Removable Orthodontic Appliances

Removable Orthodontic Appliances

October is National Orthodontic Health Month. According to the American Association of Orthodontics, 25% or more of the people undergoing orthodontic treatment today are adults. One reason for this trend is the recent improvements in orthodontics. One improvement we will discuss today is the use of removable appliances.

Removable orthodontic appliances consist of layers of molded plastic which hold wires and screws used to move teeth and jaws into better relationships. They are designed individually from plaster casts of the patients jaws.

Inherent in the fact that they are removable, these appliances offer numerous advantages. A removable appliance is an excellent choice for patients who are highly susceptible to tooth decay. Because they can be completely removed by the patient, they enable the patient to do a more thorough job of home care.

Removables are advantagous for adult patients who object to wearing fixed braces for business and social reasons, they are also an excellent choice in cases where only a small amount of correction is needed.

Removables are helpful in preventing temporomandibular joint pain and eliminate excess wear of tooth enamel in patients who have a habit of grinding their teeth (bruxism).

Removable functional devices work to stimulate muscular activity around the teeth and jaws promoting optimal growth and development. Removable expansion devices function to widen dental arches and thus create space for overcrowded, misaligned teeth. Fixed banding often cannot accomplish this without the extraction of four permanent teeth. In many cases the use of a removable expansion device eliminates the need for extractions.

Lest I paint too optimistic a picture here, I should mention there are several disadvantages to removable appliances, nor can they be used in every orthodontic situation. First and foremost the patient must be made aware that there can be no improvement if the appliance is not worn. Because of its removable nature, the patient must discipline himself/herself to wear the appliance. If not worn for the prescribed time everyday there will be no improvement. If worn irregularly, on one day/off the next, the teeth may be adversely stimulated to resist further movement.

As long as the teeth and their supporting structures are healthy, there is no age limit for removable treatment. Treatment time will depend on the individual's needs. After tooth movement and/or arch widening is completed, a retainer must be worn to hold the teeth and jaws in their new and proper position. The retainer must usually be worn for approximately one year to help prevent the teeth or jaws from relapsing back to its original or starting position.

Dr. Stephen Petras

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