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Orthodontic Glossary
Adjustment
A painless procedure where small changes are made in your orthodontic appliances (for example, wires are tensioned) to keep your teeth-straightening treatment moving forward as it should.
Appliance, Orthodontic
A device that is placed into the mouth and is designed to help straighten the teeth. Common examples include braces, palatal expanders and clear aligners
Archwire
The thin, springy wire that runs horizontally across the teeth, and is attached to them with bands or brackets. The small force exerted by this wire helps cause the teeth to move.
Band
A metal loop that goes around the tooth and anchors other orthodontic components, such as brackets (braces), elastics and wires. Bands are usually used on back teeth (molars).
Banding
The procedure where bands are cemented to the teeth, usually at the start of orthodontic treatment.
Bonding
The use of a special adhesive to attach brackets, fixed retainers, or other appliances to the teeth.
Braces
A general term that refers to metal or ceramic brackets, as well as several types of orthodontic appliances in which a flexible archwire is attached to the teeth via the brackets. Some types of braces include traditional metal braces, clear ceramic braces, and lingual braces.
Bracket
A small metal or ceramic attachment that is bonded to a tooth with a special adhesive or welded to a metal band. Brackets connect the teeth to the archwire and help move them into better positions.
Buccal Tube
A small tube usually attached to the cheek side of a band. It is often used as an attachment point for orthodontic appliances, such as archwires, headgear, or other devices.
Caries
The scientific term for cavities, tiny holes in teeth that are caused by the action of tooth decay bacteria.
Ceramic or Clear Braces
A newer type of braces in which the brackets are made from a tooth-colored material instead of metal. Because they are harder to notice until you get up close, ceramic braces are often preferred by adults having orthodontic treatment.
Clear aligners
An alternative to braces, this system consists of custom-made plastic trays that are worn over the teeth for 22 hours per day, and changed every two weeks. Each tray moves the teeth a small amount, over time causing a dramatic improvement in the alignment of the smile. Best for minor to moderate malocclusions.
Crossbite
This type of malocclusion occurs when some top teeth close inside the bottom teeth. It may cause tooth loosening, gum recession or premature tooth wear, but can often be corrected by orthodontic treatment.
Crowding
A situation where there is not enough room in the upper or lower jaw for all of the teeth to fully erupt (emerge) in the correct positions. It may be treated with a palatal expander or via tooth extraction.
Decalcification
Also called “white spot lesions,” these are areas on the teeth, usually near brackets or bands, where minerals in the tooth's enamel (outer layer) have been lost. Decalcification is caused by bacteria that thrive in the absence of good oral hygiene, but can be prevented and often reversed with treatment.
Dentition
The technical term for your entire set of teeth.
Diastema
A gap or space between the front teeth.
Elastics
Small rubber bands attached to braces, they exert the gentle, continuous forces needed to move teeth into better alignment.
Eruption
The process in which teeth, which are initially formed below the gum line, emerge into the bite.
Extraction
Tooth removal. Using special tools and gentle manipulation, dentists can carefully dislodge and remove a tooth that is causing (or will cause) problems.
Fixed Retainer
A type of retainer that is permanently attached to the back side of the teeth, it helps keep the newly straightened smile stable after appliances like braces or clear aligners have come off.
Functional Appliance
An orthodontic appliance, worn in the mouth, that is designed to harness the forces of growth and development as well as muscular activity in the jaw to help correct bite problems. Some examples include the Activator, Bionator, Twin Block and Herbst appliances.
Gingiva
The soft pink gum tissue that surrounds and supports the teeth.
Gingivitis
An inflammation of the gum tissue which, if left untreated, can cause bone loss and compromise oral health.
Hard Palate
The bony plate, covered by soft tissue, which forms the "roof" of your mouth.
Headgear
A generic term for orthodontic appliances that are worn partly outside the mouth, headgear usually has straps that extend from the head, neck or chin, and attach to the braces. Some common varieties include the face bow and reverse pull types.
Herbst Appliance
A functional appliance consisting of a small piston-like mechanism that extends from the top to the bottom teeth. The device puts a slight constant pressure on the lower jaw, encouraging it to develop in a more forward position.
Impaction
A situation where the existing teeth or other anatomical structures will prevent other teeth from erupting (emerging) in the proper positions. Impacted teeth sometimes need to be extracted.
Impression
An exact model of your teeth, traditionally made by biting on a tray filled with an elastic compound, but today often made with digital imaging systems. This model is used to plan orthodontic and other dental treatment.
Interceptive Orthodontics
A method of orthodontic treatment that harnesses natural growth processes to help correct malocclusion or other problems at an early stage. Typically begun before puberty, interceptive orthodontics can reduce the amount of time spent in braces, and may help avoid more invasive treatments.
