Like many preteens, you may visit an orthodontist to determine if there are problems with the alignment of your teeth. The orthodontist looks around your mouth and takes some x-rays (pictures of your teeth). After examining your mouth, your orthodontist will then determine if you will need treatment. You may get braces if you have an overbite, an underbite or just very crooked teeth, because those conditions can easily be corrected by braces.
If you do get braces, you might need a few more x-rays taken, as well as a number of measurements taken of your head to see how your jaw is aligned (or not). Also, your orthodontist will take molds of your teeth. This means your orthodontist will place a tray of putty in your mouth for a few minutes and it creates an imprint of your teeth. After analyzing your head measurements and your teeth molds, your orthodontist will decide when you will be ready for braces.
Orthodontic problems can develop as quickly as your teeth do. Although most problems are more effectively treated when all the permanent teeth are in (at about age 12 or 13), some problems are treated earlier.
You may need to get a space maintainer in your mouth. A space maintainer is a looped piece of metal that keeps your teeth apart, usually so an adult tooth will have the room to grow in.
Sometimes, kids need to have their jaws made wider. In this case, the orthodontist adds an extender. It fits in your mouth like a retainer and slowly pushes out the teeth and bone to make more room.
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How Braces Work
Braces don’t actually move the teeth. It is the pressure that the wires, springs and rubber bands apply to the braces that moves the teeth. This pressure is transmitted from the tooth to the Periodontal Ligament (PDL) that holds the tooth to the bone. The PDL houses cells that allow the bone to yield when it is pushed or pulled so the tooth can occupy a new position in the bone.
The process is called bone remodeling and is modulated by cells that remove bone (osteoclasts) in response to pressure and cells that lay down new bone (osteoblasts) in response to tension. There is a time lag from the moment pressure and forces are applied until actual tooth movement occurs. So you may not feel the pressure until a few hours after your adjustments. And, because the teeth are moving through the bone, your teeth will feel loose; so don’t be surprised or worried when the teeth feel wobbly. Once the teeth are in the correct position and the pressure to move the teeth has lessened, the PDL fibers will tighten, holding the tooth firmly to the bone.
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