Orthodontics is the branch of dentistry that specializes in the diagnosis, prevention and treatment of dental and facial irregularities. The technical term for these problems is “malocclusion”, which means “bad bite”. The practice of orthodontics requires professional skill in the design and use of corrective appliances (braces) to bring teeth, lips and jaws into proper alignment and achieve facial balance.

Why is Orthodontic Treatment Important ?

3 folds – To restore Normal health and Function of Dental apparatus
-  To Improve and Enhance Facial Esthetics (Appearance and Smile)
-  To Enhance the Longevity of the Dental Apparatus
Everyone wants a beautiful smile – and everyone ought to have healthy one. The orthodontist’s goal is to achieve both for the patient.
Crooked and crowded teeth are difficult to clean and maintain. This may contribute to conditions which cause not only tooth decay but eventual gum disease and tooth loss. Other orthodontic problems can cause abnormal wear of tooth surfaces, excess stress on supporting bone and gum tissue or misalignment of the jaw joints with resultant chronic headaches or pains in the face or neck
When left untreated, many orthodontic problems become worse. Treatment by a specialist to correct the original problem is often less costly than the additional dental care required to treat the more serious problems that can develop in later years.
The importance of an attractive smile should not be underestimated. A pleasing appearance is a vital asset to one’s self confidence. A person’s self-esteem often improves as treatment brings teeth, lips and face into harmony. In this way, orthodontic treatment can be beneficial to social and career success as well as improve one’s general attitude towards life and the quality of life itself.

There is no one answer to this because each orthodontic problem determines its own best starting time. For this reason the American Association of Orthodontists recommends that every child first visit an orthodontist at age 7. This may surprise you because orthodontic treatment is usually associated with adolescence.
An early examination, however, allows the orthodontic specialist to determine when a child’s particular problem should be treated for maximum improvement with the least time and expense. In many patients early treatment achieves results that are unattainable once the face and jaws have finished growing.
Another plus is that early intervention frequently makes the completion of treatment at a later age easier and less time consuming.
It is best to seek an Orthodontic consultation by 8 to 9 years of age.

How Long Does Treatment Take ?

In General, active treatment time with Orthodontic appliances ranges from one to three years. The actual time depends on the growth of the patient’s mouth and face, the co-operation of the patient and the severity of the problems. Mild problems may require less time and some individuals respond faster to treatment than others .

Orthodontic treatment time varies from 3 to 6 months up to 2½ years depending on the complexity of the problem. Each case is different and a consultation is necessary to determine the exact treatment time.
After the braces are removed, a patient may have to wear a retainer for some time to keep the teeth in their new positions. The need for a retainer and the length of time it will be worn is determined by the orthodontist.
Most patients remain under the supervision of the orthodontist following active treatment to assure that the teeth remain in satisfactory alignment.

Teeth and sometimes faces are permanently changed by orthodontic treatment; therefore it is very important that the treatment be properly done.
Orthodontic specialists limit their practice to orthodontic treatment only. They have learned the special skills required to manage tooth movement and guide facial development by completing an advanced training program after receiving a dental degree. Like all the branches of Medicine expertise gets all better with prolonged on- job experience.
Specialists use the most advanced techniques available today, and because of their extensive knowledge, they can select cost-effective methods and materials for correcting individual problems.

During the consultation Dr. Agarkar will conduct a physical examination and explain if and why treatment is necessary for the patient. The charge for the same will be a token amount.

What will Treatment Cost ?

The actual cost of orthodontic treatment depends on the severity of the problem. Many orthodontic problems require only limited treatment at relatively inexpensive fees. Your orthodontic specialist will be glad to discuss fees with you before treatment begins.
Convenient financing with an initial down payment and monthly installments can usually be arranged. Watch out for new insurance plans which may include orthodontic reimbursement.
When you consider the cost of orthodontic treatment, be sure to keep in mind the many benefits of having a lifetime of beautiful and healthy smiles.

Most malocclusions are inherited, but some are acquired. Inherited problems include crowding of teeth, too much space between teeth, extra or missing teeth, cleft palate and a wide variety of other irregularities of the jaws and face.
Acquired malocclusions can be caused by thumb or finger sucking, tongue thrusting, the airway being restricted by tonsils and adenoids, dental diseases like caries and premature loss of primary or permanent teeth.
Whether inherited or acquired, many of these problems, affect not only alignment of the teeth but facial appearances and oral functions like chewing, speech and mastication, as well as the longevity of dentition.

