Orthodontic treatment remains an elective procedure with many benefits. Like any other treatment of the body, there are some inherent risks and limitations. These seldom prevent treatment, but should be considered in making the decision to undergo treatment.
Predictable factors that can affect the outcome of orthodontic treatment:
In the vast majority of orthodontic cases, significant improvements can be achieved with patient cooperation. Excessive treatment time and/or compromised results can occur from non-cooperation.
Caring for appliances
Poor tooth brushing increases the risk of decay when wearing braces. Excellent oral hygiene, reduction in sugar, being selective in diet, and reporting any loose bands as soon as noticed will help minimise decay, white spots (decalcification), and gum problems. Routine visits (3-6 months) to your dentist for cleaning and cavity checks are necessary.
Wearing removable devices and elastics
These are forces placed on teeth so they will move into their proper positions. The amount of time worn affects result. Wear as instructed!
Missed appointments create scheduling problems and lengthen treatment time.
Unpredictable factors that can affect the outcome of orthodontic treatment
Mouth breathing, thumb, finger or lip sucking, tongue thrusting (abnormal swallowing) and other unusual habits can prevent the teeth from moving to their correct position or cause relapse after braces are removed.
Facial Bone Patterns
Unusual skeletal patterns and insufficient or undesirable facial growth can compromise the dental result, affect a facial change and cause shifting of teeth during retention. Surgical assistance may be recommended in these situations.
Post Treatment Tooth Movement
Teeth have a tendency to shift or settle after treatment as well as after retention. Some changes are desirable, others are not. Rotations and crowding of the lower anterior teeth or slight space in extraction sites or between the upper centrals are common examples.
Temporomandibular Problems (TM)
Possible TM problems may develop with this sliding joint on which the lower jaw moves either before, during or after orthodontic treatment. Tooth position, bite or non-symptomatic, pre-existing TM problems can be a factor in this condition. An equilibration (selective smoothing or reshaping the tooth) or other special treatment may be recommended to improve occlusal or joint relationship.
In attempting to move impacted teeth (teeth unable to erupt normally), especially cuspids and third molars (wisdom teeth), problems are sometimes encountered which may lead to periodontal problems, relapse, or loss of teeth.
Shortening of root ends can occur when teeth are moved during orthodontic treatment. Under healthy conditions the shortened roots usually are no problem. Trauma, impaction, endocrine disorders or idiopathic (unknown) reasons also cause this problem. Severe resorption can increase the possibility of premature tooth loss.
Non-vital or Dead Tooth
A tooth traumatised by a blow or other causes can die over a long period of time with or without orthodontic treatment. This tooth may discolour or flare up during orthodontic movement and require endodontic treatment (root canal).
Periodontal Problems (gum disease)
This condition can be present before or develop during treatment. It could deteriorate during treatment causing loss of bone around the teeth. Excellent oral hygiene and frequent prophylaxis by your dentist can help control this situation.