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Orthodontics is experiencing a considerable boom in recent years

 Various options from brackets to invisible aligners

Orthodontics is experiencing a considerable boom in recent years

Orthodontics has been experiencing a big boom in recent years, both because of an increase in the demand for these treatments in adults and because of the marketing of new products that overcome some deficits of classic resources; in addition, the interest in improving dental and facial esthetics, and in correcting malocclusions and improving masticatory function, encourage many patients to opt for this therapy.

What is Orthodontics? 

Orthodontics is the specialty of dentistry responsible for preventing, diagnosing, intercepting, and treating alterations in the position and relationship of the teeth and jaws. In addition to improving dental and facial esthetics, orthodontics aims to correct malocclusions and improve masticatory function.

Who are the candidates for this treatment, and what are the benefits?

Orthodontic treatment is associated with growing patients, so it has always been considered appropriate for children and adolescents. However, it is increasingly demanded or indicated in adults due to its benefits and advantages in terms of esthetics, rehabilitation, and oral health maintenance.

What practical advice should be followed before, during, and after orthodontics to optimize your results?

Before starting orthodontic treatment, it is essential to put yourself in the hands of a professional who, after a comprehensive diagnosis and evaluation of your oral health, will indicate the type of orthodontics and the appropriate treatment that suits your needs. In addition, you should understand what the treatment consists of, the advantages and possible disadvantages, the frequency of scheduled visits, and resolve any doubts you may have.

During treatment, the patient must respect the scheduled visits and follow the recommendations on oral hygiene, diet, and the use of the devices related to the treatment he/she is receiving. It is essential to maintain strict control of plaque and to attend follow-up visits and evaluation of the state of the gums if necessary. In the patient who has been treated for periodontitis and started orthodontic treatment, his gingival health should be controlled and monitored synchronously by the periodontist. In addition, he will have to attend maintenance visits.

After orthodontic treatment, it is essential to maintain the occlusal stability achieved and maintain the teeth' position. For this reason, it always ends with the placement of a fixed and/or removable retention that should be periodically reviewed by the professional at "retention appointments." The documentation, breakage, or non-use of the retainers could cause tooth movement and the teeth to return to an undesired position, hence the importance of detecting it in time.

Why is it so important in orthodontic treatment that the teeth are aligned and have a good occlusion?  

Malocclusions often cause contact or interference at rest or during chewing. This situation can increase the probability that the tissues surrounding the teeth receive trauma, causing mobilities and migrations; on the other hand, it can predispose to alterations in the temporomandibular joint and increase the possibility of suffering headaches, migraines, or ear pain. For all these reasons, occlusal stability is essential for the maintenance of periodontal and joint health, as well as masticatory function. All this undoubtedly contributes to an improvement in the quality of oral life.

In this context, why do you consider close orthodontist-periodontist collaboration essential?

Tooth movement is the result of an interaction between an orthodontic force applied to a tooth and the tissues surrounding the tooth. For the result to be satisfactory, the tissues must be healthy. In the presence of inflammation, the orthodontic movement can initiate or accelerate a process of destruction that becomes irreversible if it affects the bone surrounding the tooth.

For this reason, before starting orthodontic treatment, it is crucial to evaluate the state of the gums and diagnose any periodontal pathology. If gingivitis or periodontitis is present, they should be treated by the periodontist before orthodontic treatment begins; this specialist will be the one who, once these disorders have been controlled, will decide when it is time to start orthodontic treatment and will schedule the pertinent revision or maintenance visits. Communication between the orthodontist and periodontist must be very close to detect and intercept any incident related to gingival health.

Is orthodontics in its heyday? Why? Is it mainly for aesthetic reasons?

Adult patients' demand for orthodontic treatment has increased significantly in recent years. This is due, on the one hand, to esthetic and restorative reasons; in the anterior areas, specific movements can relocate the teeth to a more harmonious position, redistribute spaces needed to place implants, or carry out the restorative treatment necessary to achieve esthetics. On the other hand, much of the current boom in orthodontics is due to the appearance of a range of options, from brackets to invisible aligners.

Aligners or "invisible orthodontics," lingual orthodontics, and porcelain brackets make the option of orthodontic treatment for adults much more attractive and bearable.
In this area, some unadvisable practices have recently been denounced, such as the online sale of aligners; what are the dangers of these fads?

Behind the online sale of aligners, some companies offer these products without any scientific rigor or guarantee of quality. In addition, the lack of control of orthodontic treatment involving these aligners could irreversibly alter oral health, causing alterations in occlusion, esthetics, and articular and periodontal disorders.

The indication for orthodontic treatment should come from the specialist and professional. After the proper evaluation and study, they should indicate and personalize the orthodontic treatment according to the state of each patient's oral, gingival, and articular health. In addition, any orthodontic treatment requires follow-up and monitoring by the orthodontist, who must supervise the evolution of the treatment, and by the periodontist, in the case of a patient with a history of periodontal problems.

What are clear or invisible aligners?

Clear aligners are invisible devices that are individually designed to move the teeth. They are supported by small 'attachments' cemented to the teeth to make the movements more effective. They are renewed every 2 weeks, and each aligner differs from the previous one.

What advantages do they offer compared to other classic orthodontic devices?

The main advantages are that they are 'removable,' which allows you to clean and eat more comfortably, and they are more discreet or practically invisible.