Medford Orthodontist - Gwendolyn Cugine, DMD

Orthodontic Treatment Phases

Orthodontic treatment is highly predictable and immensely successful.  Depending on the severity of the malocclusion (bad bite) or irregularity, orthodontic treatments may occur in either two or three distinct phases.

The benefits of correcting misaligned teeth are many.  Straight teeth are pleasing to look at and greatly boost confidence and self esteem.  More importantly, properly aligned teeth enhance the biting, chewing and speaking functions of the jaw.  There are several types of irregularities, including:

Overbite – The upper teeth protrude further than or completely cover the lower teeth.

Underbite – The lower teeth protrude further than the upper teeth causing the chin to look prominent.

Crossbite – Some of the upper teeth may close inside the lower teeth rather than on the outside.

Overcrowding – Insufficient room on the arch causes some adult teeth to erupt incorrectly and become rotated.
The Phases of Orthodontic Treatment

Generally, orthodontic treatment takes between six and thirty months to complete.  The treatment time will largely depend on the classification of the malocclusion, the type of dental devices used to correct it and the perseverance of the patient.

Here is a general overview of the three major stages of treatment:

Phase 1 – The Planning Stage

The orthodontist makes an exact diagnosis in order to realign the teeth in the most effective and expedient way.  The first several visits may comprise of some of the following evaluations:

Medical and dental evaluations – Dental and physical problems tend to go hand in hand.  Problems in the oral cavity can lead to (or be caused by) medical problems.  The goal of this evaluation is to ensure that prior medical and dental issues are completely under control before treatment begins.

Study model (castings/bite impressions) – The patient is asked to bite down into a dental tray filled with a gel substance that hardens around the teeth.  The trays are removed from the teeth and filled with plaster to create models of the patient’s teeth.  Study models enable the orthodontist to scrutinize the position of each tooth, and how it relates to the other teeth.

Panoramic X-rays – X-rays are fantastic tools for viewing potential complications or pre-existing damage to the jaw joint.  X-rays also allow the orthodontist to see the exact position of each tooth and its corresponding root(s).

Computer generated images – Such images allow the orthodontist to treatment plan and examine how specific treatments may affect the shape of the face and symmetry of the jaw.

Photographs – Many orthodontists like to take “before, during and after” photographs of the face and teeth to assess how treatment is progressing, and the impact the treatment is having on the patient’s face shape.
Phase 2 – The Active Phase

All of the above diagnostic tools will be used to diagnosis and develop a customized treatment plan for the patient.  Next, the orthodontist will recommend custom orthodontic device(s) to gently move the teeth into proper alignment.  This orthodontic appliance may be fixed or removable.  Most commonly, traditional fixed braces are affixed, which utilizes individual dental brackets connected by an archwire.  Lingual braces are also fixed, but fit on the inside (tongue side) of the teeth to make them less visible.

Removable devices are an alternative to fixed braces.  Examples of removable devices include the Invisalign system, headgear and facemask.  These devices are designed to be worn for a specified amount of hours each day to expedite treatment.

Whatever the orthodontic device, the orthodontist will regularly adjust it to ensure adequate and continual pressure is being applied to the teeth.  It is essential to visit the orthodontist at the designated intervals and to call if part of the device breaks or becomes damaged.

Phase 3: The Retention Phase

When the teeth have been correctly aligned, fixed braces and removable devices will be removed and discontinued.  The most cumbersome part of the orthodontic treatment is now over. The orthodontist will next create a custom retainer.  The goal of the retainer is to ensure that the teeth do not begin to shift back to their original positions.  Retainers need to be worn for a specified amount of time per day for a specified time period.  During the retention phase, the jawbone will reform around the realigned teeth to fully stabilize them in the correct alignment.

If you have any questions about orthodontic treatments, please contact our Medford orthodontic office @  (781) 391-2800 .