The standard procedure for correcting jaw misalignments is fixed braces, so-called multibrackets. Small retaining plates, the brackets, are glued to the teeth and connected with tension wire. The misaligned teeth are compensated for overtime.
This technique is mainly used with teenagers. It can just as well be used in adulthood when teeth are displaced. The archwire brings the teeth into line with light pressure. The orthodontist can mobilize forces on each individual tooth in order to move it in a targeted manner. The wire is readjusted every 4 weeks. After that, the teeth hurt for about 2 to 3 days.
Fixed braces: advantages and disadvantages
The fixed braces are suitable for both children and adults. Your dentist will stick the brackets firmly onto the tooth and connect them with wires. A fixed brace corrects the dentition completely over a long period of time. It is suitable for all malpositions.
Advantages of fixed braces:
- It corrects almost all misalignments.
- It can be worn permanently over a long period of time.
- It is suitable for adults and children.
- It brings reliable results.
- It can be replaced with a retainer after the treatment.
Disadvantages of fixed braces:
- It is visible to everyone.
- It restricts eating and speaking.
- It can damage and discolor the teeth.
Brackets wearers need particularly good oral hygiene
It takes more time and effort to thoroughly clean teeth and brackets. Dr. Cecilia Tchoumi is a dentist in London: “Patients who wear brackets have to practice particularly good oral hygiene. The problem is that food residues get stuck between the brackets and wires. ” It is difficult to use dental floss because the wires make threading difficult or even impossible. According to Tchoumi, special toothbrushes that have been developed for bracket wearers are suitable instead: “These are available as manual toothbrushes or as a special attachment for some electric toothbrushes.”
In the opinion of the London dental expert, you should also use interdental brushes or so-called single- tuft brushes. Thanks to their shape and a bristle field that is concentrated on the point, these clean hard-to-reach areas. “Good fluoridation is also important,” emphasizes Tchoumi. So, use a fluoridated toothpaste and brush with a high-dose fluoride gel once a week.
At least roughly clean your teeth after meals. Especially thoroughly then in the evening. Because at night the tooth enamel should have the opportunity to remineralize, i.e., to recover. Incidentally, according to Tchoumi, the oral hygiene effort is the same for children and adults wearing brackets.
Dentists mainly use removable braces on younger children whose teeth are not yet fully formed. Loose braces are made of plastic and metal and cover the roof of the mouth, and the little ones can put them on and remove them themselves.
The loose braces are mainly worn at night and for a few hours a day. Orthodontists recommend wearing it for 16 hours a day for success.
It takes a lot of discipline. This is often a problem, especially for young children. But if the braces are not worn for a few days, the teeth can slide back into their old position.
Removable braces: pros and cons
In many cases, removable braces are not suitable as a permanent solution. But these braces prepares the teeth for fixed braces when the child is still too young for it.
Advantages of removable braces:
- It prepares the teeth for the fixed braces.
- It can be removed while eating.
- It facilitates dental and oral hygiene.
- It does not damage the tooth enamel.
Disadvantages of removable braces:
- It demands discipline: patients have to wear it for at least 16 hours a day.
- It requires a longer duration of treatment.
- It interferes with speaking.
What are the possibilities?
In addition to fixed and removable braces, there are other ways to change the position of the teeth:
Braces can also be attached to the teeth from the inside. Many adults choose this so-called lingual technique because the brace cannot be seen. The dentist then applies brackets to the inside of the teeth. The rest of the treatment is the same as with classic fixed braces.
Attention: The lingual technique is a private service that the health insurance companies do not cover. If you are interested in such internal braces, you have to bear the costs yourself.
Plastic aligners are also recommended for small misalignments. These transparent models are becoming increasingly popular. Your dentist will take an impression of your rows of teeth and place them over your teeth. The splint is not visible at all. Your dentist will change them at regular intervals until the goal is achieved.
Dental aligners are not part of the standard services of statutory health insurance (GKV). Therefore, you have to bear the costs yourself. Allow between € 3,000 and € 8,000 for private therapy with a dental splint or braces. You can find out more from the treatment and cost plan of your orthodontist.
Who Needs Braces?
Braces are particularly useful if the teeth are misaligned. A jaw that is too small can also be a reason for a correction, as it pushes teeth into one another.
Misalignments of the teeth can occur e.g., B. show as deep bite, overbite, crowding or cross bite. The malpositions can be assigned to one of 5 degrees of severity. These are called orthodontic indication groups (OIG). The health insurance company only pays treatment costs for severity grades 3 to 5.
Many children get braces when the permanent teeth are formed and misalignments are recognizable. But it can also be that a permanent tooth is not created at all. The gap can be kept free with the help of braces. The dentist later places an implant in this gap.
But adults too often want to correct a misalignment. Often these are just small flaws. Or teeth that have already been treated and have returned to their original position. The dentist often treats minor misalignments in adults with a transparent splint or with the help of the lingual technique.
Indications for braces
When are braces necessary? The following indications suggest that it is time for an appointment with an orthodontist:
If there are gaps in the dentition, the individual teeth have too much space. They don’t touch and can move freely. The gaps are often not the same size and appear asymmetrical.
The crowding is the opposite of a patchy set of teeth. With this misalignment, the jaw is too small for all teeth. These push together and partially overlap. This not only leads to pain, but also possibly to damage. In addition, crowding makes dental hygiene difficult.
In the case of a crossbite, the molars do not fit together: the lower molars are further out in the jaw than the upper ones.
The deep bite describes a defect in which the upper incisors protrude too far. They almost completely overlay the lower incisors.