All active members of Indian Orthodontic Society (IOS) and American Association of Orthodontics (AAO) are Orthodontic Specialists. They have each met the exacting standards of education and experience required by the IOS and AAO for membership.

The education requirement for IOS membership is Master of Dental Surgery (M. D. S.) in Orthodontics for 3 years or more in a recognized Dental College of an Approved University.

DIPLOMATE position of Indian Board of Orthodontics or American Board further signifies a person who has put in the required number of years in the practice of Quality Orthodontics and passed the stringent requirements of the ‘Review Board’.
Degrees like F. R. SH. , M. R. SH. , F. I. C.D. , F. A. C. D. , etc. are not Orthodontic Qualifications and does not signify any Orthodontic Proficiency.

You do not need to go first to a dentist office. If you think you have a problem related to the way your teeth look you can go directly to the orthodontist’s office.

There are three basic reasons for obtaining orthodontic treatment: The first reason is that your teeth look crooked to you and you are embarrassed by your smile. The second would be that your bite is not correct and you have extra pressure on the gums, the teeth, and the joints. And the third reason is your dentist needs to perform some type of dental treatment that requires the teeth to be moved to facilitate restorative correction.

Orthodontic treatment can be successful at any age. The biological problems involved in tooth movement are the same in both adults and children. The health of an individual’s teeth, gums and supporting bone is what’s most important in determining the prospects for improving an adult’s smile and dental health.
Because an adult’s facial bones are no longer growing, certain corrections cannot be accomplished with braces alone. However, very dramatic facial changes are now being achieved with a combined approach of surgery and orthodontics for individuals who need this type of treatments.

Custom-made appliances or braces are prescribed and designed according to the problem being treated. They may be removable or fixed (cemented and/or bonded). They may be made of metal, plastic or both. All corrective appliances have one aim-to use gentle pressure to move teeth into their proper positions. Under this pressure the body builds new tissue to support the improved position of the teeth.
There are a few inconveniences, but most patients adjust to braces quickly and wear their “tin grins” with pride. Certain treats such as Chikki, caramels and bubble gum are off limits; and the teeth may be a little tender after major adjustments. The good news is that the new techniques and the materials used by the orthodontic specialist today have not only greatly decreased the discomfort of wearing braces but have also decreased the frequency of office visits and overall treatment time.

The clear braces that Dr. Agarkar uses are of the highest quality ceramic material and do not discolor. These braces are just as effective as metal braces, but they are far more attractive. The clear braces are more fragile than the metal braces, but not so fragile that they break easily. There is an additional charge for these ceramic braces.

If the teeth are very crowded, and they are protruding very far, sometimes removing teeth is an excellent choice for a patient. Typically, most orthodontists choose to extract two upper back teeth (premolars) and two lower back teeth (premolars) to accomplish the goals of treatment. Alternative extraction approaches may be indicated depending on the nature of the case.

Yes. It is normally more difficult to take care of the teeth because the braces are more difficult to clean around. However, it only takes 3 to 4 minutes several times per day to keep them perfectly clean.

It does not hurt to place the braces on. There is a special instrument which will be used to remove the braces without pain, and the discomfort is minimal.

More and more people are having braces including physicians, other dentists, lawyers, school teachers, and children of all ages. They are accepted by the population more than they ever have been and we don’t feel there is the stigma associated with them that there once was.

Yes and no. If you follow the instructions for the care and maintenance of the braces, keep your appointments, and brush your teeth regularly, you should not have any problems whatsoever. There should not be any problems with marks underneath the braces because the braces are cemented with a cement that seals that area of the tooth.

A retainer is a simple, removable device that is fitted to your teeth to hold them in their corrected position after the orthodontist removes the fixed (bonded) braces that were used to straighten your crooked teeth. Initially our patients are advised to wear the retainer full time for a period of 6 months, subsequently there is a gradual phasing out with reduced wear time.

It does not hurt to place the braces on. There is a special instrument which will be used to remove the braces without pain, and the discomfort is minimal.

