Risks of Orthodontic Treatment
All forms of medical and dental treatment, including orthodontics, have
potential risks and limitations. Fortunately, in orthodontics, complications are
infrequent and, when they do occur, they are usually of minor consequence.
Nevertheless, all potential risks and limitations should be considered when making the decision
to undergo orthodontic treatment.
This section covers the usual
material risks associated with orthodontic treatment. Other risk factors may
also be identified by your orthodontist.
You should be aware of the potential risks and limitations which apply to your treatment and you should be aware if there are alternative
treatment options. Ask your orthodontist to
explain anything you do not understand.
You should clarify what is expected of you as a
patient, or as the parent of a young patient, to achieve excellent results.
Keep in mind that with orthodontic treatment, like other healing arts, results
cannot be guaranteed. The unknown factor in any orthodontic correction
is the response of the patient to the orthodontic treatment.
The principal risks in orthodontic
treatment pertain to:
Oral Hygiene and Diet
If the teeth are not cleaned properly, problems such as gum disease, tooth decay, and decalcification (white or coloured marks on the teeth) can result.
A diet with excessive sugar intake increases the likelihood of decalcification and tooth decay.
Orthodontic appliances do not cause these problems. However, it takes more effort to maintain adequate oral hygiene if you are wearing orthodontic appliances, so the risk of any of these problems occuring is greater during orthodontic treatment.
Therefore, it is imperative that extra care be taken with
oral hygiene (tooth brushing in particular) when you are undergoing orthodontic teratment.
During treatment, your orthodontist should advise you if you are not cleaning your teeth adequately.
Teeth may have a tendency to change their positions after treatment. The
long term, faithful wearing of retainers should reduce this tendency.
can however, move any time, whether or not they have had orthodontic
treatment. This is especially true during the late teen period when active
growth of the facial bones is coming to an end. The most vulnerable teeth
are those at the front.
Very occasionally tooth movements will be severe enough to merit
a further course of treatment to ensure a satisfactory result.
The health of the bone and gums which support the teeth may be affected
by orthodontic tooth movement if a condition already exists, and in some
rare cases where a condition does not appear to exist.
In general, orthodontic
treatment lessens the possibility of tooth loss or gum infection due
to misalignment of the teeth or jaws.
Inflammation of the gums and loss of
supporting bone can occur if bacterial plaque is not removed daily with
good oral hygiene.
In some patients the length of the roots of the teeth may be shortened
during orthodontic treatment. Some patients are prone to this happening,
some are not. It is nearly impossible to predict susceptibility.
shortening does not have significant consequences, but on very rare occasions
it may become a threat to the longevity of the teeth involved.
Occasionally patients may suffer pain or dysfunction in the jaw joints
(TMJ). This may present as joint pain, headaches or ear problems.
problems may occur with or without orthodontic treatment. Any of the
above noted symptoms should be reported to the orthodontist. Some
patients are susceptible to TMJ problems and some are not.
studies have shown that the movement of the teeth during orthodontic
treatment is unrelated to the onset of TMJ problems.
Just as for painful
conditions in other joints, discomfort in TMJ can last from a few days to
several weeks or longer.
Sometimes a tooth may have been traumatised by a previous accident or
a tooth may be decayed or have fillings which can cause damage to the
nerve of the tooth.
Orthodontic tooth movement in some cases aggravates
this condition and in rare instances may lead to loss of tooth vitality
and discolouration of the tooth requiring root canal treatment and other
dental treatment to restore the colour of the tooth.
Loose appliances and discomfort
The gums, cheeks or lips may be scratched or irritated by newly placed
appliances or by loose or broken appliances or by blows to the mouth.
You will be given instructions on minimising these affects.
Very rarely loose
orthodontic appliances may be accidentally swallowed or aspirated. You
should inform your orthodontist of any unusual symptoms, or broken or
loose appliances, as soon as they are noted.
Usual post adjustment tenderness
should be expected and the period of tenderness or sensitivity
varies with each patient and the procedure performed. (Typical post adjustment
tenderness may last 24 to 48 hours)
Insufficient, excessive, or asymmetrical changes in the growth of the jaws
may limit the orthodontist’s ability to achieve the desired result.
becomes disproportionate during orthodontic management the treatment
may be prolonged.
Growth changes that occur after orthodontic treatment
may alter the quality of treatment results and may require further orthodontic
treatment. In some cases of atypical growth, the bite may change
so much that oral surgery is required to achieve the best possible result.
If improperly handled, headgear may cause injury to the face. Patients are
warned not to wear the appliance during times of boisterous or competitive
The total time required to complete treatment may exceed the estimate.
Poor co-operation in wearing the appliance or the elastics the required
hours per day, poor oral hygiene, broken appliances and missed appointments
can lengthen the treatment time and affect the quality of the results.
Co-operation throughout treatment is your best guarantee of achieving a
pleasing smile and a good bite. Failure to co-operate could force the orthodontist
to change the procedures and goals of your treatment. As a
last resort treatment might have to be suspended. The consequences of
early suspension may be worse than no treatment at all.
Complementary aesthetic dentistry
If your teeth vary from normal in the number size or shape of the teeth,
achievement of the ideal result (for example, complete closure of excessive
space) may require restorative treatment. The most common types of
complementary treatment are cosmetic bonding, crown and bridge restorative
dental care and periodontal therapy.
General medical problems can affect orthodontic treatment. You should
keep your orthodontist informed of any changes to your medical health.