Invisalign
The trade name for a system of clear aligners that can be used as an alternative to braces for mild to moderate malocclusions.
Labial
Referring to the side of teeth that is nearest the lip, the “outside” or visible side.
Ligating tie or Ligating Module
A metal wire or elastic band used to attach the archwire of braces to the bracket on a tooth. Some braces have this feature, while others have special self-ligating brackets.
Lingual
Referring to the tongue side, or “inside” of the teeth, normally invisible from the outside.
Lingual Braces
Orthodontic braces in which the brackets and archwires are attached on the tongue side of teeth, making them virtually invisible. Lingual braces can be used in many situations, but require an adjustment period, and are more costly than traditional braces.
Malocclusion
Literally “bad bite,” this term describes a situation where the top upper and lower teeth don't align as they should when they are closed together.
Mandible
The lower part of the jaw or jawbone, the only moveable bone in the skull.
Maxilla
The upper part of the jaw, or jawbone, which is part of the skull.
Mixed Dentition
Having a combination of primary (baby) teeth and adult teeth; this is usually the situation between the ages of 6-12, but is subject to variation.
Mouthguard
A device worn over the teeth that is designed to protect them from injury, for example while participating in sports. Mouthguards are often recommended during orthodontic treatment, and can be custom-made from impressions taken at the dental office.
Occlusion
The technical term for your bite; the way the top and bottom teeth come together when they function in chewing, speaking and other actions.
Open Bite
A type of malocclusion where the upper and lower teeth don't meet or overlap when the mouth is closed, but instead leave an open space in the front (most commonly) or back of the mouth. This problem often affects speech, eating and appearance, but can be usually treated via orthodontics and other therapies.
Orofacial Myofunctional Therapy (OMT)
A method of training the tongue and facial muscles to assume a healthier (or more normal) posture that uses exercise and behavioral modification. OMT may be recommended during or after orthodontic treatment, in situations where tongue thrusting or poor oral rest posture is an underlying cause of malocclusion.
Orthodontics
One of the nine recognized dental specialties, orthodontics is concerned with the diagnosis, treatment and prevention of malocclusions. Orthodontists are experts at correcting misaligned teeth.
Overbite
A situation where the upper teeth overlap the lower teeth when the mouth is closed. A certain amount of overlap in the vertical dimension is normal, but too much or too little is considered a type of malocclusion.
Overjet
A condition where the upper teeth project outward from the jaw in a horizontal dimension, well outside of the lower teeth. Sometimes called “buck teeth,” this type of horizontal overlap can generally be corrected via orthodontic treatments.
Palatal Expander
An orthodontic appliance that is worn inside the upper row of teeth, consisting of two parts connected by a screw-like mechanism. Moving the halves apart puts gentle pressure on a child's developing palate, causing it to widen. This creates more space for teeth to erupt, and can resolve issues of crowding without the need for extraction. Only used in children whose mouths are still growing.
Panoramic X-ray
An x-ray taken by a machine that rotates around the head, producing a more complete picture of the teeth, jaws and facial structures. It provides valuable information for diagnosis and treatment.
Periodontics
Relating to the condition of the gums and soft tissues that surround and support the teeth. Good periodontal health, especially for adults, is crucial when undergoing orthodontic treatment.
Permanent Dentition
A situation where only adult teeth are present in the mouth, whether or not the jaw has stopped growing. The first permanent teeth usually begin to erupt around age 6, and the last (wisdom teeth) around age 21.
Plaque
A sticky film of bacteria and food particles that clings to teeth. If not removed by brushing and flossing, it can harden into a mineralized form called calculus (tartar), and can cause serious oral health problems. Maintaining good oral hygiene is especially important while you are wearing orthodontic appliances.
Primary Dentition
This refers to the deciduous or “baby” teeth, which begin to erupt around age 6 months, begin being replaced around age 7, and are generally gone around age 13. When both primary and adult teeth are present, it is referred to as “mixed dentition.”
Removable Retainer
An appliance made of molded plastic and wires that is worn after braces have been removed, which can be put in and taken out of the mouth. The plastic base is molded to fit the palate or the lingual surface of the lower jaw, and held to the teeth via wires that are anchored in the base.
Retention
A period of time which follows the active phase of orthodontics, where the teeth were moved into better positions with braces or aligners. The passive retention phase helps to stabilize the teeth in their new alignment and prevents them from moving back to their former places.
Separator
An elastic device that is used to create space between teeth so that a band or bracket to be placed.
Space maintainer
A metal or plastic device that is used to hold a space open in the jaw for a new tooth to emerge.
Temporomandibular Joints
The “hinges” of the jaw, these two joints (on the left and right sides of the face, below the ears) allow the lower jaw to open and close properly. When these joints don't work properly due to muscle spasms, malocclusion or other causes, a number of problems can result.
