Teeth malalignment not only affect the overall appearance, crowding of teeth will encourage more plaque accumulation which in turn will increase the risk of periodontal disease and dental caries. Masticatory efficiency can also be affected. Prolonged chewing function problem can lead to Temporomandibular joint disorders.
Objectives of orthodontic treatment:
Orthodontic treatment optionsOrthodontic treatment can mainly be divided into three types, which are metal braces, lingual braces and clear aligners. Treatment time varies depending on patients’ oral condition. It usually takes between 1 to 1.5 years, or may take 2 or more years for complicated cases.
|Metal braces||Lingual braces||Clear aligners|
|Principle||Brackets are attached on the surface of teeth. Using an arch wire to connect brackets to exert pressure to move teeth into proper positions||Brackets are attached on the surface of teeth. Using an arch wire to connect brackets to exert pressure to move teeth into proper positions||Use computer to demonstrate teeth movement during treatment. Patients need to change tailor-made braces regularly to correct teeth position gradually|
|Material||Metal/ Enamel / Resin||Metal/ Enamel / Resin||Medical-grade plastic|
|Removable||Cannot be removed by patients||Cannot be removed by patients||Can be removed and worn anytime|
|Can be removed and worn anytime||Attached to the outside of teeth, easy to be noticed||Attached to the inside of teeth, hard to be noticed||Invisible aligners, virtually invisible, very hard to be noticed|
|Cleaning||Need to use tools to clean the braces and the arch wire||Need to use tools to clean the braces and the arch wire||Can clean it after removing from teeth|
|Effectiveness||More suitable for patients with crooked teeth||More suitable for patients with crooked teeth||Suitable for patients with mild or moderate teeth irregularity|
|Others||Brackets may cause discomfort||Brackets may cause discomfort||The surface of aligner is smooth|
Orthodontic treatment procedure:
Crown and Bridge
A crown is an artificial “cap” placed on a single tooth. When the tooth is damaged, caused by extensive decay, cracked tooth, fractured tooth or after the completion of root canal therapy, etc. It is more desirable to place a dental crown to strengthen and protect the fragile tooth, rather than removing the entire tooth.
Crown treatment procedure:
Teeth that are suitable for crown treatment:
Using a bridge to replace missing teeth. It is suitable for people who still have healthy adjacent teeth. Dental bridge is not only able to repair appearance, but also to restore normal chewing function and improve pronunciation problem resulted from loss of teeth.
Bridge treatment procedure:
All-Ceramic Crown and Zirconia Crown
There are various materials for making dental crowns, including full metal, porcelain fused to metal (PFM), all-ceramic and zirconium. Each material comes with its pros and cons, your dentist will recommend a suitable one depending on your situation.
|Full metal crown||Porcelain fused to metal crown||Zirconia crown||All-ceramic crown|
|Pros||·Great strength and durable, suitable for posterior teeth that require greater bite force
·As resistant as natural teeth
·Strong even very then, so no need to trim a lot of precious tooth substance
Unlikely to wear the opposing tooth
|·Metal inside and with ceramic covers outside, making the crown tooth-coloured but still as strong as metal crown||·Great strength and durable, which is as strong as full metal crown
·Aesthetic natural-looking tooth-coloured
|·Most natural-looking, reflects and transmits light like natural teeth
Suitable for anterior teeth where the highest aesthetics is required
Metal colour which is not suitable to use on anterior teeth
Expensive if precious metal like gold is used
May cause inflammation or metal allergies
Have double layers, so the crown is relatively thick, more tooth substance has to be trimmed
Unnatural colour because light cannot shine through
May leave visible grey lines at the margin which affect appearance
The outer ceramic layer can chip off from the metal core
|Thicker than full-ceramic crown, so the original teeth need to be trimmed more||Not as strong as metal crown|
Complete and Partial Denture
Denture is a removable set of false teeth. It can be divided into complete and partial denture depending on whether some or all teeth are lost. Partial dentures have clasps that attach on teeth next to missing teeth for retention. Removable denture is a simple and least invasive way of replacing multiple teeth.
