Treatments

We treat all forms of “crooked” teeth. In Western countries the most common malocclusion is an overjet, where the upper front teeth are positioned too far forward in relation to the lower front teeth. This malocclusion is often seen in connection with a retrusive mandible or jawbone. The jaws’ position in relation to each other has a large effect on how large the overjet will be by the end of the treatment.

A mandibular overbite is the opposite of an overjet. Here the lower front teeth are positioned in front of the upper front teeth. It often takes more than dental braces to get an optimal correction. In cases where difference in jaw growth is extreme, a mandibular overjet needs to be corrected with corrective jaw surgery (orthognathic surgery) combined with fixed appliance treatment after the patients growth is completed.

Patients with an overjet in addition often have a deep bite, where the upper and the lower front teeth erupt past each other. This might lead to the patient biting himself in the gums behind the teeth, which can lead to pain and loose teeth or excessive wear on the front teeth. The long-term prognosis for the teeth is sometimes poor if not corrected orthodontically.

An open bite is when the upper and lower teeth have no contact in the front and/or in parts of the sides.

The consequence is poor contact of the upper and lower jaw, which can lead to strain in the temporomandibular joint and the jaw muscles.

An open bite can be induced by abnormal growth of the jaws or by a tongue habit. It is often the tongue’s placement and pressure against the front teeth when swallowing and speaking that gradually changes the teeth’s position (and speech in general).

A cross bite is a condition where the interrelation between of one or more upper and lower teeth are reversed. This might lead to temporomandibular complications and asymmetric development of the lower jaw, resulting in facial disharmony.

Crowding occurs when teeth are rotated or overlapping due to lack of space. This condition occurs when teeth are unusually large or if the jaws are smaller than normal. In some cases, the teeth do not have enough space to move into the right position or even to emerge from the gums at all (impacted teeth). One solution is to expand the dental arches in order to create the space needed. Another solution is to extract some permanent teeth to create more space. Yet another solution is enamel reduction – grinding the neighbouring sides of the teeth, so that the teeth become narrower. Sometimes one of the two first solutions is combined with the latter.

Spacing is a condition in which there are large and uneven spaces between the teeth. Some children are born lacking one or two teeth in their jawbones, or their teeth do not develop and emerge from the gums properly. Spacing also occurs with loss of teeth throughout life. Whatever the reason, spacing creates cosmetic problems and can have serious health consequences, such as difficulties in chewing or an unstable occlusion leading to bite function problems. In most cases, orthodontic treatment can close the gaps by moving teeth closer together, though sometimes leaving a new gap in an area where it is not visible.

Orthodontic treatment can also create the perfect space for a fixed dental prosthesis.

A full orthodontic treatment most often aims to solve a combination of the above-mentioned problems. It is important to have a thorough examination in order to create a valid treatment plan.

We recommend that you set up an appointment for a consultation with Harry Fjellvang.

Duration of treatment

How long does it take?

That depends on many factors. The most obvious one is the severity of the problem. How crooked are the teeth? How complex are the causes of the crookedness? Can the problem be treated with braces alone? Or does the patient need braces combined with orthognathic surgery?

An average active treatment lasts approximately 1½-2 years. Afterwards, there will be a period of passive treatment in order to stabilize the end result.

Things you as a patient can do to shorten and optimize the treatment are:

• Ensure a good working relationship between you and us.
• Avoiding certain foods that can damage the braces. Damage to the braces can prolong the treatment and may decrease the quality of the treatment.
• Good oral hygiene benefits both your teeth and your braces, and it’s an important factor in avoiding irreversible damage to the teeth and gums. Please see our recommendations.
• Be sure to keep your appointments and be on time for each visit to ensure we have enough time to carry out any adjustments.
• Closely follow the instructions given to you by the orthodontist and orthodontic assistants.

Damage and Risk

In orthodontic treatment the teeth straighten and move through the bone in a specific direction, over a specific distance, according to the treatment plan. The movement takes place due to forces put on the teeth by the orthodontic appliance. This gives a strain on the roots of the teeth and the tissue that surrounds them which causes the bone around the teeth to remodel, i.e. resorb and rebuild.

At the same time the teeth that move experience resorption of the tip of the roots. This phenomenon is caused by the same cells that resorb the bones. They start resorption of the root apices but stop immediately when the appliance is removed or not active.  This phenomenon is unavoidable in orthodontic treatment. We make sure that the extent of the resorption is minimal by moving the teeth smoothly with the correct forces and optimal velocity. In cases of more pronounced resorption, we inactivate the appliance for approximately 3-4 months to allow the cells to “reset”. After this period, the treatment resumes. If the roots continue to resorp, we will need to terminate the treatment which is very rare.

It’s essential to keep your teeth clean during an orthodontic treatment. It’s also challenging, because the fixed appliances have many corners and crypts where food debris can hide. If bacteria are left undisturbed on the teeth and appliance, they can cause cavities and gum inflammation. It is therefore very important to keep teeth and appliances clean to reduce the risk of damage to the teeth and gums.