Tongue Crib
An orthodontic appliance that helps curb the habit of thumb sucking, which can lead to serious malocclusion if allowed to continue for too long. It can also help re-position the tongue to counter a tongue-thrusting habit.
Tongue Thrust
A habit in which the tongue presses against the front teeth, potentially pushing them out of alignment. Related to poor tongue posture, it can be treated with an orthodontic appliance or via orofacial myofunctional therapy.
Underbite
A non-technical term for a bite problem in which the upper teeth close inside the lower teeth, often the result of a protruding lower jaw.
Elastics (Rubber Bands)
Orthodontic elastics, also referred to as rubber bands, are small stretchy loops of latex that help move teeth into proper alignment during orthodontic treatment. Their purpose is to create additional force for tooth movement in any of the three dimensions — up or down, back and forth, side to side — that is more difficult using braces alone.
Elastics attach to tiny hooks on traditional braces or buttons created for this purpose on clear aligners (Invisalign®). The bands may stretch from upper jaw to lower jaw, or be connected to teeth in the same jaw. These connection points are carefully determined to create the desired movement of individual teeth or groups of teeth, while preventing other teeth from moving out of alignment.
Likewise, the rubber band must be stretched in a precise pattern. For example, it may hook to one upper tooth and two lower teeth, creating a triangle shape. It may attach to four teeth, creating a box pattern. Or it may simply stretch between one upper tooth and one lower tooth on a diagonal. The important thing is that you attach them exactly as instructed. Wearing them incorrectly can prevent the teeth from moving, or create unwanted movement. If you have any questions about how to attach your elastics correctly, please don't hesitate to ask.
Important Things to Remember About Rubber Bands
The most important thing to remember is that treatment with orthodontic elastics can only be successful if the rubber bands are worn continuously as directed. They should only be removed for eating or brushing your teeth. If you wear Invisalign, you already are used to a similar type of routine. If you wear traditional braces, however, assuming this new level of responsibility for the success of your own treatment may be new. But it will be well worth the extra effort!
When you first start to wear elastics, you may experience some soreness. This is normal, and should go away in a few days. Please do not remove the elastics to relieve the soreness — this will only prevent your teeth from moving as desired, while delaying you from reaching the point when you will feel better! Likewise, don't double up on elastics, thinking that this will move your teeth faster. It won't! The various stages of your treatment have been precisely planned and designed specifically for you, to give you the best smile possible.
Here are some other helpful tips:
Carry extra elastics with you at all times. That way, if one breaks or gets lost, you'll be ready- If you run out of elastics, don't wait until your next appointment to get more; stop in to the office right away.
- Always wash your hands before putting in or taking out elastics.
- Contact us if you have any questions about elastics, or any other aspect of your treatment.
Oral Muscle Therapy (OMT)
When it comes to keeping your mouth healthy and your smile bright, dentists may be the first health care professionals you think of. But for certain orthodontic problems, we may recommend a team approach that involves consulting a professional in another field. For example, when a persistent habit like tongue thrusting is causing trouble with your child's bite, it may be time to pay a visit to an orofacial myologist. If you haven't heard of this specialist, you're not alone. Let's take a closer look at how the muscles in your mouth work together, how problems in this area may develop, and how they can be fixed.
Your oral cavity is surrounded by many muscles, including those that control facial expression, speech, mastication (chewing), and swallowing. One of the largest is the tongue, which has a prominent role in speaking and swallowing. In a normal, relaxed posture, the tip of the tongue touches the upper palate (roof of the mouth), the top and bottom teeth aren't in contact, and breathing is done through the nose. But in some people, this posture doesn't occur naturally. Instead, the tongue may rest on the "floor" of the mouth, allowing too much open space above; or it may be positioned too far forward, even protruding between the front teeth (tongue thrusting). Either of these postures can spell trouble for the bite.
The Trouble With Tongue Thrusting
Tongue thrusting is a behavioral pattern sometimes found in children, where the tongue is habitually pressed against the front teeth. A related behavior, called the infantile swallowing pattern, occurs when the tongue is thrust into the gap between the front teeth while swallowing; this is a normal phase of development, but is usually replaced by the adult swallowing pattern around age four. Tongue thrusting may be instigated by many factors, including airway obstructions, low tongue posture, or anatomical irregularities. Once this behavior becomes a habit, it can cause serious bite problems.
Over time, the slight, constant pressure of the tongue against the front teeth may be enough to push them forward and out of alignment. In severe cases, it can result in an open bite — a situation where the front teeth don't come together or overlap when the mouth is closed, but instead leave an open gap in the front of the mouth. This type of malocclusion (bite problem) not only detracts from the appearance of the smile — it may also make it difficult to speak, chew, and swallow properly. Correcting an open bite often requires extensive orthodontic work.
