ORTHODONTICS

For most people, achieving a healthy, beautiful smile is the reason for choosing to receive orthodontic care. If you’re self-conscious about your smile, having braces will greatly improve the way you look and feel. 

Contact us to find out more about orthodontics treatment.

When your treatment is complete, you will have the smile you’ve always dreamed of and the confidence to show it off! We also want you to feel comfortable and confident throughout your entire orthodontic experience and our practice is dedicated to making sure that you receive the quality care you deserve.

How Orthodontic Treatment Works?

Orthodontic appliances are made of metal, ceramic, or plastic. They may be removable or they may be brackets bonded to the teeth. By placing a constant, gentle force in a carefully controlled direction, braces slowly move teeth to the proper position.

Gone are the days when a metal band with a bracket was placed around each tooth. You can now choose from brackets that are clear or metallic, and in some cases, the color of your appliance. Wires are far less noticeable, and the latest materials are designed to move teeth faster with more comfort. Today, any age is a great age to wear braces!

Duration of Treatment

Treatment time varies, and can last between one and three years, depending on several factors including age, treatment method, and how minor or severe your case is. A big factor to a successful treatment is you, the patient! The more involved and diligent you are, the quicker and more efficient your treatment will be. For children, receiving interceptive, or early treatment, can also help provide a quicker treatment time.

Before beginning your orthodontic care, your doctor will discuss all of your options and provide an estimate for how long your full treatment may take. Please contact our practice to schedule an appointment, and learn more about orthodontics and the treatments we provide.

 

 

 

Fixed orthodontic treatments

The controlled arch system is one of Dr. Galella’s inventions. It might seem like other fixed orthodontic treatments but it has a huge advantage. What differs this system from other systems is its different way of approaching orthodontic principles.

This system is:

- More predictable than other systems

- Works perfectly for both adults and children and has no age limit

- Protects your jaw joint and sometimes can treat some headaches

- Works for making space in your jaw and doesn’t require pulling out 

   healthy teeth

- It prevents gummy smile in your kid and in most cases, treats

  this condition in adults

- In most cases, it treats an asymmetric jaw and jaw rotation

Fixed orthodontics usually starts after all permanent teeth have grown, at the age of 12, and it works for all ages. The higher the patient’s age is, the slower the teeth would move. But once the movement has started, there are no differences between an adult’s treatment and a teenager’s.

Types of Braces

 

Traditional Metal Braces

Traditional metal braces are the most common type of braces and are more comfortable today than ever before. Made of high-grade stainless steel, metal braces straighten your teeth using metal brackets and archwires. With metal braces, you have the option of adding colored elastics (rubber bands) for a more unique and colorful smile.

Clear (Ceramic) Braces

Ceramic braces are made of clear materials and are therefore less visible on your teeth than metal braces. For this reason, ceramic braces are used mainly on older teenagers and adult patients who have cosmetic concerns. While they are visually less prominent, they do require more attention to oral hygiene as ceramic braces are larger and are more brittle than their metal counterparts. For these reasons, ceramic braces tend to be used more on upper front teeth than on lower teeth.

Self-Ligating Braces

Self-ligating braces are made from the same materials as traditional braces. However, self-ligating braces do not require the use of elastics, meaning fewer appointments and less friction being placed on the tooth. Self-ligating braces come with traditional metal, ceramic, or clear brackets. They are the same size as metal braces but use a specialized clip in place of elastics to help the archwire guide teeth into place. The clip helps reduce the amount of pressure being placed on the tooth and requires fewer adjustments because there are no elastics to replace.

 

 

 

Invisalign

In patients who have mild orthodontic problems, these clear invisible aligners come in handy. This system consists of removable aligners that have to be placed on teeth respectively – each for about two weeks, at least 20 hours each day – and they fix the teeth gradually during this period. 

 

 

 

Children's orthodontics (mixed dentition)

The mixed dentition period is the time when both baby and adult teeth are present in the mouth which is usually between 6 to 12 years of age

During this period, many dental or skeletal problems can be diagnosed or fixed and that is why orthodontic consultation at age 7 is highly suggested.

