Extreme Makeover Using Instant Orthodontics
By Ralph DeFelice, DDS
Published on July 21, 2006
Are you unhappy with your bite or the way your teeth look and feel, but can't face the idea of orthodontic braces? Instant orthodontics may be the solution to your dental problem.
“Instant” orthodontics (IO) can be defined as the use of techniques to correct malocclusion, crowding, and spacing of teeth in minutes or days (versus the months or years required by traditional orthodontic techniques). Most often, the corrections are accomplished with ceramic veneers, bonding, crowns, and bridges – or a combination of these techniques.
Dentists are trained to prescribe orthodontic treatment whenever patients display malocclusions. Patients with overbites, crowding, and malocclusions are often told by their general dentists to seek a consultation from an orthodontist. When the patient is a child, parents often respond by saying, “Okay. We'll do that, especially if you think he will have problems later in life. I want my child's teeth to be perfect.” Adult patients, however, often respond differently: “I don't like the way my teeth look, but they don't hurt. I'm used to them as they are. Besides, I'll feel funny sitting around in an orthodontic office full of 10 year-olds. I'm not wearing all that stuff on my teeth. I'm too old for that, and too busy for all those appointments. It's true – I don't like the way my teeth look. Can't something else be done?”
These patients often end up with no treatment at all, because many dentists will not do restorative treatment unless the patient submits to orthodontic treatment first. But as it turns out, there is ”something else” that can be done. In fact, it is often possible to give adult patients the beautiful smile they desire without orthodontic treatment. In many situations we can correct cases of “over-bite,” “under-bite,” crowding and/or missing teeth without any orthodontic treatment.
Why Instant Orthodontics?
Here are just a few reasons to consider instant orthodontics:
- Convenience. Many of the “instant” results are possible in one or two visits. This suits the schedule of most busy adults.
- No retainers! With conventional orthodontic treatment, retainers are often worn for years (or even for the remainder of the patient's life). Retainers are not needed in IO.
- Lack of side effects. This is a big one. As in any dental procedure, postoperative symptoms such as tooth sensitivity can occur, but most patients do not experience side effects.
This last benefit merits further discussion, because beyond having more side effects, traditional orthodontics can actually create problems that didn't exist before treatment. For example, when crowded teeth are straightened, “black triangles” of space often appear near the gum, between the teeth. These black triangles are very unattractive and hard to deal with. After opening the bite with braces, a long period of retention – sometimes lasting a patient's entire life – is required before restoration is possible. Bone loss and root reabsorption are also possible.
Another problem that occurs with traditional orthodontics is relapse, wherein teeth return to their original, crooked positioning. This occurs when something dentists call the neutral zone – the position of the teeth established over time by the combination of genetic and functional forces – is violated during orthodontic treatment. Veneers and crowns largely avoid this problem because they leave teeth in their long-established location. Also, even with the best of intentions, spaces left by missing teeth cannot be successfully closed by orthodontic treatment alone. Crowns, veneers, bridges, and implants are often more predictable solutions to the problem of missing teeth.
Modern aesthetic or cosmetic dentistry can run counter-current to traditional dental school training. Dentists are taught to conserve healthy tooth structure, and avoid removing tooth structure unless a disease process needs to be halted. It is true that crowded teeth are not diseased. Neither are teeth blackened by root canal therapy, those with silver-amalgam fillings, or those that are simply discolored or worn. However, many patients are willing to have some tooth reduction in order to solve these problems.
While the tradition of conserving healthy tooth structure has merit, it is too simplistic in the face of the methods and materials available to dentists today, and it is at odds with one of the main reasons patients seek care—because they want their teeth to look better. “These are MY teeth,” they often say. “I want them to look better. Either you do the veneers, or I'll find someone else who will.” This is a good point, and one that dentists who believe in patient-based treatment planning embrace.
Dr. Ralph DeFelice's dental practice is located at 404 William Street in Geneva, New York. For more in formation, please visit his website, www.ralphdefelicedds.com, or contact his practice at 315-789-5665.
For more information on the author, please visit www.ralphdefelicedds.com