Dental Health Orthodontics An Overview of Orthodontics By Steven Lin, DDS facebook twitter linkedin Steven Lin, DDS, is a dentist, TEDx speaker, health educator, and author. Learn about our editorial process Steven Lin, DDS Medically reviewed by Medically reviewed by Edmund Khoo, DDS on November 27, 2019 Edmund Khoo, DDS, is board-certified in orthodontics. He teaches full-time as a clinical associate professor at his alma mater, New York University College of Dentistry, is a diplomate of the American Board of Orthodontics, and serves on advisory boards for the American Dental Education Association. Learn about our Medical Review Board Edmund Khoo, DDS Updated on January 18, 2020 Print Table of Contents View All Table of Contents Benefits Indications Treatment Stages Braces Cost Orthodontics is a specialized area of dentistry that focuses on the diagnosis, prevention, and treatment of conditions affecting the alignment of the teeth and jaw. Orthodontists and some general dentists design and fit corrective devices like braces, clear aligners, expander plates, and headgear to help bring the teeth or jaw into alignment. There are many factors that can reveal why your teeth are crooked in the first place and what orthodontic options may be appropriate for you. LeoPatrizi / Getty Images Benefits Well-aligned, straight teeth may be desired for aesthetic reasons, but, more importantly, they generally indicate an overall healthier mouth. Misaligned teeth and jaws can be related to uneven tooth wear, gum problems, breathing difficulty, poor oral hygiene (due to hard-to-clean teeth), speech development, and damage of the jaw joint. Orthodontic treatment can often deliver a smile that not only addresses these issues but helps you (or your child) feel more confident. Indications You may simply notice that your teeth, or that of your child, are not as straight as you'd expect (or hope) them to be. Some people are more susceptible to crooked teeth, though many of these problems can be caused by what someone is exposed to, such as breastfeeding or thumb sucking/pacifier use. Alternatively, your dentist may detect a problem that orthodontia can help with and suggest that you consider it. Some common ones include: Crowded teethUnderbiteOpen biteCrossbiteDeep biteSpaced out teethWisdom teethMissing teethImpacted teeth The teeth and jaw relationship begins right from birth, so it’s important to pay close attention to a child’s jaw development. By the time a child is 7 years of age, it's usually quite obvious to a dentist/orthodontist if a patient will have orthodontic problems, as most of the adult teeth should be present. Primary care and ear-nose-throat doctors may also have a hand in suggesting orthodontic treatment. Your teeth are an indication of how your jaw and face are developing, and a poorly developed jaw may contribute to issues with airway function. Today, orthodontics can be performed to actually help people breathe better. There are some signs that indicate that you/your child aren’t breathing properly: Mouth breathingOpen mouth at restDaytime sleepinessMemory/attention problemsDark circles under the eyesSnoringBedwettingSleep disturbance/poor sleep A doctor may suggest orthodontic work as part of treatment for these concerns, sometimes after other assessments have been completed, such as a sleep study. Treatment Stages Early treatment is best, as it prevents problems from becoming more serious. Treatment can also be more difficult once growth has stopped. That said, orthodontic treatment can start at varying ages, depending on the case. Before you get your teeth straightened, there are several stages you need to get through to achieve the desired end result: Expansion: A special orthodontic device is used to expand the width of the palate or jaw, if necessary. This helps make more room for the teeth so they can come in as straight as possible. Correction: A correction device is then fitted to help correct the existing teeth. Adjustments are made as teeth move during treatment.Retention: A second device, called a retainer, is fitted and expected to be worn regularly for another 12 months to prevent teeth from moving back into their old position. In the following year, patients are usually required to wear the retainer just at night. In cases when you need help using your jaw in a way that will help correct your bite and prevent tongue movements that cause further displacement of your teeth, functional devices may also be recommended. Braces Braces (also known as brackets) are one of the most common orthodontic treatments. The thought of getting braces can be a little nerve-wracking for some people, especially if you have visions of those big, chunky metal braces from the 80s. However, braces these days are vastly improved from what they were decades ago, and they can be made from stainless steel, metal, ceramic, or plastic. While ceramic or plastic braces may look better aesthetically, you need to consider that plastic may stain and discolor by the time you reach the end of your treatment. In some cases, it may be suitable to use invisible, removable aligners that are changed every two weeks. They allow you to brush and floss normally, unlike traditional braces. Your or your child's lifestyle and habits, along with your budget and insurance coverage, will all need to factor into what is ultimately chosen as well. Fittings and Adjustments The process of being fitted with an orthodontic appliance begins with your orthodontist determining which one is suitable for your mouth. If braces are required, the first step is placing little brackets on your teeth and bonding them to the tooth with a special adhesive. Metal bands are applied to the back teeth, and wires are placed inside the brackets. When you are fitted, your appliance will be fine-tuned by your orthodontist or dentist to apply slight pressure on your teeth, so they move in the desired direction. Because your teeth will move during treatment, you will need to have adjustments from time to time. Generally speaking, orthodontic treatment takes some time—the average length is around two years. The actual time required depends on the severity of the condition, the type of treatment needed, and if a patient follows their orthodontist’s instructions with regard to appliance use. Cost What you end up spending can vary depending on the extent of the treatment, what modalities are used, and your insurance coverage. Traditional metal or ceramic (clear) braces start around $5,000. Behind the teeth, or sublingual, braces range from $5,000 to $13,000. Clear aligners, like Invisalign, can range from $3,000 to $8,000 depending on how many adjustments are needed. At your initial consultation, your orthodontist or dentist should discuss options and costs. You should ask any questions during this time so that it's clear what is required to achieve the final treatment outcome from a time, commitment, and financial investment standpoint. Many orthodontic offices will allow you to set up a payment plan for treatment. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Grippaudo C, Paolantonio EG, Antonini G, Saulle R, La torre G, Deli R. Association between oral habits, mouth breathing and malocclusion. Acta Otorhinolaryngol Ital. 2016;36(5):386-394. doi:10.14639/0392-100X-770 Tran K, Picheca L. Orthodontic Treatment for the Management of Pain or Impacted Teeth in Patients with Malocclusion: A Review of Clinical Effectiveness and Guidelines. In: CADTH Rapid Response Report: Summary With Critical Appraisal. Updated June 5, 2017. American Association of Orthodontists. The Right Time for an Orthodontic Check-Up: No Later than Age 7. 2013. Dempsey JA, Veasey SC, Morgan BJ, O'Donnell CP. Pathophysiology of sleep apnea. Physiol Rev. 2010;90(1):47–112. doi:10.1152/physrev.00043.2008 Agarwal A, Mathur R. Maxillary Expansion. 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