Welcome to Milwaukee Orthodontist
This site is dedicated to helping you find a qualified orthodontist in the greater Milwaukee area. It also provides some information you might find helpful. Start by reading the articles below for good general information. Then start reading the blog posts to learn more. New posts will be made periodically. Some featured articles/guest bloggers are not from Milwaukee--but hey, if the information is good, that's all that matters, right?
Soon, this site will provide listings of qualified Milwaukee orthodontists by ZIP code so you can find a practice near you.
Orthodontics is a specialty of dentistry that is concerned with the study and treatment of malocclusions (improper bites), which may be a result of tooth irregularity, disproportionate jaw relationships, or both.
Orthodontics is formally defined by the American Association of Orthodontics as, "The area of dentistry concerned with the supervision, guidance and correction of the growing and mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of the jaws within the craniofacial complex."
Orthodontic treatment can be carried out for purely aesthetic reasons with regards to improving the general appearance of patients' teeth. However, there are orthodontists who work on reconstructing the entire face rather than focusing exclusively on teeth. Treatment is most often prescribed for practical reasons such as providing the patient with a functionally improved bite (occlusion).
Orthodontic Treatment Methods
Also removable appliances, or "plates", headgear, expansion appliances, and many other devices can be used to move teeth.
After a course of active orthodontic treatment, patients will often wear retainters, which will maintain the teeth in their improved position while the surrounding bone reforms around them. The retainers are generally worn full-time for a short period, perhaps 6 months to a year, and then worn periodically (typically nightly during sleep) for as long as the orthodontist recommends.
Appropriately trained doctors align the teeth with respect to the surrounding soft tissues, with or without movement of the underlying bones, which can be moved either through growth modification in children or jaw surgery in adults.
Getting Dental Braces
The first step is to determine if braces are suitable for the patient. The doctor consults with the patient and inspects the teeth visually. If braces are appropriate, a records appointment is set up where X-rays, molds, and impressions are made. These records are analyzed to determine the problems and proper course of action. Typical treatment times vary from six months to two and a half years depending on the complexity and types of problems. Orthognathic surgery may be required in extreme cases.
Teeth to be braced will have an applied to help the cement bond to the surface of the tooth. In most cases the teeth will be banded and then brackets will be added. A bracket will be applied with dental cement, and then cured with light until hardened. This process usually takes a few seconds per tooth. If required, orthodontic spacers may be inserted between the molars to make room for molar bands to be placed at a later date. Molar bands are required to ensure brackets will stick. Bands are also utilized when dental fillings or other dental work make securing a bracket to a tooth infeasible.
An archwire will be threaded between the brackets and affixed with elastic or metal ligatures. Elastics are available in a wide variety of colors. Archwires are bent, shaped, and tightened frequently to achieve the desired results. Brackets with hooks can be placed, or hooks can be created and affixed to the archwire to affix the elastic to. The placement and configuration of the elastics will depend on the course of treatment and the individual patient. Elastics are made in different diameters, colors, sizes, and strengths.
Modern orthodontics makes frequent use of nickel-titanium archwires and temperature-sensitive materials. When cold, the archwire is limp and flexible, easily threaded between brackets of any configuration. Once heated to body temperature, the archwire will stiffen and seek to retain its shape, creating constant light force on the teeth.
Each month or two, the braces must be adjusted. This helps shift the teeth into the correct position. When they get adjusted the orthodontist takes off the colored rubber bands keeping the wire in place. The wire is then taken out, and may be replaced or modified. When the wire has been placed back into the mouth, the patient may choose a color for the new rubber bands, which are then fixed to the metal brackets. The adjusting process may cause some discomfort, which is normal. A licensed orthodontist can help you decide which braces options are best for you.
Types of dental braces
Traditional braces are stainless steel, sometimes in combination with nickel titanium, and are the most widely used.
"Clear" braces serve as a cosmetic alternative to traditional metal braces by blending in more with the natural color of the teeth. Typically, these brackets are made of ceramic or plastic materials and function in a similar manner to traditional metal brackets. Clear elastic ties and white metal ties are available to be used with these clear braces to help keep the appliances less conspicuous. Clear braces have a higher component of friction and tend to be more brittle than metal braces. This can make removing the appliances at the end of treatment more difficult and time consuming.
