Orthodontics
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Orthodontics "orthodontia" or the specialty of dentistry that is concerned with the study and treatment of malocclusions, which may be a result of tooth irregularity, disproportionate jaw relationships, or both.
Orthodontic treatment can be carried out for purely aesthetic reasons - improving the general appearance of patients' teeth for cosmetic reasons- but treatment is often prescribed for practical reasons, providing the patient with a functionally improved bite (occlusion).
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Treatments
Treatment includes fixed appliances, most commonly dental braces, which can be made from stainless steel or a more esthetic ceramic material; removable appliances, or "plates"; headgear; elastic bands; and other appliances, including expansion appliances, and functional appliances.
After a course of active orthodontic treatment, patients will often wear retainers, which will maintain the teeth in their improved position whilst the surrounding bone reforms around them. The retainers are generally worn full-time for a short period, perhaps 6 months to a year, and then worn periodically (typically nightly during sleep) for as long as the orthodontist recommends. It is possible for the teeth to stay aligned without regular retainer wear. However, there are many reasons teeth will crowd as a person ages and thus, there is no guarantee that teeth, orthodontically treated or otherwise, will stay aligned without retention. For this reason, many orthodontists recommend periodic retainer wear for many years (or indefinitely) after orthodontic treatment.
Orthodontists
An orthodontist is a dentist who specializes in diagnosing and treating malocclusions, which are mis-alignments of the teeth, jaws, or both. Following dental school, an orthodontist completes 2-3 years of full-time additional training resulting in a specialty certificate in orthodontics. In many orthodontic training programs, students can also earn one of three master's degree (Master of Science - MS; Master of Dental Science - MDS, or Master of Science in Dentistry - MSD) in addition to a specialty certificate.
The orthodontist will align teeth with respect to the surrounding soft tissues, with or without movement of the underlying bones (which can be moved either through orthopaedic or orthognathic movements). Orthopaedic movements are attained through the judicious use of (mainly) acrylic appliances (functional appliances), that influence the position of the jaws relative to one other and the face, and will be carried out on growing children. The correct application of orthopaedic appliances can influence the development of an adolescent's jawline, giving a much improved aesthetic and functional result.
Orthognathic movement is achieved by surgically repositioning the jaw(s), in patients that have completed their growth. Such surgical treatment is carried out by maxillofacial surgeons who work closely with the orthodontic team.
One of the most common situations leading to orthodontic treatment is crowding of the teeth. In this situation, there is insufficient room for the normal complement of adult teeth, which can sometimes result in teeth being extracted. Crowding of teeth is recognised as an affliction that stems in part from a modern western lifestyle. We do not know for sure whether it is due to the consistency of western diets; a result of mouthbreathing; or the result of an early loss of deciduous (milk, baby) teeth due to decay. It is also possible that Homo sapiens have evolved smaller jaws without a reduction in the number of teeth they will house happening at the same time. orthodontistry is not always for aesthetic purposes. Braces may be fitted in the case of an overbite to help prevent the occurence of teeth being knocked out in an accident, for example, hockey or skating.
Much has been made in the media of links between tooth extraction and temporo-mandibular joint dysfunction (problems, including clicking and jamming, of the jaw joint). No research has shown a definitive link between extraction of teeth and jaw joint problems. Most temporo-mandibular joint problems are a result of the patient having a clenching habit - that is the patient bites the teeth together on a regular basis (e.g. when under stress).
Training
Various countries have their own systems for training and registering specialist orthodontists; generally a period of full-time post-graduate study is required for a dentist to qualify as an orthodontist. The orthodontic specialty is the earliest dental specialty.
In the United Kingdom, this training period lasts three years, after completion of a fellowship diploma from a Royal College. In Europe a similar pattern is followed. It is always worth contacting the professional body responsible for registering orthodontists to ensure that the orthodontist you wish to consult is a recognized specialist.
Canada
Currently, speciatly programs in orthodontics (3 year M.Sc. or M.Cl.D.) are offered at four Canadian universities: the University of Manitoba, University of Toronto, the University of Alberta, and the University of Western Ontario. Students are trained to handle complex cases while completing a research project in orthodontics. The programs are accredited by the Council on Education of the Canadian Dental Association. Certification requirements set by the Royal College of Dental Surgeons of Ontario and the Royal College of Dentists of Canada are also met by these three programs. Post-graduate orthodontic studies in the United States requires at least two years and most orthodontic programs offer a three-year Master program.
India
Orthodontic News magazine: "Torq" is quarterly newsmagazine for orthodontics, run by four orthodontists from India. Check the website: www.torq.in for more information
Pakistan
Orthodontic education in Pakistan is run under the Semi-autonomus organization College of Physicians and Surgeons they confer a fellowship degree after three years of training under an accredited supervisor in an approved institution.
United States
A number of medical and dental schools in the United States offer advanced education in the specialty of Orthodontics to dentists seeking postgraduate education. The courses range from two to three years of full-time classes and clinical work in the clinical and theoretical aspects of orthodontics. Generally, admission is based on an application process followed by an extensive interviewing process by the institution, in order to select the best candidate. Candidates usually have to contact the individual school directly for the application process. A list of orthodontic schools can be obtained from the American Association of Orthodonitists[1].
See also
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