There are usually some minor changes following orthodontic treatment. These changes are normally insignificant in comparison to the original malocclusion.

T M J stands for Temporomandibular Joint, which is the name of the joint associated with chewing. This occurs independently of braces and is treated by our doctors in a conservative fashion without surgery. Commonly physical therapy is the treatment.

Wisdom teeth do not usually affect the orthodontic treatment directly, but if they are impacted it is recommended they be removed to prevent future crowding.

Successful orthodontic treatment requires a co-operative effort between the orthodontist and patient (and the parent when the patient is a child or adolescent).The orthodontists provides the expertise, the treatment plan and the appliances to straighten the teeth. The patient must follow the doctors instructions carefully so that the teeth move properly and on schedule.
Those patients who brush thoroughly; avoid hard sticky foods; wear their rubber bands and/or headgear as instructed; and keep their appointments usually finish treatment on time with good results.
Regular visits to the family dentist should continue during orthodontic treatment because good dental care and fluoridation remain important. Proper nutrition is also essential.
Successful orthodontic treatment is a partnership of efforts between all of those involved. Through this co-operative effort the treatment goal is achieved – a healthy mouth and a beautiful smile.

Whether you need to replace a single tooth or many teeth, dental implants can provide a permanent solution that will let you smile, laugh and enjoy your favourite foods with confidence. Dental implants are specially-made titanium screws placed in the jawbone to serve as a firm foundation for a new tooth or denture that looks and feels completely natural.
The preferred method of tooth replacement
Today, the preferred method of tooth replacement is a dental implant. They replace missing tooth roots and form a stable foundation for replacement teeth that look, feel and function like natural teeth. Dental implants also help preserve the remaining bone by providing the stimulation previously provided by the natural tooth roots.
The most common dental implants are called “root form implants.” They are similar to teeth, in that they mimic the shape of the roots of teeth. They can be used to support individual teeth or to help anchor removable dentures. Using local anesthesia , the implants are surgically placed under the gum and into the bone. The healing period for dental implants varies depending on the location and the health of the bone. It can be as little as 6 weeks or as much as four months. Some form of anesthetic temporization is always placed in visible areas. Once the implant is biologically attached to the bone, a post (abutment) is inserted inside the implant. The post becomes the extension to which a crown is attached.

Implants are made of a bio-compatible material called titanium, which cannot decay. One advantage of implants is that they stimulate bone growth, and thus, prevent future bone loss. Bone that disappears when a tooth is removed can only be replaced with a bone graft.

Maintain Anatomy: If you have missing teeth, the bone begins to shrink over time. Unhealthy bone loss can make your jaw line recede and change your facial structure. Dental implants can help prevent deterioration of the jawbone so your face retains its natural shape

Keep your healthy teeth: A better long-term alternative to bridgework, dental implants eliminate the need to grind down healthy teeth when replacing one or more adjacent teeth. Your own natural healthy teeth are not compromised.

Security: Securely anchored dental implants do not slip or move. This eliminates some of the key problems of dentures, including poor fit, gum irritation and pain from exposed nerves. The result is superior comfort, reliability, and freedom from embarrassment.

Advantages of Dental Implants Over Dentures or a Fixed Bridge

Aesthetic Dental implants look and feel like your own teeth! Since dental implants integrate into the structure of your bone, they prevent the bone loss and gum recession that often accompany bridgework and dentures. No one will ever know that you have a replacement tooth. Tooth-saving Dental implants don’t sacrifice the quality of your adjacent teeth like a bridge does because neighboring teeth are not altered to support the implant. More of your own teeth are left untouched, a significant long-term benefit to your oral health! Dental implants will allow you to once again speak and eat with comfort and confidence! They are secure and offer freedom from the irksome clicks and wobbles of dentures. They’ll allow you to say goodbye to worries about misplaced dentures and messy pastes and glues.The success rate of dental implants is highly predictable. They are considered an excellent option for tooth replacement. Fractures, decay, blocked canals and other conditions can prevent the successful completion of root canal treatment. Fortunately, if this is anticipated, it is possible to remove the tooth and immediately replace it with an implant.

