Swiss Health Magazine

Leave the braces behind

When your teeth grow unevenly, you can forget about a Hollywood smile. Usually, malocclusion is corrected in childhood, but if not, you can try for perfection in adulthood. Braces can become your «point», a fashion accessory, or an invisible device that corrects the position of the teeth. The crucial thing is that a professional should evaluate the kind of braces that are suitable for each particular patient. One of Switzerland’s leading dentists, Michael Meier, tells us about the different types of braces and what kind of results can be achieved with them.

— Dr. Meier, 20-30 years ago, only children had braces. It was believed that it was already too late to change anything by the time one was an adult.

— Fortunately, there are no age limits these days. You can make corrections to the teeth with braces at the age of 40 or 50. Another thing is that there is an individual design for each age. We need to assess the specific situation — how teeth develop, and how to influence this process. The main point is for a professional orthodontist to draw his conclusions: when to put in braces, what model to choose and how long the patient should wear them for.

— But what is the most favorable age for the correction of occlusion?

— There is no standard age; it all depends on each specific case. As you know, at six years of age the milk dentition falls out and permanent teeth appear. A family doctor, observing a child, can see whether they are growing evenly. And if something is wrong, if some teeth are growing crookedly, you should consult an orthodontist and he will make a decision. There are no universal recommendations: sometimes it is better to put the braces in early to achieve the desired effect, sometimes later, but to correct curvature in childhood is easier. In addition, it is important to adjust the position of the teeth, because their appearance changes as you grow up, and it is better that the jaw develops correctly.

It should also be taken into account that fixed braces require a high «dental IQ» – i.e., a person should be educated in the field of dental hygiene and understand how to take care of his teeth, because when one has braces, the risk of development of caries increases. In other words, the child should realize that he should not eat a lot of sweets, should not drink soda, and must regularly brush his teeth.

— Tell me, are teeth necessary for beauty only, or do they also affect the health of the oral cavity?

— For health, it is important how you occlude your teeth. If there is a gap in the teeth or the jaw does not move enough, a person can not chew normally. So, basically, teeth are a matter of aesthetics. Moreover, if a patient wants to perform an aesthetic restoration of the teeth with the use of veneers (special decorative linings), the braces will most likely be installed in terms of treatment. Veneers simply will not take to uneven teeth.

— And what kind of braces would you recommend for adults?

— Most adult patients do not want profound changes but only a slight change in the position of the teeth. The invisible braces from the company Invisalign, a scientifically based and proven method used worldwide, handle this task perfectly. They have already been used by millions of people. The braces are a mouth guard made of a transparent material that is almost invisible on the teeth.

First, one should make a computer model. We send pictures and materials to the headquarters of the company and in return receive a video showing how the teeth will change after the correction is completed. The company produces mouth guards — 12 pieces for the entire treatment period. They are numbered; the patient himself changes them every 14 days, and the teeth gradually shift to the desired position. Every 5-6 weeks you need to come in for a check-up with a doctor. If the patient cannot come, he should wear the previous model. If something goes wrong, the dentist sends the mouth guard to the central office, and they do the correction.

— Do you need to wear the mouth guard around the clock?

— One should wear it 22 hours per day, taking it out only at mealtimes. I would not use Invisalign braces for children. They require self-discipline; you need to look after the oral cavity more carefully. And children might forget the mouth guard, or take it off and lose it. For them, it is better to wear fixed braces. And for adults, in the case of strong tooth movements being required, traditional fixed braces are better suited to the task. There are also ceramic braces, which are not very noticeable on the teeth.

— Are there any contraindications?

— No, but there is an important condition. Before putting on the braces, you need to completely cure caries and inflammation of the gums and soft tissues. Any correction should be done on a healthy basis; otherwise it’s like building a house on sand instead of a foundation. Wearing the braces can seriously aggravate the condition of soft bone tissues, right up to the loss of teeth. In addition, it is necessary to check whether there is bone disease — for example, in diseases such as osteoporosis, there is a high risk of complications.

— Might the patient feel pain or discomfort?

— Only at the beginning, in the case of conventional braces, but the skin from the inside of the cheeks is not injured.

— Once, braces with diamonds were popular. What is trending now?

— Now it is important to put in braces based on the indications. For adults, ceramic or sapphire braces are better. The price of the latter is higher as they have a number of advantages — high strength material, no metal, no excessive salivation, no injury to the tongue. There are lingual brace structures called Incognito; they are put onto the inside of the teeth. The advantages of the Incognito system are fast and easy installation, invisibility, and comfort. But there are also disadvantages. The lingual constructions sometimes affect diction; however, many patients adapt quickly to this. The only ones, who know that you have braces installed are you and your orthodontist, but the results will soon be seen by everybody.

Michael Meier

MD, Doctor of Dental Sciences, graduated from the Department of  Medicine at the University of Zurich in 1998, after which he worked for one year in the Department of General Internal Medicine at the Hospital of Canton Zug, and approximately three years as a research fellow at the University of Zurich’s Institute of Forensic Medicine. From 2002 to 2006 he worked as a doctor’s assistant in the Zurich Dental Center, then in 2006 he began to work independently at a private dental practice. In 2011 he became one of the founders of the Kinder-

Permanence by Swiss Medi Kids Zurich AG pediatric center. He also owns the Perfect Smile Ragaz GmbH dental clinic in the Grand Resort Bad Ragaz medical centre.