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Orthodontic Treatment Phases

Orthodontic irregularities are extremely common and vary in their complexity. In the case of a severe irregularity, the dentist may work in conjunction with a maxillofacial surgeon or another auxiliary to realign the teeth and underlying jawbone. Malocclusions, or misaligned bites, however, are usually treated by the dentist alone. Orthodontic treatment for malocclusion typically occurs in two or three main stages:

Phase 1: Planning

  • The planning stage is the most crucial phase in orthodontic treatment. During this phase, the dentist pinpoints a diagnosis and plans the most effective treatment. The planning phase includes conducting thorough examinations, taking x-rays and keeping meticulous dental and medical records.

    Orthodontic treatment is highly predictable, successful and beneficial when planned appropriately. Not only does a straight smile look attractive, but it also helps stave off a wide range of dental and physical problems, which include:

    • Tooth Decay – Improper alignment can reduce the effectiveness of oral hygiene at home. Hard-to-reach places created by crooked teeth can become breeding grounds for harmful bacteria.

    • Gum Disease - Periodontal disease is a result of a bacterial infection within the gums. Poor oral hygiene resulting from misalignment can cause gum recession, jawbone deterioration and tooth loss.

    • Digestive Disorders – Misalignment commonly impairs chewing function. This leads to improperly chewed food working its way through the digestive system, contributing to digestive discomforts and disorders.


    What Types of Orthodontic Exams Will Be Conducted?

    The first visit to the dentist can involve different examinations to determine what treatments are required and how they will impact the teeth and jaws. It is highly beneficial for the dentist to create treatment plans with as much information as possible.

    Here is an overview of the types of orthodontic examinations and records that the dentist uses to plan treatment:

    Medical and Dental History Evaluation

    Orthodontic treatments cannot begin until other existing medical and dental issues are resolved or are at least under control. Gum disease, for example, is often exacerbated by fixed braces and must be treated prior to orthodontic treatment. Dental health greatly impacts physical health and vice versa. Certain prescription medications can affect teeth and gums, so great care must be taken to evaluate the whole picture of medical and dental concerns.

    Bite Impressions

    Bite impressions or molds are invaluable tools in determining the exact nature of the malocclusion. Molds allow a closer look at how the upper and lower jaws fit together. Alginate, a soft material that hardens on the teeth, is poured into a horseshoe-shaped tray, producing an imprint. Plaster is then poured into the impressions, resulting in a model of the teeth.

    Photographs of the Face and Mouth

    The dentist takes regular photographs of the face and mouth. This shows how the treatment is progressing and impacting overall facial appearance. Facial photographs also allow for the measurement of facial proportions.

    Computer-Generated Pictures of the Head and Neck

    Computer-generated pictures of the head and neck allow the dentist to measure facial proportions and to determine ideal facial aesthetic. Facial appearance is an important consideration to make when planning treatment.

    Panoramic X-rays of the Jaws and Teeth

    Panoramic x-rays offer excellent insight into the general health of the teeth, gums and jawbone. X-rays show precise root structures of the teeth and inform the dentist as to how the upper and lower jaws fit together. X-rays of the temporomandibular jaw joint may also be taken, as necessary.

Phase 2: Active Treatment

Once a specific diagnosis has been made, the dentist applies a device to realign the teeth, which is either fixed or removable. The best known type of fixed device is traditional dental braces, which use brackets interconnected by an archwire. Continual gentle pressure is applied on teeth by the gradual tightening of the archwire. Regular orthodontic adjustments are necessary to continue the straightening process.

Removable devices include the Invisalign® system and headgear. These devices should be worn for a specified number of hours each day. The success of these removable appliances largely depends on the motivation of the wearer. The dentist monitors and adjusts the device at regular appointments.

Phase 3: Retention

When treatment is complete, the braces and appliances are removed. The dentist then creates a retainer. The retainer ensures that the teeth do not regress back to their original positioning. The retainer is worn for a specified number of hours each day to allow the bone to reform and stabilize the teeth in their new, correct alignment.

If you have questions about orthodontic treatment, please contact our office.





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Dental Associates of Marlborough
222 Bolton Street Marlborough, MA, 01752
Phone: (508) 485-1800 URL of Map