Anyone who is missing one or more of their teeth due to injury, disease or decay is a candidate for dental implants. If one, a few or all teeth are missing, dental implants in conjunction with a crown or bridge can replace those teeth. Occasionally, older patients express concern that their age may prevent them from enjoying the benefits that dental implants offer. However, health is more of a determining factor than age. A careful evaluation of your dental and medical health history must be made to determine whether you can safely have a tooth removed. If you’re healthy enough to have a tooth extracted, you’re healthy enough to receive dental implants.

The “root replica” fixture made of titanium is inserted in a channel created in the jaw by precision instruments that control heat, speed and any variable that could affect a successful outcome. After osseointegration (when the surrounding bone has bonded to the implant), a replacement tooth is secured to the top of the implant. This new tooth looks, feels and performs similar to your natural teeth.

Most patients report very little discomfort and they are much more comfortable following the procedure than they anticipated.

The benefits of implant treatment include appearance, the enhanced ability to chew and enjoy your food, and often protection of your remaining teeth and jawbone. Dental implants offer many benefits never before available for the treatment of missing teeth. In short, dental implants will look, feel and function like your real teeth.

Treatment time will vary depending on your particular situation. Nowadays it is often possible to get well-functioning and esthetic looking teeth within a few days. In some cases it may be necessary to wait longer before finishing the restoration in order to obtain an optimal result.

The dental implant process involves several steps that take place over a time period that averages from literally immediate placement and loading to 6 months. The typical process will include:

Pre-treatment consultation: After a careful evaluation of your dental and medical history, we will determine if you are a good candidate for dental implants. If you are, you will then have a thorough consultation before your treatment begins.
Initial implant placement:: The dental surgeon places the dental implant into your jaw while you are under either local or general anaesthesia. Over the next several months, bone will heal to the surface of the implant, anchoring it into position. Depending on your particular case, an additional minor procedure creates an opening through which your artificial tooth will emerge.

Implant prosthetic attachment: During this phase, your dental surgeon painlessly attaches a prosthetic “post” to the implant. An impression will be taken, and soon after, an artificial replacement tooth will be created for a natural restoration.

Proper maintenance: We will guide you on the proper care and maintenance of your new implants before, during and after the procedure. By following a regular routine of careful oral hygiene and regular checkups, your implants will look, function and feel great for many years to come.

This depends on your situation. Most patients can leave the office wearing some type of temporary prosthesis.

What steps are involved in getting an implant?

If you recently lost a tooth or have full or partial dentures, you might want to consider a dental implant. Getting an implant is basically a three part process:

1. An anchor – a titanium screw – is embedded in the jaw bone
2. A post is inserted into the anchor to hold an artificial tooth
3. The artificial tooth is attached to the post
   In some cases, the whole procedure may require no more than two or three sessions, depending on the clinical situation. Your dentist can explain the whole procedure in detail and provide you with an estimate of time and costs.

When a single tooth is missing and has been replaced with a removable partial denture or a fixed bridge, an implant-supported crown may be a better alternative. Single tooth replacements look and feel natural and function as a natural tooth.

Thus, the advantages of Dental Implant over the more conventional methodology are:
– Dental Implants do not compromise adjacent teeth
– Preserves surrounding bone (replaces tooth root)
– Prevents bone collapse and jaw line recession
– Oral care same as a natural tooth
– Restores a secure natural biting strength
– Restores self-confidence and appearance

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Socket Preservation

The area of the jaw bone that holds a tooth in place is called a tooth socket. After a tooth has been removed, the bone that supported this tooth rapidly begins to melt (resorb) away. A socket preservation grafting procedure is performed to reduce the bone loss in the socket.

This procedure is done as gently as possible. In many cases a tooth can be removed gently using newly invented instruments called periotomes. Rather than using a great deal of force with dental pliers (forceps), the periotomes are pushed between the tooth root and bone so that the bone is gently pushed away from the tooth root. The tooth then comes out and the implant can be placed into the residual tooth socket.

There are circumstances that mandate additional bone creation to address damage due to trauma or periodontal disease. The tooth is gently removed, bone is inserted into the tooth socket during the socket preservation grafting procedure. The socket preservation grafting procedure is done immediately after removal of a tooth. There is a waiting period of four to six months after tooth removal before a dental implant is placed into the old tooth’s position.