What are the risks associated with orthodontic treatment?

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Dentist Melbourne
Melbourne's Home of Dentistry

As with almost all medical and dental treatment, orthodontic treatment carries inherent risks, as described below. These can be minimised with cooperation, planning and careful management.

Gum disease and tooth decay

All Smile Solutions, patients undergoing orthodontic treatment must first have a full dental and periodontal assessment carried out by a dentist. Any necessary dental work must be completed before orthodontic treatment begins.

Gum disease and tooth decay are preventable. The responsibility for maintaining healthy teeth remains with the patient throughout orthodontic treatment.

Tooth decay may extend from a permanent white patch (“decalcification”) to holes in the teeth requiring further treatment by a general dentist.

In order to prevent gum disease, tooth decay and decalcification we recommend the following:

  • A thorough home oral hygiene regime
  • A professional dental clean every four months
  • A general check-up by your dentist every six months during treatment
  • A diet low in sugar

Root-end resorption and tooth vitality

Tooth root shortening (“resorption”) may occur during treatment and is unpredictable in nature. The majority of resorption cases do not have long-term effects; however, in a minority of cases the long-term prognosis of the teeth may be affected. Patients who have previously had orthodontic treatment are at greater risk of resorption during retreatment.

“Tooth vitality” refers to the health of the nerves within our teeth. Orthodontic movement of teeth can further insult the nerve in teeth previously exposed to trauma or deep fillings, leading to potential loss of vitality and discolouration.

Relapse and growth changes

Teeth will continue to move with age, even in patients who have not had orthodontic treatment. Retainers prevent this natural ongoing movement. If you do not wear your retainers as instructed, you can expect your teeth to move.

This ongoing movement is outside our responsibility and may necessitate re-treatment at an additional cost. The re-treatment fee will be determined by the amount of movement involved and how long the braces or removable plates are in place. Your treatment will be proposed by your orthodontist and you will be fully informed of any costs.

Jaw growth which is considered atypical, either in terms of direction or extent, may change thr course or length of treatment. Further growth after the conclusion of treatment may alter the final result. Despite every effort by the treatment orthodontist, this growth cannot always be predicted and a recommendation may be made for re-treatment and/or surgery.

Wisdom teeth

Any impacted wisdom teeth that remain after orthodontic treatment may affect the stability of the outcome achieved by your orthodontist. In order to help prevent unwanted movement of your teeth and other problems associated with malpositioned.

Wisdom teeth, we strongly recommend that you discuss this risk with your orthodontist. Where necessary, your orthodontist may refer you to an oral & maxillofacial surgeon to discuss options for management of your wisdom teeth. If you choose not to have an assessment with an oral & maxillofacial surgeon and do not undergo any recommended treatment, your newly aligned teeth may move.

Bone and gum loss

The health of the bone and gums (“peridonal health”) should be assessed by a general dentist or specialist periodontist before orthodontic treatment begins. This is the responsibility of the patient.

Further progression of periodontal disease can occur if the patient does not maintain excellent oral hygiene and remain under the close care of a general dentist or specialist periodontist.

Temporomandibular joint (TMJ) symptoms

During treatment, patients may develop problems with the jaw, either in terms of pain or function. This can be difficult to predict and may have occurred regardless of orthodontic treatment. Any relationship between orthodontic treatment and temporomandibular dysfunction is tenuous. If any jaw pain does develop patients must advise their treating orthodontist.

In some circumstances changes to the treatment plan may be necessary. Typical scenarios are as follows:

Ankylosis

If teeth are fused to bone (“ankylosed”) and thus unable to be moved, an alternative approach will need to be considered.

Therapeutic extractions

Individuals’ biological response to orthodontic treatment varies. In some cases extraction of teeth may be required partway through the treatment in order to obtain the best aesthetic and functional outcome. If extraction was not part of the initial treatment plan, the treating orthodontist will discuss these changes with the patient.

Treatment time

Treatment time may vary according to the response of the teeth and jaws to treatment, and depending on patient compliance.

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