The open bite is the opposite of the deep bite. The incisors of the upper row of teeth do not protrude beyond the lower incisors at all.
In an overbite, the lower incisors stand in front of those of the upper row of teeth when the mouth is closed. Colloquially, the underbite is also known as the underbite.
Tooth correction procedure using braces
Do you or your child suffer from such misaligned teeth? Then braces can help. A visit to the orthodontist is the first step. This creates an X-ray image and makes a cast. In addition, a functional analysis of the mobility of the jaw takes place. The dental expert then assesses the degree of severity or the OIG in which the malposition should be classified.
To assess the OIG, the dentist measures the distance between the teeth. Slight misalignments of the teeth fall into severity grades 1 and 2. The severity grades 3, 4 and 5 describe coarser misalignments such as cross or overbites or a cleft lip and palate.
The estimate of the orthodontist, you can submit it to the SHI. This approves the therapy – or rejects it. If the health insurance company gives the okay, you can start: The doctor adjusts the removable braces to the plaster model. He makes the fixed braces directly on the patient. Attaching the brackets can take a few hours.
You will have to come to the practice at regular intervals to check and if necessary, adjust the braces. Because the teeth move quickly in the desired direction, so that repairs are necessary.
Duration of braces treatment
The duration of a treatment with braces is individual. Usually, patients have to wear the braces for several years. At least that’s how it is with children. Small corrections in the tooth position are also possible more quickly.
In the first phase of treatment, your doctor will move the teeth to the desired position. In the second phase, the tooth position is strengthened. The treatment is not completely finished for a lifetime: the orthodontist often places a so-called retainer behind the teeth when he has removed the braces. This wire prevents the teeth from moving back to their old position.
If the treatment is stopped too early, the therapy can fail. In addition, if you discontinue treatment, you risk co-payments from the statutory health insurance.
Does the health insurance company pay for the braces?
In some cases, your health insurance will cover the full cost of braces. However, there must be a medical need for this. This applies to patients in orthodontic indication groups 3 to 5.
Of course, orthodontic treatments can also take place for aesthetic reasons. The orthodontist then makes a plaster cast of the teeth and assesses the necessary therapeutic measures. He creates a treatment and cost plan that the GVK has to approve. If at all, the health insurance will only cover the costs in full up to the age of 18.
Even if the GKV approves the treatment with braces, it only pays for the standard treatment. However, this does not include all materials and possibilities. Tooth cleaning, special brackets or wires are not included, for example. If the patient wants such an extra, he has to pay for it himself.
The health insurance companies reserve the right to reimburse only 80% of the treatment costs in advance. You will only get the remaining 20% back once the treatment has been successfully completed. This prevents you from not finishing the therapy despite the high costs.
Which braces does the health insurance company cover?
There are different ways to correct the position of the teeth. However, the catalogue of services provided by the health insurance company only includes the standard method: external braces with brackets.
The GVK does not cover any services that go beyond this standard treatment. If you want internal braces or a plastic splint, you have to finance them yourself. The same applies to special requests such as ceramic brackets or thinner wires.
A dental insurance may pay for additional special requests. Therefore, before starting therapy, find out exactly whether and to what extent the health insurance company supports the desired method. The private treatment of misaligned teeth can quickly cost a few thousand euros. The best thing to do is to get a quote so that you can get an approximate price idea.
Can misaligned teeth be prevented?
Many misalignments of the dentition are genetic and therefore cannot be prevented. But there are some problems that can be avoided. When children e.g., B. sucking too much on the thumb can lead to misalignment of the teeth. Because if something constantly hits the front teeth, the teeth look for a suitable path.
The same applies to children who do not close their mouths: the teeth of the upper and lower jaw give each other stability. If they don’t touch, they may grow incorrectly. So, make sure that your children always close their mouths. They should also not suckle too much on a pacifier or thumb. In addition, careful dental hygiene from an early age is important to promote healthy tooth development.
Are there any risks involved in treatment with braces?
As with all medical treatments, braces come with a few risks. The treatment can lead to complications, especially with fixed braces. This is mainly due to the fact that fixed braces cannot simply be removed if they are pressed or painful.
When adjusting the wires with fixed braces, pain often occurs, especially in the first few days. Because strong forces act on the teeth. Due to the great pressure, the tooth roots can recede. The gums can also recede or become painfully inflamed. In addition, fixed braces can lead to greater sensitivity of the teeth. Sometimes teeth stain if the enamel was damaged while attaching and removing the brackets.
Regular, thorough dental care is very important for fixed braces. It also prevents discoloration that often occurs when you wear braces. In most cases, however, the therapy is largely uneventful.
This is how you support the success of the treatment
Whether the treatment with braces is successful in the long term depends on your cooperation. It is important that you wear a removable aligner regularly. But your commitment is also important with fixed braces. Oral hygiene plays a crucial role in maintaining your teeth. Brush your teeth regularly with fluoride-rich toothpaste and clean the spaces between them thoroughly.
Does your child wear braces? Then make sure that they wear the braces regularly and clean them thoroughly. Experts recommend wearing removable braces for at least 22 hours a day. This is the only way to achieve the desired goals.
Also, important: do not take any breaks in therapy. Otherwise, the teeth will find their place after a short time and move back to their starting position. Be consistent and establish firm rules for your child.
In addition, have the braces checked by an orthodontist at regular intervals. He can also adjust it if the position of the teeth has changed. And last but not least: make sure that your dentist inserts a retainer after the treatment is completed. He attaches this thin wire to the rows of teeth from the inside. It prevents the deformity from regressing. In this way, the success of the treatment is permanently maintained.