The most common orthodontic conditions which could be diagnosed during mixed dentition are:

  1. Oral habits

  2. Anterior cross bite

  3. Underdeveloped top jaw

  4. Underdeveloped bottom jaw

  5. Predicting the risk of future unerupted teeth

  6. Predicting the risk of future crooked or spaced teeth

  7. Narrow palate

  8. Ankylosed baby teeth which can stop the permanent ones’ eruption

 

Functional orthodontic appliances

These tools use patient’s muscle force and neuromuscular responses to change the jaw position. There are various appliances for this used in different conditions.

 

Maxillary advancement (top jaw advancement)

Along with growth in other body parts, the upper jaw will grow forward and a bit downwards.

Unfortunately, nowadays people’s lifestyle, which includes a soft diet and mouth breathing, along with other reasons, causes insufficient growth or growth in an improper direction.

This insufficient growth is seen in people with flat cheeks. Growth in an improper direction causes a gummy smile.

These are the common effects of improper top jaw growth:

Gummy smile: While smiling, about two millimeters of gum is visible. As mentioned, the reason is that the upper jaw has grown downward and the upper lip is too short. In mild cases, gum surgery or restorative treatments are sufficient. For more severe cases, orthodontics treatments are necessary, and for even worse cases, jaw surgery may be needed. The important point is that if the problem is diagnosed early, it can be prevented.

Open mouth: when resting, lips have a little space between them and when the patient tries to close them, he/she would feel a contraction in his/her chin. If diagnosed early, this condition is preventable.

Long face: usually in these cases the top jaw grows more downward rather than forward

Big nose: improper jaw growth doesn’t cause a big nose, but small flat cheeks and a held back upper lip causes the nose to seem bigger. After an orthodontics treatment, these patients feel that their nose has gotten smaller.

Headaches or a locking jaw (temporomandibular disorder): unlike the upper jaw, the lower jaw follows genetic growth. This means that if the upper jaw can’t reach its size, the lower jaw has to be bigger. If this difference is more than what it should be, the lower jaw exceeds its size and the lower anterior teeth will be ahead of the upper anterior teeth. But if this difference is less, the upper jaw locks the lower jaw in itself. In other terms, the lower jaw, which is bigger, is held back by the muscles so that patient can’t close his/her mouth in a normal way. This causes many joint problems and headaches.

Gap between upper anterior teeth: your upper anterior teeth start getting slightly distant from each other. Gum disease can be one of the main causes, but if there is no periodontal disease, then the reason is a small upper jaw that can’t withstand a bigger lower jaw. Don’t forget that the lower jaw in women grows until age 15, and in men until age 23.

Crooked teeth: obviously, when the jaw hasn’t reached its size, teeth will not have enough space to grow and this causes the teeth to look messy or can stop a tooth from growing because of lack of space.

Snoring and hypertension (high blood pressure): Most of our upper respiratory tract is positioned right behind our jaws. Now, if your lower jaw is held back because of lack of growth the in upper jaw, this tract is tightened and causes heavy snoring, low quality sleep, fatigue, and high blood pressure.

To treat the underdeveloped upper jaw we can use the following appliances:

Removable growth guidance appliance

Some similar appliances have existed for years, but Dr. Galella has made some important modifications in it.

This tool is usually used for children between 6 to 9 years old. The patient has to use this for about 8 to 12 months.

After this period, a third of children won’t need orthodontic treatments afterwards, but others need a maximum of 8 months of fixed treatment after they have reached age 12.

30% of cases who take advantage of this appliance never need braces in the future and the rest will need a short time orthodontics when the permanent teeth erupt.

Advantages:

This is an excellent appliance to develop the mid-face complex and upright the lower jaw through remodeling. Because this appliance is used during growth it takes advantage of the displacement and remodeling occurring in the facial region.

