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The Phases of Orthodontic Treatment

Here is a general overview of the three major stages of treatment:

The Planning Stage

Dr. Kothari makes a diagnosis in order to realign the teeth in the most effective way. The first visits may comprise of some of the following evaluations:

  • Medical and dental evaluations: Dental and physical problems tend to go hand in hand. Problems in the mouth can lead to (or be caused by) medical problems. The goal of this evaluation is to ensure that prior medical and dental issues are completely under control before treatment begins.
  • Study model (bite impressions): The patient is asked to bite down into a dental tray filled with a gel substance that hardens around the teeth. The trays are removed from the teeth and filled with plaster to create models of the patient’s teeth. Study models enable the orthodontist to examine the position of each tooth and the mouth as a whole.
  • Cephalometric and Panoramic X-rays are used for viewing potential complications or pre-existing damage to the jaw joint. X-rays also allow the orthodontist to see the exact position of each tooth and its corresponding root(s).
  • Dr. Kothari takes photographs of the face and teeth to assess how treatment is progressing, and the impact the treatment is having on the shape of the patient’s face.

The Active Phase

All of the above tools will be used to diagnose and develop a treatment plan for the patient. Most commonly, traditional fixed braces are used, which are individual dental brackets connected by an archwire. Devices like headgear, Herbst appliance and other functional appliances may be used with fixed braces; these are used to quicken the movement of the teeth and jaw bone.

The Retention Phase

Long-term retention is the goal of orthodontic treatment. When the teeth have been correctly aligned, fixed braces and removable devices will be removed and discontinued. A fixed lower retainer placed on the tongue side of the bottom teeth and a removable retainer for the upper teeth are given after active treatment. The goal of the retainer is to ensure that the teeth do not begin to shift back to their original positions.

The upper retainer with an anterior adjustment wire has to be worn at all times except when eating, brushing or playing sports. After one year, we recommend patients wear the upper retainer at night as long as possible. During the retention phase, the jaw will reform around the realigned teeth to fully stabilize them in the correct alignment.

It should be emphasized that the duration and successful completion of treatment depends on patient cooperation. To this end, every patient receives detailed instructions regarding diet and hygiene as well as the use and care of orthodontic appliances.