Orthodontics is the branch of dentistry that specializes in the diagnosis, prevention and treatment of dental and facial irregularities.  The technical term for these problems is "malocclusion," which means "bad bite."  The practice of orthodontics requires professional skill in the design, application and control of corrective appliances, such as braces, to bring teeth, lips and jaws into proper alignment and to achieve facial balance.

All orthodontists are dentists, but only about 6 percent of dentists are orthodontists.  An orthodontist is a specialist in the diagnosis, prevention and  treatment of dental and facial irregularities.  Orthodontists must first attend college, and then complete a four-year dental graduate program at a university dental school or other institution accredited by the Commission on Dental Accreditation of the American Dental Association (ADA).  They must then successfully complete an additional two- to three-year residency program of advanced education in orthodontics.  This residency program must also be accredited by the ADA.  Through this training, the orthodontist learns the skills required to manage tooth movement (orthodontics) and guide facial development (dentofacial orthopedics).

Only dentists who have successfully completed this advanced specialty education may call themselves orthodontists.

The American Association of Orthodontists is the national organization of dental specialists who limit their practice to orthodontics and dentofacial orthopedics.  Founded in 1900, the AAO is the oldest and largest dental specialty organization in the United States and Canada.  To date, the AAO has more than 13,500 members, including more than 2,000 international members from outside North America.  This membership consists of approximately 94 percent of all orthodontists who currently practice in the United States.

The AAO is dedicated to advancing the art and science of orthodontics and dentofacial orthopedics, improving the health of the public by promoting quality orthodontic care, and supporting the successful practice of orthodontics.  All members must meet the specialty educational requirements as defined by the Commission on Dental Education of the American Dental Association.

The American Dental Association has recognized that "specialists are necessary to protect the public, nurture the art and science of dentistry, and improve the quality of care.

Children and adults can both benefit from orthodontics, because healthy teeth can be moved at almost any age.  Because monitoring growth and development is crucial to managing some orthodontic problems well, the American Association of Orthodontists recommends that all children have an orthodontic screening no later than age 7.  Some orthodontic problems may be easier to correct if treated early.  Waiting until all the permanent teeth have come in, or until facial growth is nearly complete, may make correction of some problems more difficult.

An orthodontic evaluation at any age is advisable if a parent, family dentist or the patient’s physician has noted a problem.

Most malocclusions are inherited, but some are acquired.  Inherited problems include crowding of teeth, too much space between teeth, extra or missing teeth, and a wide variety of other irregularities of the jaws, teeth and face.

Acquired malocclusions can be caused by trauma (accidents), thumb, finger or dummy (pacifier) sucking, airway obstruction by tonsils and adenoids, dental disease or premature loss of primary (baby) or permanent teeth.  Whether inherited or acquired, many of these problems affect not only alignment of the teeth but also facial development and appearance as well.

Crooked and crowded teeth are hard to clean and maintain.  This may contribute to conditions that cause not only tooth decay but also eventual gum disease and tooth loss.  Other orthodontic problems can contribute to abnormal wear of tooth surfaces, inefficient chewing function, excessive stress on gum tissue and the bone that supports the teeth, or misalignment of the jaw joints, which can result in chronic headaches or pain in the face or neck.

When left untreated, many orthodontic problems become worse.  Treatment by a specialist to correct the original problem is often less costly than the additional dental care required to treat more serious problems that can develop in later years.

The value of an attractive smile should not be underestimated.  A pleasing appearance is a vital asset to one’s self-confidence.  A person's self-esteem often improves as treatment brings teeth, lips and face into proportion.  In this way, orthodontic treatment can benefit social and career success, as well as improve one’s general attitude toward life.

By age 7, enough permanent teeth have come in and enough jaw growth has occurred that the dentist or orthodontist can identify current problems, anticipate future problems and alleviate parents' concerns if all seems normal.  The first permanent molars and incisors have usually come in by age 7, and crossbites, crowding and developing injury-prone dental protrusions can be evaluated.  Any ongoing finger sucking or other oral habits can be assessed at this time also.

Some signs or habits that may indicate the need for an early orthodontic examination are:

early or late loss of baby teeth, difficulty in chewing or biting, mouth breathing, thumb sucking, finger sucking, crowding, misplaced or blocked out teeth, jaws that shift or make sounds, biting the cheek or roof of the mouth, teeth that meet abnormally or not at all, and jaws and teeth that are out of proportion to the rest of the face.

An orthodontic screening no later than age 7 enables the orthodontist to detect and evaluate problems (if any), advise if treatment will be necessary, and determine the best time for that patient to be treated.

For those patients who have clear indications for early orthodontic intervention, early treatment presents an opportunity to:

guide the growth of the jaw, regulate the width of the upper and lower dental arches (the arch-shaped jaw bone that supports the teeth), guide incoming permanent teeth into desirable positions, lower risk of trauma (accidents) to protruded upper incisors (front teeth), correct harmful oral habits such as thumb- or finger-sucking, reduce or eliminate abnormal swallowing or speech problems, improve personal appearance and self-esteem, potentially simplify and/or shorten treatment time for later corrective orthodontics, reduce likelihood of impacted permanent teeth (teeth that should have come in, but have not), and preserve or gain space for permanent teeth that are coming in.

Yes.  Wearing a protective mouthguard is advised while playing any contact sports.  Your orthodontist can recommend a specific mouthguard.

Healthy teeth can be moved at almost any age.  Many orthodontic problems can be corrected as easily and as well for adults as children.  Orthodontic forces move the teeth in the same way for both a 75-year-old adult and a 12-year-old child.  Complicating factors, such as lack of jaw growth, may create special treatment planning needs for the adult.

One in five orthodontic patients is an adult.  The AAO estimates that nearly 1,000,000 adults in the United States and Canada are receiving treatment from an orthodontist.  To learn about correction of a specific problem, please consult your family dentist or an orthodontist.

Most people have some discomfort after their braces are first put on or when adjusted during treatment.  After the braces are on, teeth may become sore and may be tender to biting pressures for three to five days.  Patients can usually manage this discomfort well with whatever pain medication they might commonly take for a headache.  The orthodontist will advise patients and/or their parents what, if any, pain relievers to take.  The lips, cheeks and tongue may also become irritated for one to two weeks as they toughen and become accustomed to the surface of the braces.  Overall, orthodontic discomfort is short-lived and easily managed.

In general, active treatment time with orthodontic appliances (braces) ranges from one to three years.  Interceptive, or early treatment procedures, may take only a few months.  The actual time depends on the growth of the patient’s mouth and face, the cooperation of the patient and the severity of the problem.  Mild problems usually require less time, and some individuals respond faster to treatment than others.  Use of rubber bands and/or headgear, if prescribed by the orthodontist, contributes to completing treatment as scheduled.

While orthodontic treatment requires a time commitment, patients are rewarded with healthy teeth, proper jaw alignment and a beautiful smile that lasts a lifetime.  Teeth and jaws in proper alignment look better, work better, contribute to general physical health and can improve self-confidence.