 

This appliance develops the top jaw three dimensionally

 

This appliance can eliminate facial asymmetries, excessive gingival show, and remodels the mid-face complex to a more functional configuration.

 

This appliance stimulates the lower jaw to upright through remodeling and decreases the lower face height

 

This appliance creates a positive effect on the nasopharyngeal airway

 

It is composed of heavy duty materials, yet is comfortable for the patient to wear, and easy for the parent to see.

 

Activating the screws is easy for the patient and the parents

 

Construction is quite straightforward, and chairside adjustments are easy, requiring only a few moments of the dentist’s time.

 

Patient and parent acceptance is excellent.

 

The ideal time to initiate treatment with this removable appliance is between the ages of 6-9 years old. The normal treatment time is 8-12 months.

Fixed growth guidance appliance

This appliance is one of Dr. Galella’s most significant inventions.

This tool has to be cemented on the upper teeth for 3 to 8 months and can be used for anyone above age 9. For severe cases, we may need a longer period.

Advantages:

 

This is an excellent appliance to develop the mid-face Complex. This appliance takes advantage of the remodeling occurring in the facial region by influencing residual growth sites.

 

This appliance develops the top jaw three dimensionally through remodeling

 

This appliance can eliminate dental and facial asymmetries, excessive gingival show, and remodels the mid-face complex to a more functional configuration.

 

This appliance creates a positive effect on the nasopharyngeal airway

 

It is composed of heavy duty materials, yet is comfortable for the patient to wear, and easy for the parent to see.

 

Construction is quite straightforward, and chairside adjustments are easy, requiring only a few moments of the dentist’s time.

 

Patient and parent acceptance is excellent.

 

Mandibular advancement (bottom jaw advancement)

An underdeveloped lower jaw is a critical issue which can lead to sleep apnea and increased blood pressure.

There are several reasons for an underdeveloped lower jaw:

The most common reason is a narrow and high arched palate where the palate is unusually high and narrow. It is usually a developmental problem, but it can also be an acquired condition caused by chronic thumb sucking

 A low tongue posture due to mouth breathing is a common cause for this 

problem.

A narrow and high-arched palate can also cause a restricted airway and sleep apnea.

Deep bite: Naturally, when jaws are resting, the upper anterior teeth will be 

positioned a little bit ahead compared to the lower anterior teeth. Vertically

speaking, they will cover the lower anterior teeth by about one to two

millimetres. If this coverage is more than mentioned, it is called a deep bite

which can trap the lower jaw not allowing it to come forward freely.

Back tilted front teeth: this is more common in people with weak facial muscles

and long faces.

Under developed / short top jaw: this is very common in modern societies and

needs to be fixed.

Underdeveloped lower jaw Treatment

Twin blocks

Twin block appliances are removable bite blocks with occlusal inclined planes which can bring the lower jaw forward. These inclined planes transmit favourable occlusal forces to the lower jaw.

This appliance can also work as a palatal expansion appliance.

They should be worn 24 hours a day.

Twin force bite corrector

This appliance is usually used at the very end stage of braces. Its mechanism is very similar to the twin blocks. This appliance is comprised of two special springs which connect the top and bottom jaws together. When the patient closes their teeth together, the lower jaw will be pushed forward and consequently the changes in the bone will happen.

 

Lower jaw advancement for sleep apnea

There are several removable appliances which should be worn at night to advance the lower jaw. This advancement in the mandible will bring the tongue forward, enlarging the airway.

Note: long term use of these appliances will result in permanent jaw advancement.

 

 

 

Palatal expansion appliances

This tool has different types and its purpose is to widen the upper jaw in the lateral direction. Using Dr. Galella’s latest system that three-dimensionally widens the upper jaw, we only need this appliance in very severe cases.

 

Two by four (2X4)

Two by four is a fixed appliance comprised of two bands on the first molars and four brackets on the four front teeth connected with a wire. The golden time to use this appliance is between 7 to 12 in which the patient has some baby and some permanent teeth

The mechanism pushes the front teeth forward, bringing them to a nice arch, fixing the crowding and irregularities and making more space for the future erupting teeth.