Gold-plated stainless steel braces are often employed for patients allergic to nickel (a component of stainless steel), but may also be chosen because some people simply prefer the look of gold over the traditional silver-colored braces.
Lingual braces are fitted behind the teeth, and are not visible with casual interaction. Lingual braces can be more difficult to adjust to, since they can hinder tongue movement.
Progressive, clear removable aligners (one example of which is Invisalign) may be used to gradually move teeth into their final positions. Aligners are generally not used for complex orthodontic cases, such as when extractions, jaw surgery, or palate expansion are necessary.
A new concept under development is the "smart bracket." The smart bracket contains a microchip capable of measuring the forces applied to the bracket/tooth interface. The goal of this concept is to significantly reduce the duration of orthodontic therapy and to set the applied forces in non-harmful, optimal ranges.
The pre-finisher is molded to the patient's teeth by use of severe pressure to the appliance by the person's jaw. The pre-finisher is then worn for the prescribed time, with the user applying force to the pre-finisher in their mouth for ten to fifteen seconds at a time. The goal is increasing the "exercise" time, time spent applying force to the appliance. Like the retainer, the pre-finisher is not a permanent addition to one's mouth, and can be moved in and out of the mouth.
The best-known type is the Hawley retainer, which is made of a metal wire that surrounds the teeth and keeps them in place. The Hawley retainer is designed for treatment after use of products that close diastemas (gaps). The advantage of this type of retainer is that the metal wires can be adjusted to finish treatment and continue moving teeth as needed.
Another common type is the vacuum formed retainer (VFR). This is a polypropylene or polyvinylchloride (PVC) material, typically .020" or .030" thick. Essix is a brand name many dental offices are familiar with. This clear or transparent retainer fits over the entire arch of teeth and is produced from a mold. It is similar in appearance to Invisalign trays, though the latter are not considered "retainers". VFRs, if worn 24 hours per day, do not allow the upper and lower teeth to touch because plastic covers the chewing surfaces of the teeth. Some orthodontists feel that it is important for the top and bottom chewing surfaces to meet to allow for "favorable settling" to occur. VFRs are less expensive, less conspicuous, and easier to wear than Hawley retainers. However, for patients with disorders such as Bruxism, VFRs are prone to rapid breakage and deterioration, especially if the material is PVC, a short chain molecule. This breaks down swiftly as compared to polypropylene, a long chain molecule.
Most removable retainers are supplied with a retainer case for protection. During the first few days of retainer use, many people experience extra saliva in their mouth. This is natural and is due to the presence of a new object inside the mouth and consequent stimulation of the salivary glands. It may be difficult to speak for a while after getting a retainer, but this speech difficulty should go away over time as one gets used to wearing it.
An entirely different category of orthodontic retainers are fixed retainers. A fixed retainer typically consists of a passive wire bonded to the tongue-side of the (usually, depending on the patient's bite, only lower) incisors. Unlike the previously-mentioned retainer types, fixed retainers can not be removed by the patient. Some doctors prescribe fixed retainers regularly, especially where active orthodontic treatments have effected great changes in the bite and there is a high risk for reversal of these changes. Fixed retainers may lead to tartar build-up or gingivitis due to the difficulty of flossing while wearing these retainers.
Common conditions treated by Orthodontists
Anteroposterior discrepancies: This type of condition is the most frequent reason people seek orthodontic treatment. Anteroposterior discrepancies are deviations between upper and lower teeth in the anteroposterior (front-to-back--as opposed to side-to-side) direction. A common example is "overbite"--when top teeth are too far forward relative to bottom teeth. Such conditions are often treated by using braces and headgear. The headgear is attached to the braces with hooks or a facebow and is anchored from the back of the head or neck with straps or a head-cap. Elastic bands are typically then used to apply pressure to the bow or hooks. This helps to slow or stop the upper jaw from growing, which can preventing or correct overbite.
Crowding of teeth: Another common situation leading to orthodontic treatment is crowding of the teeth. This occurs when there is not enough room for the normal number of adult teeth. Sometimes this can be corrected with braces, but in some cases one or more teeth may need to be removed in order to create enough room for the remaining teeth.