Where Do Lingual Braces Fit In With [Today’s] Orthodontist?

A Little Historical Perspective

Braces on teeth did not begin when you or your friends were teenagers with “platinum smiles.” Today’s orthodontists come from a long history of success in adjusting teeth for beauty and practical daily function.

Ancient mummies have been found with metal appliances straightening their teeth. Ancient philosophers, e.g., Aristotle, Hippocrates, etc., explored the management of crooked teeth 2400 years ago. Metal strips, catgut, and gold wire were already in use at that time to adjust and maintain tooth alignment.

bracesModern Smiles

Pierre Fauchard was an early “modern” dentist in France in the first part of the 1700s. His metal apparatus called a “Bandeau” was designed to reshape the dental arch. This early brace for moving and realigning teeth was discussed in Le Chirurgien Dentiste, the first modern dental “manual” describing dental procedures and prosthetics.  Today’s “orthodontics” has its genesis with Fauchard.

 

Sorting Out Dental Care

First of all, in the early 1900s, Edward H. Angle codified occlusion problems and their management in the USA. He established the first orthodontics college and was instrumental in founding what became the American Association of Orthodontists in the 1930s. Today that AAO has 13,500 members focused on the diagnosis and treatment of dental anomalies. That management includes fabricating and employing braces to align your teeth and fix your smile. The focus of the orthodontist is your mouth, and that’s where braces for your teeth come in. Simply, the orthodontist is concerned with your smile. That smile comes when your teeth fit your mouth and your mouth fits your face.

 

Big Picture

The teeth initiate the mastication process where saliva and food are mixed in the mouth before they are swallowed. The teeth bite, tear, grind and mix food with that saliva, but there may be problems.

 

Alignment

The bite may be inefficient because of the upper teeth protruding beyond the lower teeth, the so-called “overbite.” Alternatively, that bite may be inefficient because the upper teeth misalign with the lower teeth protruding, causing an “underbite.”

 

Jaw Involvement

Jaw muscles may be more powerful on one side of the mouth, causing a “crossbite” where one side of the lower teeth is pushed forward, misaligning the bite. Teeth may be just fine, but the jaw bone itself may be warped or its teeth are not equally protruding from the gums, causing an “open bite” where upper and lower teeth do not fully occlude. The result is an incomplete bite and food is not completely broken before mastication begins.

 

Teeth Eruption and Gum Issues

Teeth align ideally when upper and lower teeth address one another directly. When alignment is crooked, there is a “misplaced midline.” This alignment issue is not due to the jaw itself. Teeth may erupt from the gums misdirected and cause “spacing” problems, e.g., too much gap between teeth or “crowding” of the teeth where there are too many teeth for the gum space available.

 

Understanding Braces and Your Orthodontic Options

The term “braces” still conjures up a vision of a “metal mouth” and a metal mesh surrounding teeth. Braces today, however, are more than simple metal pieces.  They may involve one or more of these components:

  • Bands—welded rings attached to molars. Bands are anchored to the teeth with metal straps or dental cement. They, in turn, allow wire connections with other teeth. Bands are constructed of traditional stainless steel, ceramics, or plastic.
  • Brackets—miniature squares of metal, ceramic, or other material attached to a band or a tooth. Brackets are slotted to allow the use of an arch wire or are hooked to allow rubber band attachments.
  • Arch Wire—metal wires fabricated to link the brackets of the braces. Arch wires tend to maintain their bend or shape, but they allow adjustments to the braces as the teeth reposition from ongoing pressure exerted via the wire.
  • Rubber Bands—removable elastics attached to brackets to slowly move teeth with the pressure exerted by the rubber bands linking upper and lower teeth.
  • Ligatures—wire or elastic bands linking brackets to the archwire. They allow brace adjustment during treatment with braces and come in colors. Some ligatures are self-adjusting.
  • Coil Spring—springs mounted on arch wires between brackets causing teeth to separate. These springs add space between adjacent teeth.
  • Power Chain—the apparatus linking the teeth to prevent spaces between teeth from expanding during management with braces.

Options for Braces

The orthodontist is in the business of straightening those teeth, aligning those ivories to fix your bite and your occlusion and doing it all using an oral prosthesis called a brace. But, “a brace” is not “a brace.” A tooth is a 3D object with a front, a back, and sides. In cosmetic terms, a tooth has a side that shows and sides that do not show. People are not happy to have teeth with metal hiding their teeth. The braces you are familiar with from your teenage years were on the outside of your teeth or around them. Also, teenage embarrassment relates to the visibility of those metal braces. Thus, times have changed and orthodontist expertise and inventiveness have brought new cosmetic alternatives for braces.

The braces you are familiar with from your teenage years were on the outside of your teeth or around them. Also, teenage embarrassment relates to the visibility of those metal braces. Thus, times have changed and orthodontist expertise and inventiveness have brought new cosmetic alternatives for braces.

 

Outside vs. Inside Placement

Braces have been attached to teeth going back to those Egyptian mummies and those old Greeks. Lots of things happened with modern technology in the last century. Orthodontists began to use “ligating brackets” to encapsulate the tooth being adjusted, minimizing the need to anchor any appliance to the palatal arch. The side of the tooth facing outward has been the default for brace attachment. Therefore, the cosmetic downside is the visibility of this variety of brace.

 

Lingual Braces

Things changed in the last quarter of the 1900s when Craven Kurz and Kinya Fujita developed braces that attached on the tooth’s other side, the “inside” called the “lingual” or “tongue side.” Brace materials using plastics and ceramics began to add color options to make the brackets embracing the teeth even less conspicuous.

 

Orthodontia and Computers

Furthermore, the turn of our new century brought more innovation to the construction of braces. Kelsey Wirth developed a computer design approach to braces, essentially taking three-dimensional images and modifying them for orthodontic purposes. Zia Chisti used that technology to generate custom plastic braces.  Consequently, that same technology has allowed your orthodontist to make computer projections, visualizing on the computer monitor how your teeth alignment will change as the treatment with braces commences.

 

Computer-Aided Design

Finally, you live in an exciting time if you have been investigating braces. Your orthodontist is trained to use today’s technology to fabricate a personal intervention strategy to augment your smile. With today’s imaging with standard X-rays, MRIs, and CTs, your orthodontist’s accurate prosthetic device will be based on those images. As a result, your orthodontist is able to design and visualize alternative orthodontic options for enhancing your smile, giving you, the patient, options. As a result, your orthodontist in the near future may use robotics in conjunction with a 3D printer to provide you a wearable brace device quickly. Indeed, today’s orthodontist will involve you in selecting your potential innovative alternative to adjusting your smile.

Furthermore, your orthodontist in the near future may use robotics in conjunction with a 3D printer to provide you a wearable brace device quickly. Indeed, today’s orthodontist will involve you in selecting your potential innovative alternative to adjusting your smile.

You can find your local ELOS orthodontist here. Contact the practice for an appointment.

 

Where Do Lingual Braces Fit In With [Today’s] Orthodontist?

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