The golden time to use this appliance is between 7 to 12 in which period the patient has some baby and some permanent teeth.

The indications are:

  1. Anterior cross bite in which one or more lower front teeth are ahead of the top ones

  2. When a permanent tooth can not erupt due to insufficient space between the teeth

  3. Severely rotated and crowded front teeth with risky gum condition

  4. When the teeth’s appearance is the target for peer group teasing (especially 9-10 year old boys)

 

The advantages of 2X4

  1. A very short period is enough (usually 2 to 5 weeks)

  2. Very comfortable

  3. Minimal need for patient cooperation

  4. 3D effect on teeth appearance

 
 

 

Habits

Some environmental influences can modify or disturb face and jaw development and oral habits such as mouth breathing, tongue-thrusting or other swallowing habits, thumb or lip sucking can affect the normal growth.

What is the most common undiagnosed condition which can affect both the short and the long term orthodontic treatment outcome?

The answer is tongue habits, which are usually more difficult to diagnose or treat than the other oral habits.

The tongue habit appliances 

These appliances were designed and developed by Dr. Steve Galella in 1997

These should usually be the last appliance used in the sequence of Dentofacial-Orthopaedic Appliances otherwise there is a high risk of the tongue habit returning.

The ideal time to initiate treatment is as soon as the tongue habit is first diagnosed. The normal treatment time for children and adolescents is 6 months and for adults may take up to two years.

Advantages:

Being fixed, it lessens the potential for loss or damage, as well as the need for constant repair during the treatment period.

It is composed of heavy-duty materials, yet is comfortable for the patient to wear, and easy for the parent to see.

The spinner bead allows for predictable retraining of the tongue.

The trans-palatal element serves as an active reminder when an improper swallow occurs.

Patient and parent acceptance is excellent.

 

 

 

 

Gummy smile

A condition that causes the patient’s gum to be seen while smiling, more than two to four millimetres. The main reason is that the upper jaw has grown downward and/or the upper lip is too short

In mild cases, gum surgery or restorative treatments are sufficient. For more severe cases, orthodontic treatments are necessary, and for even worse cases, jaw surgery may be needed. The important point is that if the problem is diagnosed early, it can be prevented.

 
 

Impacted teeth orthodontics

Sometimes permanent teeth cannot break through the gum tissue and get locked behind the other teeth. After wisdom teeth, the most common unerupted teeth are the top canines, or eye teeth.

In many cases, we can surgically access the unerupted tooth crown and try to bring it out orthodontically. In this process, at the time of surgery we connect a golden chain to the crown and try to bring it out gradually.

It is of note that many of these cases are preventable if they are diagnosed during childhood.

 

TMJ Management

Our jaw joint is a joint between the bottom jaw and the Temporal bone. The position of the lower jaw bone in the joint is highly influenced by our teeth. For example, if the top jaw is small and the bottom jaw cannot sit in its normal position, the bottom jaw will be pushed backward which can cause headaches and even many symptoms beyond the head.

In this kind of problem we face complications of the neuromuscular system, which is very complicated and unpredictable. If the origin of the problem is the joint, we can usually manage it but that is not always the case.

For the first step, we use splints and if this step is successful it can be followed by a successful orthodontic management. Otherwise, referral to a chiropractor or neurologist would be the next step.

Sydney NSW Australia

Novel Dental , orthodontics , Braces , clear correct , insignia , implant , Dentist , dental , prosthesis ,  Faraz , Sydney , CBD , Strathfield , Newtown , New town , veneers , surgical , surgery , crown , bridge , Dewhust Dental , Bluetoothdental.com.au , blue tooth dental , Uplusdental.com.au , Uplus Dental , overdenture , all on 4 , Persian Dentist , Iranian

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faraz@noveldental.com.au

Phone: 02 8809 4631