Forever or just for now

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Braces don’t add to one’s look but that’s only in the short term. DR. VIJAILAKSHMI ACHARYA on how it helps in the long run.

A great smile in the works...Photo: N. Sridharan
A great smile in the works...Photo: N. Sridharan

Peering into that mirror every morning, I sigh. My teeth. They protrude. My lips stay open till I forcefully close them. Look slightly away and even in a half profile you see them. I wanted to look my best at the graduation party but something was not quite right. I march off to the dentist to try and get a solution to the problem, one more time.

I am 18. My mind goes back to the summer when I was 12. “You need braces,” is the solemn verdict by the orthodontist, towering over me. My saga begins. The crooked road to straight teeth. I reluctantly have braces fixed.

“No fizzy drinks, no pizzas, nothing crunchy,” says the doctor. I wear it for a few months and then insist they be removed. The doctor obliges. Good riddance, I exult. A retainer is worn whenever I remember to and it gradually finds its place at the bottom of the drawer.

Fast forward to now. God, I wished I had finished it then. Now when I want to look my best, those same teeth stand in the way of my otherwise irresistible good looks.

No one has perfectly aligned teeth. Minor irregularities pass unnoticed but many of these situations need correction to have a great smile. Orthodontics, the science that deals with straightening teeth has come up with answers for irregular teeth.

Begin early

Potential problems can be detected and often prevented when your kids go for their orthodontic check-up. At this time, though fixed braces are not used, the child may need to wear corrective appliances or clips such as space maintainers, habit breaking appliances or jaw restricting bands called “head gear”.

All this sets the stage for proper growth and development, basically paving the way and directing the future permanent teeth into their optimum place in the jaw. However, this does not happen classically. Missing out on the right timing and strong genetic traits can cause irregularly placed permanent teeth as well. At about 10 years or after, braces are used to correct the problem.

How do braces work? Wires are bent to follow the shape of the jaw. These are placed into slots in brackets which are stuck onto the tooth. The wire, which has been forced into the slot tries to regain its original shape and in so doing, takes the teeth along with it. Every bracket or “clip” as it is called, has built in “torque” to exert the right pressure in the right direction.

Effect on teeth

The net result of this piece of clever engineering is a constant, continuous pressure on the teeth. This has to be very light but continuous. The place ahead of the tooth that is moving is remodelled to adjust to the pressure and the tooth moves in that direction. That is why; teeth under braces feel detached and “loose”. All of this at a rate of one mm a month!

Slow, you might say but effective! If braces had been started in one form or the other (removable first, then fixed) from the age of 10 or so, with careful wear, it would take you about four years to finish up with a great smile.

If you started as a young adult, it could take you a maximum of 2- 3 years. If you are older, (now you can have them when you are 55) it could take much longer. “I had braces for 10 years,” was the plaintive cry of an orthodontic patient not so long ago.

Now why would this happen? The most common cause, according to orthodontists, is “missed appointments”. The wire that moves through the bracket needs to be changed every 4-6 weeks to exert continuous force. This is the interval during which the wire has reached its original shape and has become non-active. This means that there is no pressure on the tooth and the movement stops.

When the appointment is missed, it is critical to follow up as soon as possible. Failing to do this would actually mean that the teeth that have been moved could go back to their starting point because this is where they would naturally like to be. In essence the tooth moves no more and wearing the brace during this period is a waste of time, especially lost time.

If you were to report for adjustment after say, three months, the orthodontist probably has to put you into a previous wire because now the wire that was for this visit is too tight and causes pain. It’s now easy to understand how the process of tooth movement could be done and undone. In short, it could go on forever.

Dislodged brackets

The other common cause for a long haul with the orthodontist is when the bracket that holds the wire comes off. Even when this happens on one tooth, the entire wire is affected and the teeth will be passive once more. The bracket has to be placed back and the wire re-inserted all over again.

How do brackets come off? By playing or tugging on them. Often some foods that need your incisors may be responsible. These include apples and pizzas, chips or corn. Other habits like biting nails or anything hard, playing hard and vigorous games could also cause the dislodging of brackets.

Allowed to follow its scientific and researched course, braces could change your personality. Additionally you can get better chewing efficiency and be able to maintain your teeth and gums much better. Headaches will be less frequent and painful joint clicking will be minimised.

A healthy smile — wide and beguiling, appealing and pleasing — that is what we all want don’t we? And needless to say, in the shortest possible time!



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