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    So, your child has a problem with his teeth; but who should you take him to - a dentist or an orthodontist?

    Christine Machado Christine Machado 15 Mins Read

    Christine Machado Christine Machado


    Written For ParentCircle Website new design update

    It can be pretty confusing for parents to choose between a dentist and an orthodontist for treating their children's dental problems. Read this article to get a better understanding

    Toddler to 18+
    So, your child has a problem with his teeth; but who should you take him to - a dentist or an orthodontist?

    Mithun's 10-year-old son had always been upset about his protruding teeth. As he grew up, he was becoming more and more reclusive, due to the fear of being ridiculed by his friends. Mithun realised what his son was going through and wanted to help him. He took the child to a dentist, hoping to find a permanent solution to the problem. The dentist examined the little boy's teeth and suggested that they should consult an orthodontist. 'An orthodontist?' Mithun asked himself. 'Who is an orthodontist?'

    Well, Mithun is not the only one who does not know the answer to that question. In fact, most people don't know what an orthodontist does. Everybody is familiar with the role and importance of a dentist. But who is an orthodontist and in what way is an orthodontist different from a dentist? When it comes to orthodontist vs dentist, who is the right person to consult? These are questions that few can answer.

    To find answers to these and many related questions, let's take a detailed look at the services offered by an orthodontist, and how they are different from those provided by a dentist.

    Difference between dentists and orthodontists

    Who is a dentist?

    A dentist is a qualified medical professional who takes care of general oral health and attends to common dental problems and infections such as tooth decay and gum diseases. He also pulls out infected teeth.

    Who is an orthodontist?

    An orthodontist is a specialist within the dental profession. He or she undergoes specific training for a minimum period of three years after graduating as a dentist. The orthodontist's field of work relates to teeth alignment, balance of jaw bones, and facial and dental aesthetics.

    What does an orthodontist do?

    A qualified orthodontist works to correct various flaws of the teeth and jaw. These include protruding teeth, crowding of teeth, too much space between teeth, extra/missing teeth in cases of cleft lip and cleft palate, misalignment of teeth, poorly aligned jaws, underbite, overbite, open bite, deep bite, cross bite and crooked teeth.

    An orthodontist uses different types of devices to fix the incorrect positioning of teeth and jaws, and to enhance facial aesthetics. These devices fall into two broad categories - fixed and removable ones. Let's take a look at them in detail:

    Fixed devices:

    • Dental braces - These are the most commonly used orthodontic devices. They help align and straighten teeth. They are made up of components such as brackets, bands and arch wires. Brackets are tiny squares that are fixed to the front of teeth. They are attached to the bands. They also hold the arch wires which help in moving the teeth. The bands are fixed around the teeth and act like anchors . Arch wires run through the brackets across the teeth and are attached to the bands.
    • Fixed space maintainers - These are used for babies when a tooth is lost prematurely. They keep the space open till the permanent tooth grows in.
    • Special fixed appliances - They are used to stop the habit of thumb-sucking or tongue-thrusting in children, and are attached to the teeth with the help of bands.

    Removable devices:

    1. Removable space maintainers - These work like fixed space maintainers, but can be removed when not needed.
    2. Jaw repositioning appliances - They are also known as splints and are worn on either the top or lower jaw. They help in drawing the jaw backwards.
    3. Aligners - These are used as alternatives to traditional braces in adults. Since they don't use any metal wires and brackets, they are quite comfortable to wear and can be easily removed whenever they're not required.
    4. Lip and cheek bumpers - They keep the lips and cheeks away from the teeth, and help in relieving the pressure.
    5. Palatal expanders - These are plastic plates that fit over the roof of the mouth, and are used to widen the arch of the upper jaw.
    6. Removable retainers -They are used after the treatment with braces is complete. They help in preventing the teeth from shifting back to their previous misaligned positions.
    7. Rubber bands: Also known as elastics, these are used to help move the teeth and jaws into the desired positions.
    8. Headgear: These are removable devices worn over the head and attached to the braces. They are used when there is a need for extra force to move the teeth and jaws.
    "There are many parents who bring their children in for regular dental reviews, because they themselves have had some serious teeth issues in the past, and would not like to see their children going through the same. At the same time, there are the naysayers, who believe that their child should see a dentist only when there is an issue. This is a debate to which there is no right or wrong answer.
    However, regular dental check-ups should be strongly encouraged, since continuity of care is an important part of any health plan, and dentistry is no exception. Teeth have important effects on our diet, health, speech, and overall wellbeing. Regular dental visits, at least annually, are essential if an individual has other medical issues (diabetes or anaemia) that may impact the teeth and the gums. After all, a toothless smile looks cute on a baby or a grandma, but would we say the same about a teen or an adult?
    - Ms Aruna Mohan, Director, Dental Service, The Capstone Clinic

    Types of dental braces

    There are different types of dental braces available in the market. An orthodontist will recommend the right type of brace for a patient's needs and comfort level.

