It is commonly heard from dentists and orthodontists that a beautiful smile is a healthy smile. But is this true? Most of us are familiar with braces, retainers, and standard orthodontic care but are not aware of the potential side effects and how to avoid them.
When teeth move, they are subject to forces that can compromise their roots and even damage them permanently. Root resorption is the destruction of the root structure of a tooth and, left unchecked, the eventual loss of the root or the entire tooth. Almost all orthodontic procedures that involve tooth movement will result in some amount of bone loss and root resorption. Risk factors for root resorption include periodontal disease, previous bone loss or cavities, inadequate oral hygiene, and inflammation. Orthodontic treatment that lasts longer than eighteen months will also put a patient at high risk for root resorption and bone loss. The best way to prevent clinically damaging root resorption is to know what it is and all the available options. If any risk factors are present, it is vital to address them before getting braces. If previous bone loss is too great, it may be best to forego braces altogether in favor of cosmetic dental restoration, which utilizes porcelain veneers, bridges, implants, and crowns to great effect. Standard orthodontic treatment also provides many options to minimize the risk of root resorption. Custom braces, developed with the use of computer analysis and calculations, can cut down the treatment time required by anywhere between twenty-five and forty percent. Choosing braces that apply the least amount of force required can also reduce this risk.
In the process of moving teeth into new positions, braces loosen the teeth. Sometimes, this looseness persists after the braces are removed, and the teeth may still even wiggle around when pressure is applied to them. Loose teeth can persist for up to two or more years after orthodontic treatment is complete. Risk factors for this problem are extreme tooth movement during treatment or treatment that is moved along too rapidly. When considering treatment goals and duration, it can be helpful to consider this potential side effect. Once the teeth are already loose, however, it is important to follow the procedures outlined for post-treatment recovery and maintenance. The primary purpose of wearing a retainer post-treatment is to maintain the teeth’s new position in the mouth. Failure to use the retainer appropriately and consistently can result in teeth returning to their original positions, remaining loose, or, if the root has already been compromised, worsening into resorption.
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Straightening crowded teeth will usually create more space between the teeth. While this makes it easier to clean teeth properly and creates a prettier tooth arch, it can also create unsightly gaps at the tops of the teeth. Risk factors include a severely overcrowded mouth. It is possible to avoid this problem altogether by opting for extractions and restorative dentistry; however, this may or may not correct the underlying issues in the mouth. The best solution to this problem varies and should be discussed with a dentist or orthodontist.