Crooked teeth are straightened by the use of special devices and techniques (orthodontics).

In general, orthodontic treatment is undertaken for children (typically aged between 12 – 17 years) or adults. The specific timing of treatment will vary from patient to patient.

Mr Lewis will undertake a detailed examination and possibly take X-rays, moulds (impressions) and photographs of the teeth. The preferred course of treatment to obtain the best results will be explained. Options will be discussed as well as potential problems/limitations of the proposed treatment.
Why are teeth removed?
Mr Lewis may ask the patient’s dentist to remove one or more of either:

a) Baby teeth – occasionally baby teeth stay in the mouth for longer than they should and delay the adult teeth coming through. In these cases, their removal will significantly help.

b) Adult (permanent) teeth – many people have too many teeth for the size of their jaws and so the removal of some of the adult teeth may be needed to make space to straighten the crooked ones. The decision to remove teeth is never taken lightly and is based on careful consideration of the position of the teeth and how they bite together and space required. If the teeth are not too crooked, it may be possible to have treatment without any being removed.
What factors could delay the start of the treatment?
a) The number of adult teeth in the mouth. Orthodontic treatment that involves the use of fixed braces usually starts when all the adult teeth have appeared in the mouth. However, a removable brace can be fitted at an earlier age if it is necessary.

b) The general condition of the teeth and gums. If there is dental decay or gum disease, orthodontic treatment will need to be delayed until it is treated. If it is not, there is a real risk of both the decay and the gum disease getting worse when a brace is fitted.

c) The presence of a waiting list.
What types of brace are there?
Essentially there are two kinds of brace:

• Fixed Braces – these are individually fixed to the teeth with special glue and therefore cannot be removed by the patient. This type of brace is used when the teeth are very crooked and offers the best results. Some patients (especially children) like to choose different colours on the brace to make them trendier.

• Removable Braces – these are very useful at moving either individual or groups of teeth, for example for correcting a deep bite or widening a narrow upper jaw. As such they can be used at an earlier age than a fixed brace. This type of treatment usually precedes fixed brace treatment. Removable braces can be easily cleaned.
How long will the treatment take?
The time taken to effect the necessary corrections depends on:

• How crooked the teeth are.

• The more complicated the problem, the longer the treatment is likely to take.

• The type of brace.

• Fixed brace treatment on average will take up to 18 months and removable brace treatment from 6 – 9 months.
Care of the appliance
Repeated breakages and poor cleaning of the brace will significantly delay treatment time.
Is the fitting of the brace painful?
No, but the patient may well experience a degree of discomfort, from both the teeth and inside of the cheeks, for a few days following the initial placement of the brace and subsequent adjustments.
How often will the brace be checked?
Once the brace (fixed or removable) has been fitted, visits to Mr Lewis at 6 - 8 weeks will be needed to monitor progress and have the brace adjusted. It is very important to continue with regular checkups to ensure that the teeth and gums remain in the very best condition.
Cleaning of brace
It is essential that teeth and brace are kept as clean as possible. Any particles of food and plaque left around the brace means a risk of developing tooth decay or gum disease. Mr Lewis will advise the use of brushes, mouth rinses etc. to help keep your mouth as healthy as possible during your orthodontic treatment.