Orthodontics and aligners

What it is

Orthodontic treatment moves teeth to improve how they fit together and how they look. It can use fixed braces, with small brackets bonded to the teeth and connected by a wire, or a series of removable clear aligners.

Why people ask about it

People ask about it because of crowded or crooked teeth, gaps, teeth that stick out, or a bite that doesn't meet comfortably. Parents often ask when a child should first be assessed, as bite problems tend to become noticeable between about six and twelve years of age.

What assessment may involve

Assessment looks at how the teeth and jaws meet, how much space there is, the health of the teeth and gums, and what you hope to change. Records such as photographs, X-rays and impressions or scans are usually taken. Treatment may be provided by a dentist or by an orthodontist, a dentist with specialist training, depending on how complex it is.

Common approaches and alternatives

Fixed braces work continuously and suit a wide range of tooth movements. Clear aligners are removable and less visible, but they only work while they are worn for most of the day, and they aren't suitable for every kind of movement. Both need careful cleaning, and some foods are best avoided with fixed braces.

Treatment commonly lasts one to three years. Afterwards, retainers are needed to hold the teeth in their new positions, often for the long term.

Questions to ask a clinician

• What would treatment aim to change, and what would stay the same?
• Are braces or aligners more suitable for me, and why?
• Who would provide the treatment, and what is their training?
• How long might it take, and what does wearing retainers involve afterwards?
• How do I keep my teeth and gums healthy during treatment?