Adult orthodontic treatment is very different from that of teenagers, because adults have already completed their growth and development. The bone sutures in the jaw and face have become bony fusion with very low plasticity. Moreover, the metabolic rate of adults slows down and biological responsiveness decreases, increasing the difficulty of orthodontic treatment.
Things to know before adult orthodontics:
1. Most adults suffer from varying degrees of periodontitis, which leads to alveolar bone resorption, gum recession, and may even cause tooth misalignment, such as elongation or forward inclination, leading to gaps or loss of teeth. Moving misaligned teeth under the condition of periodontitis can accelerate alveolar bone resorption. Therefore, necessary periodontal treatments such as cleaning, subgingival scaling, flap curettage, etc., must be undertaken before orthodontic treatment begins when periodontal inflammation is controlled. Regular periodontal treatment should be done throughout the entire orthodontic process. Combined orthodontic and periodontal treatment helps improve the health of periodontal tissues and reduces further deterioration of periodontal disease.
2. Potential or dormant pulp and periodontal diseases or unforeseen problems that cannot be fully detected during pre-orthodontic examination may activate lesions during orthodontic treatment. When symptoms such as pain, pus discharge, and tooth mobility occur, orthodontic treatment must be temporarily interrupted until the affected teeth receive pulp or periodontal treatment. Sometimes, it may even be necessary to terminate orthodontic treatment and use restorative methods to solve remaining issues, such as using false teeth to resolve gaps left after tooth extraction. Patients should understand this.
3. Most teenagers do not experience alveolar bone resorption during tooth movement, making it easier for them to close spaces caused by tooth extraction or missing teeth. However, adults are more prone to alveolar bone resorption. To avoid this situation, sometimes adults need to rely on restorative methods like dental prosthetics when closing extraction gaps.
4. Teenagers' temporomandibular joints have high adaptability, so they rarely exhibit joint symptoms. Adults have poor adaptive remodeling functions, and those with potential joint diseases are more likely to develop joint dysfunction during orthodontic treatment. If there is joint clicking or pain, the doctor should be informed immediately for diagnosis and treatment. Patients with temporomandibular joint dysfunction prior to orthodontics should first consult a joint specialist. Due to its complex pathogenesis, orthodontics is only one of the treatment methods and must be coordinated with joint specialists.
5. Some problems that cannot be fully confirmed before orthodontics, such as whether the tooth root is adhered to the alveolar bone? Whether it is a borderline case requiring tooth extraction for correction? Whether the mandible is in a functional retraction or protrusion position? Can be initially diagnosed for orthodontics, then through observing the response to treatment, confirm the diagnosis and finalize the treatment plan. Therefore, modifying the treatment plan during orthodontic treatment is entirely possible and should be understood.
6. Since adults no longer have growth potential, mild to moderate skeletal malocclusions caused by craniofacial bones can only be partially masked by moving teeth through orthodontics to improve facial appearance. Severe jawbone developmental malformations or those requiring complete facial shape improvement must undergo orthognathic surgery to change the shape and position of the jawbone.
7. Teeth clenching and bruxism (including night bruxism) are detrimental to periodontal tissue health and can exacerbate periodontal inflammation. Such symptoms should be reported to the doctor promptly for diagnosis and treatment.
8. Systemic diseases such as diabetes, blood diseases, long-term use of steroid drugs, or pregnancy can affect periodontal health, making orthodontic treatment unsuitable.