and when growth is almost done. Interceptive treatment is finished making usre that each definitive tooth is well aligned and intercuspation is correct that opposite, so that stable and functional occlusion is maintained over time. This phase can be treated with the latest generation fixed orthodontic braces so that treatments can be carried out extremely quickly and in a comfortable manner. These braces are made of metal or white, self-ligating brackets (plates), which are placed on each tooth and connected by an arch that uses controlled and gradual force on the teeth to realign them.

This procedure is a temporary brace, perfect for carrying out the most complete orthodontic treatment possible. That is to say, that at any stage in life, even as an adult, we can solve any teeth issues with different kinds of orthodontic treatments.

orthodontics for adults

More and more adults are turning to us at our dental practice to help them solve orthodontic issues they may have. In the vast majority of cases, people who decide to resort to orthodontic treatment do it mainly due to aesthetic problems, so that they can improve the appearance of their smile. This may be because they weren't able to sort out their teeth as a child or teenager. The main aesthetic reasons for contacting our dental practice are usually as follows: teeth overlap (teeth are too close and are overlapping each other) or on the contrary, it may be due to diastema, meaning an excessive gap in between the teeth.

There are also a whole series of functional problems:

muscular problems, including grinding also known as bruxism, the unconscious habit of rubbing teeth (back and forth or sideways) during sleep
malocclusion, crossbite, open bite or deep bite: these are problems that arise when the upper and lower dental arches are not perfectly aligned and the upper teeth protrude too much, and do not touch the lower ones, or on the contrary are covered by them
problems with swallowing, chewing or even when trying to pronounce some sounds
Other common problems are headaches and joint pain. In these cases, we need to make an assessment to make sure that the origin of the pain is actually related to the teeth
Teeth that do not erupt due to lack of space or because they are badly positioned (as can happen with canines).

Aligned teeth tend to be healthier. This is because the occlusal load is correctly distributed. If there are any pre-contacts and there is more pressure on one side of the mouth or the other, this can lead to problems over time, including bone loss and gum recession. By going through orthodontic treatment, it means your teeth will be restored and work correctly which brings obvious advantages both on a functional as well as on an aesthetic level.

TYPES OF BRACES

There are many different types of braces, which can be adapted to each person's needs, and also depends on how long the braces need to be used for:

Traditional fixed braces

It is the best known and most used type of brace, with the latest generation self-ligating metal brackets, are placed and fixed on the crown of the teeth, using special glues. Metal wire passes through the brackets with internal storage, increasing in thickness as the treatment progresses. You can add a whole range of additional apparatus to these braces if necessary it such as elastic bands, hooks etc.
Fixed white braces

These have the same mechanical and functional features as the traditional ones. However, the attachments are more discreet and have better aesthetic look to them as they are clear ceramic. The arch is also made of less visible rhodium-plated metal.
Lingual braces

Lingual braces: this method means that the brackets and metal wire can be applied to the inner side (the lingual side) of the teeth. The main advantage of this type of brace is obviously the excellent aesthetic result. No one will actually notice that you are wearing a fixed brace. Normal oral hygiene cleaning may be a little more complicated and will certainly take longer to carry out.
Invisalign - invisible braces

This method involves using thin aligners, which progressively align the teeth. They are transparent and practically invisible, do not contain metal and are made to measure. The system is based on a sequence of aligners that gradually move the teeth until they are in the desired position. Each aligner is made to move the teeth with gentle pressure so that they are straighter than the previous aligner up to 0.2 / 0.3 mm for each aligner. Every one / two weeks (depending on the orthodontist's opinion), the aligners are changes by checking if the teeth have moved towards the desired position.
The advantages and disadvantages of this method compared to the previous depend on each individula patient and depends on the professional opinion of the orthodontic specialist as well as the wearability aspects and whether they can adapt to the individual's lifestyle. The average treatment time for an average adult is around 12 months. This duration may vary obviously depending on the complexity of each case.
The aligners can be used to solve many different dental issues:
- gaps between teeth
- deep bite
- open bite
- crowded teeth
However, even the aligners have their limits. They are specifically used for simple malocclusions. In more difficult cases, where more pressure is needed for tooth intrusions or extrusions, sometimes it is better to use a traditional fixed brace.
It would be up to the specialist to decide which method would be the best.