If tongue thrusting continues after orthodontic treatment is completed, the harmful habit may undo months of work; in a relatively short time, it can change the newly straightened smile back to the way it was before treatment. In fact, many young people are first referred for oral muscle therapy, technically called Orofacial Myofunctional Therapy (OMT), as their orthodontic work is being wrapped up. In other instances, OMT is recommended for treating habitual mouth breathing, persistent thumb sucking, and other conditions that affect speech, eating, and oral health.
How Orofacial Myofunctional Therapy Works
The goal of OMT is to re-train the facial muscles (including the tongue) to habitually assume the proper resting posture. A health care professional called an orofacial myologist may employ various approaches to achieve this goal, including exercises for the oral muscles combined with motivational techniques that use positive reinforcement. Some exercises are designed to accustom the tongue to resting on the proper spot on the palate; others promote good muscle tone and lip strength. An orofacial myologist may also help train your child to use the adult swallowing pattern, and encourage him or her to replace harmful habits with healthier behavior patterns.
Rather than being a one-size-fits-all treatment, orofacial myofunctional therapy is tailored to each individual's needs. Following a thorough evaluation, OMT uses age-appropriate techniques (and rewards) to bring about positive changes in behavior. As therapy progresses, exercises learned in the office are often practiced at home in front of a mirror. Simple tools, such as tongue depressors, dental elastics, or even healthy snack foods, are sometimes used to help young patients develop good oral behaviors. While every situation is different, OMT typically brings improvement in a period of weeks, and is generally completed in 15-17 sessions.
Orofacial myofunctional therapy is an established treatment method that can be beneficial in a number of situations. If you have questions about OMT or would like more information or a referral, please contact our office.
Temporary Anchorage Devices (TADs)
When it comes to keeping your mouth healthy and your smile bright, dentists may be the first health care professionals you think of. But for certain orthodontic problems, we may recommend a team approach that involves consulting a professional in another field. For example, when a persistent habit like tongue thrusting is causing trouble with your child's bite, it may be time to pay a visit to an orofacial myologist. If you haven't heard of this specialist, you're not alone. Let's take a closer look at how the muscles in your mouth work together, how problems in this area may develop, and how they can be fixed.
Moving teeth in the jaw has been compared to moving a stick through the sand. With the application of force, sand moves aside in front of the stick, and fills up the space behind. The "sand" in this case consists of bone cells and cells of the periodontal ligament, which attaches the tooth to the bone. These tissues slowly move aside and reform as force is applied to them by orthodontic appliances, such as wires and elastics.
But to do its work, that force needs a fixed point to push against. For example, imagine trying to move the stick while you're floating free in the water: Not so easy! But with two feet firmly planted in the sand, you can do it. When possible, orthodontists use the back teeth as an anchor — but sometimes, cumbersome headgear may be required to provide the necessary anchorage. In many cases, using TADS can change that.
What TADS Can Do
While it's generally preferred, the use of teeth as orthodontic anchors can have drawbacks in some cases. For example, there may not be a viable tooth located at the point where an anchor is needed. Also, when a greater force is required, the teeth used as anchors can themselves start to move. This is one instance where TADS are beneficial: These mini-implants can eliminate the need to use teeth as anchors, or stabilize a tooth that's being used as such.
TADS can also provide an anchorage point for a pushing or pulling force that would otherwise need to be applied from outside the mouth: generally, via orthodontic headgear. Wearing headgear can be uncomfortable, and compliance is sometimes a problem. In many situations TADS can eliminate the need for headgear, a welcome development for many patients. The use of TADS offers other benefits as well: It may shorten overall treatment time, eliminate the need to wear elastics (rubber bands) — and in some cases, even make certain oral surgeries unnecessary. It also allows orthodontists to take on complex cases, which might formerly have proved very difficult to treat. This small device can really do a big job!
Getting and Maintaining TADS
Like dental implants (which have been in use since the 1970s) TADS are small, screw-like devices that are placed into the bone of the jaw. Unlike implants, however, they don't always need to become integrated with the bone itself: They can be fixed in place by mechanical forces alone. Plus, they're much easier to put in and remove when treatment is complete. How easy?
Placing and removing TADS is a minimally-invasive, pain-free procedure. After the area being treated is numbed (with an injection or other numbing treatment), a patient feels only gentle pressure as the device is inserted. The whole process can take just minutes to complete. Afterwards, an over-the-counter pain reliever can be taken if needed — but many patients need no pain reliever at all. And taking TADS out is even easier. So if you're worried that it may be a painful procedure: Relax! It's far less stressful than you may think.
While they're in place, TADS require minimal maintenance. Generally, they should be brushed twice daily with a soft toothbrush dipped in an antimicrobial solution. We will give you specific instructions regarding maintenance when your TADS are placed.
Not every orthodontic patient needs TADS — but for those who do, it's a treatment option that offers some clear benefits.
