The Orthodontic Department at Harrogate District Hospital is a part time department with clinical alliances to York Hospital. Mr Kindelan, Consultant Orthodontist is the Lead Clinician at Harrogate and works from York Hospital. The Department is staffed in addition with part time visiting general dental practitioners. Mr Ian Auckland, Hospital Practitioner works Monday afternoon and Mr Adrian Finn, senior staff practitioner, works on a Monday morning with Mr Alan Casson, senior staff practitioner, working on a Thursday morning.
Referrals are accepted from local general dental and medical practitioners. Straight forward treatment may be referred back to the dentist for completion and only the more complex cases are managed within the Department at Harrogate District Hospital.
What is orthodontic treatment?
Orthodontic treatment is the process of straightening or moving teeth in order to improve the appearance and bite of the teeth. It can also help to maintain the long term health of the teeth, gums and jaw joints.
Why have orthodontic treatment?
Many people have teeth that are crowded or crooked. Orthodontic treatment can be used to straighten their teeth, which also improves appearance and can make the teeth easier to clean.
In some patient’s the upper teeth can stick out and look unsightly. These prominent teeth can be damaged easily by accident. Orthodontic treatment can make the teeth less prominent and less likely to be damaged. In others the relationships of the upper and lower jaws causes appearance problems and an incorrect bite. Orthodontic treatment may be able to correct both.
When the teeth do not meet correctly strain can be placed on the muscles of the jaw and this can lead to jaw and joint problems. Orthodontic treatment can make a bite more even and reduce strain.
Can anybody be treated?
Orthodontic treatment is generally best carried out in children, but it is possible for adults to have orthodontic treatment too - an increasing number do. Age is less important than the presence of the proper number of teeth.
What does it involve?
The most important thing is to have a full examination, which will usually involve looking at the teeth, taking x-rays and also making plaster models of your teeth. Your dentist or orthodontist will then discuss what treatment is possible and, once you are sure you wish to proceed, the treatment can begin as soon as sufficient permanent teeth have developed.
It is possible that there may not be enough room for all permanent teeth and so it may be necessary to extract some permanent teeth to make space. Your dentist will advise you whether extractions are necessary. Sometimes, space can be provided by other forms of treatment.
Orthodontic treatment can be done by many sorts of appliances which are commonly known as "braces". They fall into three main types:
Removable - simple treatment may be carried out with a removable appliance (a plate that can be taken out for cleaning purposes). It has delicate wires and springs attached, which move the teeth by gentle pressure
Functional - it is sometimes possible to modify the way the jaws grow, using orthodontic appliances. These functional appliances, using muscle forces, can help in certain types of problem
Fixed Appliance - often, teeth need to be guided more accurately than they can be by using a removable plate and so fixed appliances are placed. These have brackets and bands temporarily stuck to the teeth. A flexible wire joins all the brackets and allows the teeth to be moved. It is not possible for the patient to take the appliance out, and so it is called a fixed appliance.
Fixed braces are not always made of metal. Plastic and ceramic can be used, especially for adults. Such brackets are not generally available on the NHS.
Headgear - it is sometimes necessary to wear headgear as an addition to either a fixed or a removable appliance. Headgear usually needs to be worn only in the evening or at nights. Your orthodontist will discuss whether it is necessary. It is very important to wear it as advised otherwise treatment may not progress correctly.
Elastics - it may be necessary to attach delicate elastic bands to a fixed brace to help move the teeth. Your orthodontist will advise you on the need for elastics.
When active treatment is completed it is necessary to hold the teeth in position for a period of time. This period is called retention and the appliances which hold the teeth in place are called retainers. The retainers hold the newly straightened teeth in position while the surrounding gum and bone settles. The retainers can be removable or fixed depending on the original problem.
How long will it take?
The length of treatment depends on the severity of the original problem and may take anything from a few months to two and a half years. Most people can be treated in the period of one to two years.
How many visits?
It is usually necessary to adjust any orthodontic appliance at 4-6 weekly intervals. Your orthodontist will advise how often your particular appliance will need adjustment.
Will it hurt?
All appliances may feel strange to begin with and can cause some discomfort. If problems do persist, the orthodontist may be able to carry out adjustments to help. Teeth are usually uncomfortable immediately after treatment adjustment but this will settle.
How successful will it be?
Success depends on a partnership between the skills of the orthodontist, with the enthusiasm and help of patient and parents. It is important to attend regularly and carry out any instructions given by the orthodontist.
Is orthodontic treatment permanent?
Even after retention, it is normal for minor tooth movements to occur throughout life, so no permanent guarantee can be given. However, it is unusual for teeth to alter sufficiently to require further treatment.
How Do I Go About Getting Orthodontic Treatment?
The first thing to do is to go along to your own dentist and seek his or her advice. Your dentist will know whether treatment will be necessary and make the necessary arrangements.
Caring For Your Brace and Teeth
It is important to continue to have your teeth checked by your dentist while having orthodontic treatment. It is also necessary to use preventive methods, these include:
Cleaning daily all tooth surfaces including between the teeth where possible. Your dentist or hygienist will advise on special techniques necessary for appliances which you may wear
Keep the frequency of sugar intake to a minimum. Avoid "snacking" with food or drinks containing sugars, especially fizzy drinks. Your dentist will help. In addition, sticky and hard foods may damage the delicate orthodontic appliances.
Use fluoride toothpaste, and mouthwash
Damage can occur to teeth if they are not properly cleaned during treatment. Appliances will not in themselves cause damage but careless brushing, leaving plaque, will.
Please telephone Janet Hunter, Oral Surgery secretary, 01423 553741