Orthodontics has come a long way since I was a kid. Advancements in technology and materials have resulted in greater options and comfort. There is no "one size fits all" approach to orthodontics. The best time for treatment and the most effective appliances are based on patient needs.

Ideally, an initial orthodontic consult should take place in childhood. The age that treatment for children begins can vary. Generally speaking, children with very narrow dental jaws, crowding, and/or sleep apnea should receive treatment before age 7 and as early as age 3-4 to best influence growth of the jaws and open the airway. For patients with more normal sized jaws, age 7-8 is a good time for the initial visit. The ability of the dentist to positively influence growth and development of the jaws is greatly diminished and even lost once a person is in their teens and growth has slowed or stopped.

From the mid to later teenage years and on through adulthood traditional orthodontic treatment mainly moves teeth within the bone and is limited to how far the teeth can be moved due to the bone.

Orthodontic appliances fall into two categories: removable and fixed. Traditional orthodontics are fixed braces. They can be metal or tooth colored (plastic) brackets and metal bands. The brackets and bands are connected by a wire which puts pressure on the teeth creating movement. The brackets are usually placed on the front of the teeth and treatment can vary in time due to how much correction is involved. Removable appliances are clear trays that can sometimes be used in place of traditional braces. The dentist treating the patient will recommend which method will accomplish the best result. The key to successful tray results is compliance with wearing the trays as directed. If the trays are out of the mouth too long the results will be compromised and treatment may not be ideal. Usually orthodontic treatment is 18-30 months. In some cases, based on careful decision, accelerated orthodontics can be accomplished, shortening the time for treatment. If the case permits, there are also ways to speed treatment with vibration (AcceleDent), minor surgical interventions (Propel, Wilcodontics) and use of temporary implants as anchors.

More advanced therapies are available for cases with extensive discrepancies in jaw size and tooth position. For the most involved cases orthognathic surgery is the best alternative. This involves both orthodontic treatment and surgical treatment. It is used when the jaws do not match and orthodontic treatment alone will not accomplish an acceptable result.

Orthodontics has come a long way and is still advancing. In addition to treatment benefits, today's world of orthodontics can make childhood and adult orthodontic care easier, faster and more predictable.

Dr. Robert A. Gallegos is a Fellow in the Academy of General Dentistry, he is on the faculty of Spear Education, a member the American Academy of Cosmetic Dentistry, the American Academy of Dental Sleep Medicine and the American Dental Association. Dr. Gallegos practices dentistry in Middleburg, VA. www.Middle-burgSmiles.com.