Summary ; Many people have crooked teeth but this can be corrected by a visit to the orthodontist. After assessing the teeth they may use various types of wires and removal blocks to alter the patients bite. When teeth are crowded, the orthodontist may decide that teeth need to be extracted to make enough room for a nice smile. The treatment can be long though and may take several years or more.
A crowded mouth can result in a loss of confidence due to cosmetic reasons and also potential damage to the teeth from wear or gum recession. When teeth are crowded they may overlap or not form a level line with the eyes. When the teeth overlap they collect plaque much more easily as the toothbrush may skip over the gaps while brushing. In the lower arch the incisors may be pushed forwards so that only half the tooth is imbedded in bone.
Stages of Orthodontic Treatment:

The orthodontist will first assess the patient and may request extraction of some teeth, usually the second molars. Your regular dentist will usually carry out this procedure.

The first appliance or arch wires.

This will make gross(large) movements of the teeth to get them roughly into the right position. This may take upto 1 year to complete.

Fine Tuning

A further archwire may be needed to make fine adjustments to the teeth to get them lined up nicely. This may take several more months.


The gums take longer to redevelop than does the bone, this can keep the teeth in tension as small elastic band like tissues attach the gum to the tooth. These pull on the tooth and may make it move back slightly to its original position. A wire or plastic appliance can be used which holds the teeth in the same position for six months in order to lessen the chance of a relapse.

Types of Brace

Fixed ( aka 'tramtracks') : this type has metal brackets which are glued to the teeth, these are then connected together with a fine metal wire. The wire is springy and tries to bend back to its original shape thus pushing on the teeth. This small force moves the teeth into the desired position.

Upper Removeable Appliance

This type is like a denture but with special metal clips that grip the back teeth and other smaller springs which push on the back certain teeth. This type will only tip teeth and not move them along the arch.

The Functional Appliance

This appliance can be used in those who have sticky out top teeth and small chins, the technical term being a 'Class II' relationship. This appliance is usually used during puberty as the jaws grow more during that time and the appliance streches the lower jaw forward. It is claimed that this will make the lower jaw grow faster and catch up with the upper jaw.

What the orthodontist wants from the patient;

The orthodontist and your dentist will be very happy if:

You brush your teeth well and keep your braces clean. If plaque builds up around a brace it may cause marks on the teeth which cannot be removed as the enamel has been decalcified.

You don't eat a lot of sugar as decay can set in more easily with a brace as toffee will stick in all the wires and stay there longer, all the time feeding the bacteria which produce the acid.

You should wear the brace all the time if told to do so by the orthodontist as no tooth movement will occur if the brace isn't in for long enough each day.

Thumb Sucking:

When a child sucks their thumb at night several effects can be produced on the mouth and teeth. The upper incisors may not erupt fully and the line may curve upwards where the thumb sits. The other effect is that thumb suckers have high palates, this can complicate denture construction at a much later age. If the child is only young, then it will probulary correct itself if the child stops sucking their thumb. If the patient is still sucking their thumb when they are in the teenage years then orthodontics will probulary be required.