Orthodontics is the specialized branch of dentistry focused on diagnosing, preventing, and treating dental and facial irregularities. The main purpose is to correct a malocclusion, which is an incorrect bite or misalignment, to achieve proper function, better health, and improved aesthetics. Common problems treated by orthodontics include crowded or crooked teeth, spaces or gaps between teeth, and various bite issues such as overbites (where the upper front teeth excessively overlap the lower teeth), underbites (where the lower teeth bite in front of the upper teeth), and crossbites. Correcting these issues improves the ability to chew, prevents abnormal wear of the teeth, and makes the teeth easier to clean, thereby reducing the risk of decay and gum disease.

The most common types of fixed orthodontic appliances available are traditional metal braces, which are the most recognizable type and are made of high-grade stainless steel brackets and wires. They are the most durable and cost-effective option, and modern versions are smaller and more comfortable than in the past. Another popular option is ceramic braces, which function identically to metal braces but use clear or tooth-colored brackets, making them much less noticeable and a popular choice for adults and older teenagers concerned with aesthetics. Finally, lingual braces are a less common option where the brackets and wires are custom-fitted to the back, or lingual side, of the teeth, making them virtually invisible from the front, though they can sometimes affect speech initially.

The American Association of Orthodontists recommends that a child have their first orthodontic evaluation by age seven. This does not mean treatment will start immediately, but at age seven, the child typically has a mix of baby and permanent teeth, and the jaw is developed enough for the orthodontist to detect subtle problems with jaw growth and the emerging permanent teeth. This early visit allows for interceptive treatment (Phase I), which may involve using appliances like expanders to correct serious jaw problems—such as a crossbite or severe crowding—early on. Treating these skeletal issues early can simplify or shorten the second, comprehensive phase of treatment later, reducing the need for more complex procedures like extractions or surgery down the road.

The duration of comprehensive orthodontic treatment varies significantly depending on the severity of the malocclusion, the type of appliance used, and the patient’s compliance. On average, most patients wear traditional braces for a period of 18 to 30 months. However, simple cases involving minor crowding or spacing may take as little as 12 months, while severe cases involving significant jaw correction, impacted teeth, or complex bite issues can take longer than 30 months. The most critical factor influencing treatment length is the patient’s cooperation; consistently wearing elastics (rubber bands) and maintaining regular adjustment appointments helps keep the treatment on schedule.

Fixed orthodontic appliances, such as braces, are not generally painful, but patients should expect periods of discomfort or soreness, especially immediately after they are first placed and following routine adjustment appointments. This discomfort is described as a dull ache or feeling of pressure as the wires begin to move the teeth into new positions. This sensation typically lasts only for the first two to five days after placement or adjustment and is easily managed with over-the-counter pain relievers and a soft diet. Patients may also experience temporary mouth sores or irritation from the brackets and wires rubbing against the cheeks, which can be relieved by applying orthodontic wax.

Yes, a significant percentage of orthodontic patients today are adults, and adult treatment is highly effective. The biological process of moving teeth through the jawbone is the same for adults as it is for teenagers, so successful alignment can certainly be achieved. However, adult treatment may take slightly longer because the facial bones are no longer growing, and bone density is greater than in adolescents, which can slow tooth movement. Adults also often require more interdisciplinary care due to existing restorative work, previous tooth loss, or periodontal issues. Nonetheless, fixed braces, ceramic braces, and lingual braces are all excellent options for adults seeking to correct alignment, improve bite function, and enhance the aesthetics of their smile.

Interceptive treatment, also known as Phase I treatment, is a short course of orthodontic care that takes place when a child still has many of their primary (baby) teeth, typically between the ages of seven and nine. This phase is necessary when a child has a severe skeletal or functional problem that would be much harder to treat later, such as a severe crossbite, significant jaw imbalance (like a protruding lower jaw), or severe crowding. Phase I treatment often involves the use of appliances like palatal expanders or functional removable appliances and is designed to correct the foundation—the jaw size and relationship—before all the permanent teeth erupt. This successful early correction reduces the complexity and duration of the later comprehensive treatment (Phase II).

Wearing traditional braces requires strict adherence to dietary restrictions to prevent brackets from breaking, wires from bending, and food from getting trapped, which leads to decay. Patients should avoid all hard, sticky, and crunchy foods. Specific items to avoid include sticky candies like caramel or taffy, hard nuts, popcorn, chewing gum, ice, and hard crusty breads. It is also advised to cut hard fruits and vegetables like apples and carrots into small, chewable pieces rather than biting directly into them. Ignoring these restrictions can result in loose or broken components, which cause pain and necessitate emergency appointments, significantly delaying the overall treatment time.

Elastics, or orthodontic rubber bands, are small, removable latex or non-latex bands that are hooked onto small brackets or hooks on the upper and lower braces. They are an absolutely crucial component of treatment and are necessary for correcting the bite (occlusion). While the wires move the teeth within each arch (straightening them), the elastics apply force between the upper and lower jaws to correct the way the top teeth meet the bottom teeth, fixing issues like overbites, underbites, and crossbites. Patient compliance in wearing these elastics exactly as instructed—usually 24 hours a day, only removing them to eat and brush—is often the single greatest factor in determining whether the treatment finishes on time.

Yes, wearing a retainer after the removal of braces is absolutely mandatory and a non-negotiable part of the orthodontic process. The active phase of treatment straightens the teeth, but once the fixed appliances are removed, the bone, ligaments, and gums surrounding the teeth need time to solidify and stabilize the new positions. Without a retainer, the teeth have a natural tendency to slowly drift back toward their original positions, a phenomenon known as relapse. You will typically wear your custom-made retainer full-time for an initial period, and then transition to wearing it every night indefinitely to ensure your beautiful, corrected smile is maintained for a lifetime.