Orthodontics is the part of dentistry that deals with the correct alignment and leveling of teeth. The patient usually comes for aesthetic problems, but it goes far beyond aesthetic problems, you have to make the mouth work.
For a mouth to function, there are two sets of teeth: grinding teeth and cutting teeth. When the teeth grind, the teeth should not cut, and when the teeth cut, the teeth do not work. For that there are two safety mechanisms, the first safety mechanism is what we call anterior guidance. The incisors are placed like this with torque and the lower incisors are mounted a little bit over the upper incisors, then when making the protrusion movements, the lower incisors slide over the upper incisors and disocclude the molars, protecting the molars. Teeth cut and molars stop working. The same happens with the fangs. We normally chew by swinging and when we swing the upper fangs, the lower fangs slide over them opening the whole system, the incisors and the molars. When the teeth are well aligned and function well they are much more beautiful and above all the mouth is much healthier, because it is much easier to maintain, you have no nooks and crannies, you can brush much better and it works much better.
Types of orthodontics
The esthetic treatments that patients bring are divided into two groups: In children who have growth and in adults who are no longer going to grow. In children what we do is first remove pernicious habits that modify the alteration of function, and we also do this with direct tracks glued to the teeth without any type of appliance, so that if the teeth begin to work well, they correct the malformation of the bone and dental structures. If the patient is older, what we have is an appliance that, to do it with fixed orthodontics, we use self-ligating orthodontics with aesthetic brackets or metal brackets and now we are doing a lot of invisible orthodontics in adults. It has many advantages and some limitations. Advantages, they are very comfortable, they are transparent, they are very esthetic, they can be removed and put on… and they have limitations, one of them is that they can be removed and put on, that is, the patient can decide not to put it on and then it does not work, because it has to be in the mouth for more than 17 hours at a time. Another limitation is that they cannot do all the movements that we do with metal brackets or esthetic brackets.
Depending on the degree of severity of the malocclusion, if it is mild or moderate, we do what we call a “Set Up”. We take a measurement and make a diagnostic wax-up and on that we make a “Moke Up”, which is a set of teeth, a screen like those used in the movies and we put some teeth to see how they look. If the malocclusion is already accentuated or severe, then what we do is, we take the same impressions, digitize them and make a “Set Up” in 3D on the model on the screen.
We have a philosophy of orthodontics and that leads to a type of appliance and we have a very clear scheme, that is, for an adult or middle-aged patient we are the ones who make the proposal, that is, the diagnostic tests, the x-rays and the models, the periodontogram… Their analysis gives us a result and we already give a diagnosis with a name and surname. That allows us to establish a prognosis and a treatment plan, and with that treatment plan we give a budget. What does that mean? The diagnosis is as if we were going on a trip and we say, well, let’s go to Palma de Mallorca, do we both like it? Patient and clinic, perfect. Well, how do we go to Palma de Mallorca, and which hotel do we go to? That depends on the money we want to spend. Here is a very clear example: In Spain, I go to a three-star hotel in Palma de Mallorca without any problem, but I know that there are four-star hotels, five-star hotels and five-star luxury hotels. Well, in an orthodontic system the approach is the same, and we say, look, for this diagnosis of this malocclusion we have this treatment – we advise and the patient chooses the type of hotel he/she wants to go to.