    These are some of the most common types of dental braces used:

    Metal Braces

    These are also known as 'traditional braces'. The brackets, bands and arch wire are made of stainless steel. They are the most effective type of braces because they are the fastest in correcting misaligned teeth and also the least expensive of them all.

    Ceramic Braces

    The brackets in these braces are made of ceramic material of the same colour and texture as teeth. They are far less noticeable than the metal braces, but are a bit expensive.

    Lingual Braces

    These are same as the metal braces, but they are fixed on the inside of the row of teeth. Although they are less likely to be noticed, they are quite difficult to maintain. They take longer to correct the defect and are also more expensive than traditional braces.

    Self-Ligating Braces

    These braces use special brackets with clips or 'doors' that grip the arch wire, and are available in both metal and ceramic versions. No elastic or rubber bands are needed.

    Invisalign Braces

    These are the most advanced and modern braces, and are also the most effective in treating misalignment. Being invisible, they are also more comfortable than other types of braces. However, they are more expensive and are not really effective in severe orthodontic conditions.

    "Spotting dental problems earlier helps keep dental treatments simple and more affordable. Regular dental check-ups are thus a proactive way to keep costs down. Today, in the West, insurance companies pay 100 per cent for preventive check-ups, while higher-cost treatment procedures are only partially covered, since they realise that prevention is better and cheaper than cure. Silver fillings have given way to better tooth-coloured adhesive fillings, but these procedures cost more. Advancement in every field of dentistry is happening at a rapid pace, and its effect, while being directly proportional to better dentistry, also requires larger purses.
    However, waiting to treat dental problems is not going to make treatment any cheaper."
    - Ms Aruna Mohan, Director, Dental Service, The Capstone Clinic

    Awareness on orthodontics in India

    Although a few people know the difference between the two terms - orthodontist and dentist - many do not. A major reason for this is lack of publicity. Unlike in the West, where the Orthodontics Associations and individual orthodontists are allowed to publicise their services, in India, it is perceived as unethical to do so. However, in recent times, the Indian Orthodontic Society has taken steps to create public awareness by making short videos that are available on YouTube and also clips that are aired on FM radio programmes. These have been made after obtaining due permission from the health authorities.

    Taking your child to an orthodontist vs a dentist

    A visit to an orthodontist is as important for your child as a visit to a dentist, if the condition warrants it. It is recommended that you take your child to a dentist at least once in six months. If the child is seen to be developing a bad bite or has any other ortho-dental problems, a conscientious dentist will refer you to an orthodontist, who is the right person to deal with such problems, for early intervention.

    While orthodontic treatment can be provided at any age and the optimal time for individual patients may vary, it is strongly recommended that a child's first visit to an orthodontist be before the age of seven. Depending on the type of problem, the first visit can even take place as early as two or three years of age, though treatment can probably be started only years later. Early examination allows the orthodontist to detect and evaluate problems, and plan appropriate treatment at an appropriate time. In some cases, early treatment can be initiated to prevent much more serious problems from developing. This early intervention may make treatment at a later age shorter and less complicated.

    "Good oral health begins with clean teeth. Consider these basics:
    - Brush your teeth with a medium-bristled (for adults) or a soft-bristled (for children) toothbrush twice daily, for a duration of 2 minutes.
    - Clean your tongue with a tongue scraper daily to keep it free of bacterial accumulation.
    - Rinse your mouth after every snack and/or meal.
    - Resist the temptation to clean your teeth with toothpicks or your nails, since gum tissue can be damaged.
    - Learn to brush, from your dentist or hygienist."
    - Ms Aruna Mohan, Director, Dental Service, The Capstone Clinic

    When to visit an orthodontist

    You need to take your child to an orthodontist if he has any of these conditions:

    • Overbite: The upper front teeth are positioned too far forward over the lower teeth. This is also known as 'buck teeth'.
    • Underbite: The lower teeth are more far forward than the upper teeth. This is also called 'bulldog appearance'.
    • Crossbite: The upper teeth and lower teeth don't meet at the optimal position when biting normally.
    • Open bite: The upper teeth and lower teeth don't touch each other and there's a gap when biting.
    • Misplaced midline: The centre of the upper front teeth does not line up with the centre of the lower front teeth.
    • Spacing: Spaces or gaps occur between the teeth due to missing teeth or lack of contact points between teeth.
    • Crowding: Lack of space in the dental ridge to accommodate all the teeth.

