If your regular dentist notices problems with your teeth or jaws that may require treatment, he or she will likely refer you to an orthodontist — a dentist who specializes in diagnosing, preventing and treating dental and facial irregularities.
Most alignment problems become apparent once the permanent teeth begin to come through the gum (erupt). But your orthodontist may recommend waiting until enough teeth have come through before applying braces. Most children get braces between the ages of 8 and 14, while their facial bones are still growing and their teeth are easier to move.
Preparation for braces generally involves:
- Oral exam. Your orthodontist conducts a full exam of your teeth, jaws and mouth.
- X-rays. You'll get a series of X-rays to determine the position of teeth. The most common is the panoramic X-ray, which shows all the upper and lower teeth in biting position and any teeth still developing within the jaws. Special head X-rays also may help determine the size, position and relationship of jaws to teeth.
- Plaster models. You'll bite into soft material, which remains on your teeth for a few minutes. From this impression, a plaster model of your teeth (dental cast) is created and the orthodontist evaluates your bite. In some cases, this dental cast may be scanned into a digital format for further evaluation or treatment decisions.
- Potential tooth extraction. If your mouth is very overcrowded, your orthodontist may recommend removing one or more permanent teeth to allow room for the remaining teeth to fit comfortably.
- Other procedures. In severe cases, where tooth movement alone will not correct a bite that's significantly out of alignment, jaw surgery is required in combination with orthodontics.
After your orthodontist has evaluated your teeth and jaws, he or she customizes a treatment plan for you. This most often involves the use of fixed braces, which are temporarily bonded to your teeth.