Consequences of missing teeth:
Partial DenturePartial dentures are suitable for patients who still have healthy teeth remain. There are metal framework or clasps on the denture. The clasps help to retain the denture and allow the patient to remove easily.
Complete DentureComplete dentures are for patients who have lost all the teeth. They are supported by oral mucosa and alveolar ridge. Patients can remove them by themselves. However, the chewing force of complete denture is significantly different from natural teeth. It can keep moving in the oral cavity by movements of oral muscles and the tongue causing discomfort and speech problem. It takes time for patients to get used to.
Differences between fixed and removable prosthesis
|Fixed prosthesis||Removable prosthesis|
With healthy tooth root
Tooth substance loss is too extensive
Received root canal treatment
Have adjacent healthy teeth next to the missing tooth
The entire tooth is removed
Some healthy teeth remain
All teeth are lost
|Material||Metal, porcelain-fused- to-metal, all-ceramic and zirconium||
Metal framework and clasps
False teeth are usually made of plastic
False teeth are usually made of plastic
Can keep the root of the natural teeth
“Fixed” false teeth
|Can wear and remove freely|
Need to trim teeth
Need to trim the adjacent teeth
Need to remove the entire bridge if one of the supporting teeth is decayed or damaged
Easy to develop tender areas or ulcers
Long adapting time
Long adapting time as the bite feeling is significantly different from natural teeth
A tooth consists of three layers, the outmost layer which is the transparent enamel, the middle layer which is the slightly yellowish dentin, and the innermost layer which is pulp tissues. Most people’s teeth are in ivory white to light yellow colour. For those who have thicker enamel layer may have whiter teeth.
However, teeth will turn yellow with aging due to tooth wear. In addition, consuming food or drinks that include pigmentation, such as tea, coffee, cola, red wine, curry, and chocolate, as well as smoking may affect teeth color.
Teeth whitening method：Currently, there are several effective teeth whitening procedures, the choice of which depends on different situations.
In-office bleaching procedure:
Pros of in-office bleaching
Cons of in-office bleaching
Contra-indications of in-office bleaching
|Tooth decay||Whitening gel may penetrate into the inner layer of teeth through cavities. This may cause irritation to the dental pulp, so it is recommended to fix all other dental problems before in-office bleaching|
|Sensitive teeth||Whitening gel and blue light may cause irritation to teeth. This can make sensitive teeth even more sensitive|
Veneers can modify the shape, colour and alignment of teeth to improve aesthetics. Dentist will attach a thin covering of tooth-coloured shell over a tooth by dental adhesive. After a veneer is placed, the colour of the natural tooth can be restored and appearance can be improved.
People who are suitable to use ceramic veneer:
Ceramic Veneer treatment procedure:
Pros of ceramic veneer:
Cons of ceramic veneer:
Full Mouth Rehabilitation
Full mouth rehabilitation can enable people who have extensively missing, injured, broken or cracked teeth due to tooth grinding , tooth decay, periodontal disease, etc. to restore to normal oral function and health through artificial implants and dentures. Dentist will customize a treatment plan according to required teeth function and appearance. Treatments include braces, dental crowns and bridges, veneer and implants.
Full mouth rehabilitation methods:
Using surgical method to implant all missing teeth. Dental implants are stable and the chewing function is close to natural teeth. Complete Denture
Use the remaining teeth and oral mucosa to fix the denture in the mouth. It can stimulate the condition of natural teeth to support chewing and eating. This treatment is cheaper and can be completed in shorter time, but it may take longer for patients to adapt wearing a denture. All-on-4 Dental Implant
Place 4 to 6 metal dental implants to fix a whole set of teeth bridge on it. All-on-4 dental implant can stimulate the biting function of natural teeth. This treatment will make less wounds on the gum, and the recovery time is shorter. The price is also lower than full mouth dental implants.
All-on-4 Dental Implant Treatment Procedure:
Pros of All-on-4 Dental Implant Treatment:
Laser dentistry is suitable for various dental and oral treatments. It creates much less pain, soreness and discomfort during treatment. The recovery time is usually shorter than that of traditional treatment.