Having perfectly aligned teeth without braces, eating whatever you like without feeling the pain, does this sound too good to be true? Going further to claim that you no longer need a dentist to achieve this scenario, how far-fetched can this be?
This article will dissect and show you the hard facts based on the author’s 25 years of dental and 15 years of orthodontic experience.
Traditionally dentists have been adjusting the position of teeth using the pressure of brackets glued to the teeth. This technology does provide a predictable way of moving teeth to a position with ease. However, this method brings out some severe drawbacks, such as difficulty cleaning the teeth and making the teeth more prone to decay and gum disease. There are also risks of injury to the lips, cheeks and tongue due to the poking wires or dislodged metal pieces.
With the advent of Computer Aided Design and Computer Aided Technology (CAD-CAM), we can move teeth digitally and make it a reality clinically. How is it going to be done? At first, a digital scan of the teeth will undergo, or a mould of the teeth will prepare. This mould will be digitised and shown on the computer screen.
Dedicated software with designing capability is utilised to view the dental conditions 3 dimensionally. Movements made in this software take into consideration the biological capabilities of the human teeth and surrounding structures. That’s why someone with dental training needs to be present at this stage so we would know the movements done are possible and predictable in the patient’s mouth, resulting in the teeth moving to a new position. Moreover, a study model is produced based on this movement when each exercise is calibrated with the model monthly or twice monthly.
Patients scanned dentition in the designing 3D software.
The tool to apply force to move the teeth without ugly and unsightly metal comes in a clear “plastic” BPE-free type material. The proper material is either PEG (polyethylene glycol) or polyurethane. Using an invisible aligner or transparent dental braces to move teeth is not a new phenomenon in this current era. Using invisible teeth retainers and dental aligners to move your teeth with FDI approval was given more than 20 years ago. There are millions of patients who benefited from this technology.
In general, human teeth are not particular with where the force is coming from as long as it is consistent in a particular direction, then the teeth will move. Nevertheless, planning on space needs to be prepared for the movement. Some additional accessories need to be attached to the teeth in the form of attachments frequently. The door handles made the application of the force from the aligner more effective. A dental practitioner needs to fix this through an inconspicuous method of attachment.
As with any orthodontic treatment, the whole process of treatment may extend from 6 months to more than two years. It depends on the condition of the patient’s initial malocclusion and the objective of treatment aims. During this period, the movement of the patient's teeth must be monitored closely by the dentist. Biological tissues are so unpredictable that they might not move as you would have planned. The dentist's role is to check every month if the movement is as predicted and take the necessary steps to correct deviation before it is too late. The dentist also will provide a few checking and monitor the health and condition of the teeth and gums on this monthly visit. Healthy teeth and gum are vital for good tooth movements.
Each aligner is made to be work for one week or 10 days and changed to a new one after that. Each aligner moves the teeth in the predetermined distance which is biologically viable.
Right side view of the aligner in the mouth.
The Aligner in the mouth with the attachments which can be seen as “bumps” on the aligner
Left side view of the aligner in the mouth.