    Orthodontic treatment process

    Here's the treatment route that a professional orthodontist is likely to follow:

    • When you take your child for treatment, the orthodontist first makes a thorough physical examination of the problem.
    • The orthodontist's evaluations give a clear picture of the problem, its root cause and the possible treatment methods.
    • Normally, the orthodontist will take a plaster model of the teeth structure. The child will be asked to bite down into a dental tray which is filled with a gel-like substance to create an impression of the teeth. The tray is then removed and filled with plaster, to create a model of the child's teeth. This helps the orthodontist to clearly examine the position of teeth, and identify the exact problem.
    • The face is photographed at different positions and from different angles before the treatment begins. X-rays of the teeth and jaw are also taken, which help the orthodontist examine the position of each tooth and its root.
    • Based on all these diagnostic inputs, the orthodontist will devise a treatment plan. Depending upon the type of problem, devices such as dental braces, space maintainers or aligners will be recommended.
    • The orthodontist will examine your child at regular intervals during the period of treatment to assess progress. More photographs of the face and more X-rays may also be taken to examine the finer details.
    • Once the orthodontist confirms that the alignment issues are fixed, the device will be removed. The child will then have to use temporary, removable devices for a specific period of time, as recommended by the orthodontist.

    Choosing the right orthodontist

    Some important attributes you need to assess before choosing an orthodontist are:

    • Patience to listen to the patient's concerns, and ability to answer questions clearly.
    • Ability to communicate compassionately with patients, especially children, in a way that takes away any fear or uneasiness about the treatment.
    • Readiness to discuss the various treatment options available, and give parents the freedom to choose whichever suits them.
    • Experience in treating a wide spectrum of orthodontic disorders in patients of all age-groups.
    • Expertise in using the latest trends and treatment methodologies in orthodontics.
    • Availability to handle any emergency situation such as dismantled braces or loosened separators.
    • Transparent and affordable treatment charges.
    "Apprehension at the thought of a dental visit can prove to be a real dampener! It is important to discuss this with your dentist so that he/she can suggest suitable ways to help you go through treatment. Having your dentist walk you through an exact explanation of the planned procedure furthers your understanding and mental preparation for the same. From listening to music on your headphones to having dentistry done under sedation, your dentist can help you get through visits without trepidation. Conscious sedation can be done via oral means, inhalation (nitrous gas), or use of intravenous medication. This is a procedure that can be safely carried out in a dental clinic. There is no need to visit a hospital for the same. Of course, it is important to find a dentist with whom you feel comfortable, so that any fears you might have are addressed."
    - Ms Aruna Mohan, Director, Dental Service, The Capstone Clinic

    Questions to ask your orthodontist

    It is always good to clarify any doubts you may have regarding your child's dental treatment. So, here are some of the questions you need to ask your orthodontist:

    - What are the treatment options available for my child's orthodontic problem?

    - How long will this treatment last?

    - How many visits will be required for the treatment procedure?

    - If my child needs dental braces, what type would you suggest?

    - How long will my child have to wear braces?

    - Will braces affect my child's lifestyle? If yes, how?

    - Can my child play sports and games while wearing dental braces?

    - How can I help my child maintain oral hygiene with braces on?

    - What are some orthodontic emergencies I should watch out for?

    - What should I do if such an emergency arises?

    Orthodontists play a vital role in correcting dental misalignments and improving facial aesthetics. But since there isn't much awareness about their services, people normally don't realise who an orthodontist is. We hope this article has thrown enough light on what an orthodontist does, and why it is important to take your child to an orthodontist rather than a dentist when the situation demands it.

    ParentCircle joins you in ensuring that your child's smile becomes even more beautiful!

    Inputs from Dr Krishnaswamy, Professor and Head of the Department of Orthodontics and the Vice Principal of Ragas Dental College & Hospital, Chennai, India. He is a Fellow of the Royal College of Surgeons of Edinburgh and a Diplomat of the Indian Board of Orthodontics and The National Board of Medical Sciences. He has served as the President of the Indian Orthodontic Society and the Chairman of the Indian Board of Orthodontics.


    Jayanthan 296 days ago

    Good article

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