Orthodontics: Information & Orthodontists

Orthodontists primarily treat misalignments of the jaw or teeth that either are currently impairing important bodily functions or pose a risk of doing so. Orthodontic treatment is necessary, for example, when the misalignment

• biting,
• chewing,
• speech,
• nasal breathing,
• closing the mouth, or
• temporomandibular joint function

.

In adults,

• jaw and chewing muscle pain,
• a “clicking” jaw joint,
• migraines,
• tinnitus,
• facial pain,
• dizziness,
• chronic head or neck pain,
• back pain, or
• pelvic misalignment

may indicate improper loading or a disorder of the temporomandibular joints. If these symptoms are present, it must be determined—possibly in collaboration with other physicians—whether the complaints originate in the temporomandibular joint.

Conditions treated in orthodontics include, for example:

• Malocclusion (dysgnathia) due to misaligned teeth
• Hypodontia due to tooth loss or agenesis
• Eruption disorders
• Crowding of the teeth
• Bruxism (teeth grinding)
• Temporomandibular joint disorders and functional disorders in the maxillofacial region (craniomandibular dysfunction, CMD)

In cases of severe jaw anomalies, coordinated orthognathic and orthodontic treatment may be necessary. This is the case, for example, with

• congenital facial and jaw malformations,
• a malocclusion with a bony cause (skeletal dysgnathia), or
• malocclusion resulting from an injury

.

Before an orthodontist begins jaw treatment or tooth alignment, a comprehensive diagnosis is required.

First, the orthodontist examines the alignment of the teeth within the patient’s jaws. In many cases, it is also necessary to take an X-ray. Finally, as part of the diagnostic process, an impression of the teeth is taken to create a custom jaw model. Using this model, the orthodontist can identify which teeth require correction of their position within the jaws.

In certain situations, particularly when evaluating temporomandibular joint disorders and functional abnormalities in adults, additional diagnostic procedures may be used. These include, for example, functional analysis and structural analysis.

First and foremost, the orthodontist uses braces to correct misaligned teeth or jaw misalignment. There are generally two options to choose from:

• Removable appliances (such as plates)
• Fixed braces (such as bands, brackets, and metal wires) or external braces

The decision regarding which type of braces to use depends on

• the type of malocclusion,
• the patient’s age,
• the patient’s overall physical condition,
• the number of remaining teeth, and
• the expected level of oral hygiene

.

If the orthodontist decides on fixed braces, they will bond them to the teeth. If the braces are removable, the patient must wear them daily, but only for a specific period of time. The orthodontist will also explain how to properly clean both your teeth and the braces.

Braces are among the standard treatment methods for misaligned teeth © Microgen | AdobeStock

In two-phase treatment, both methods are combined. The orthodontist custom-fits the braces precisely to the patient’s teeth. However, this one-time treatment is not the end of the process. To ensure the teeth reach their correct position, the orthodontist must readjust the braces at regular intervals.

Treatment with braces can take several years and is also possible for adult patients.

The only difference between treating adolescents and adults lies in the type of braces used. This distinction is necessary because adolescents’ teeth—unlike those of adults—are still growing, which is why different types of braces are required.

When the jaws are too small, the teeth are very crowded, overlapping, and sometimes even outside the dental arch. If, despite standard orthodontic measures, there is not enough space for all the teeth, additional space can be created by extracting teeth.

This is also possible to correct missing or displaced teeth or to address asymmetries.

Patients do not go directly to an orthodontist but are referred there by their dentist.

Most orthodontists work independently in their own practices or collaborate with colleagues in a group practice. A group practice has the advantage that the doctors can share the high costs of instruments and equipment.

Other areas where orthodontists work include dental clinics.

After completing their dental degree, dentists typically work for at least one year as general practitioners. This is followed by a three-year specialty training program to become a (specialist) dentist in orthodontics (orthodontist).

In Germany, prospective specialists must work for at least one year in the orthodontic department of a university dental clinic during their training. They may spend two years working in an orthodontic practice authorized to provide training.

In addition, dentists can acquire the necessary specialized knowledge at various private universities through a master’s program in orthodontics (MSc in Orthodontics).

A dentist with a “specialization in orthodontics” has not completed several years of orthodontic training or a master’s degree in orthodontics. After taking the relevant courses and performing just a few orthodontic treatments, they are already authorized to use this specialization designation.

Orthodontists then have various options for further training. For example, they can complete a four-year program to become an oral surgeon. Once they have completed this program, they are authorized to perform surgical procedures in the field of dentistry.

Another option is to pursue advanced training to become an oral and maxillofacial surgeon (OMFS). However, oral and maxillofacial surgeons who choose this path must also have completed a degree in human medicine.

In addition, there are numerous continuing education opportunities. Orthodontists should, for example, regularly stay informed about new studies in their field. Studies may demonstrate the effectiveness of new treatment methods or propose new procedures.

In addition, courses are offered in areas such as aesthetic splint therapy and oral surgery in primary dentition, among others.