The benefits of having properly aligned teeth extend far beyond an attractive and confident smile. Straight teeth not only create a more beautiful smile but are also vital in maintaining your overall dental health. Properly aligned teeth reduce your risk for tooth decay (cavities) and gum (periodontal) disease. By reducing the risk of decay and gum disease, you can decrease risk factors for other health issues. Think about it, if your smile is far from perfect if it's not a healthy smile. Straight teeth contribute to overall health, well-being, ease of cleaning, and healthier teeth and gums.

Most people would like an attractive smile. There are different ways to achieve a beautiful smile based on the concerns of the patient and the condition of the teeth, bone, lips, and face. Sometimes the concern is the color of the teeth, and whitening, veneers, crowns, or tooth-colored fillings may be part of the treatment. If the problem is the shape of the teeth, then tooth-colored fillings, veneers, or crowns may be the solution. If crowding, spacing, or angulation of the teeth is the problem, then orthodontics and/or veneers and crowns may be considered. If the smile shows too much of the gums, then orthodontics and possibly a surgical (gum, lip, or jaw surgery) option may be the answer. And in some patients, there is a combination of one or more of these concerns and conditions. To help the patient make the right choices and be fully informed of the risks, benefits, and alternatives of orthodontic or other treatment, a dentist will need to determine if the teeth and bones are healthy and evaluate lip position and facial proportions.

Orthodontic treatment can be accomplished with fixed or removable appliances. Fixed appliances refer to traditional braces with metal and/or tooth-colored bands and brackets placed on the teeth with wires attached to move the teeth. Removable appliances refer to plastic aligners that can be easily identified and removed by the patient. Both fixed and removable methods move teeth by putting pressure on the teeth. They require to follow up with the dentist to assess health, make adjustments and move on to the next step in treatment.

There is an increasingly high demand for orthodontic care because people want attractive, healthy smiles. Because of this demand, more options have become available for patients to seek care. Traditionally, orthodontic specialists who did extensive training beyond dental school treated every patient, whether it was a minor or major concern. Over the last several years, general dentists, who have additional training, also provide orthodontic care for some needs of patients, leaving the complex cases to the orthodontists. There are also over-the-counter options that do not involve meeting with a dentist, but a dentist reviews your treatment.

Orthodontic movement of teeth should be done after an in-person consultation with a dentist for proper evaluation for decay, periodontal health, lip and facial analysis, and x-ray evaluation of the teeth and bone. The possible complications without good pretreatment evaluation are significant, including permanent disfiguration, including losing one or more teeth. Also, just moving teeth may not address the underlying problem if the lips, facial asymmetry, underlying disease, gums, and/or jawbones are part of the problem. I would recommend avoiding the over-the-counter options because of the lack of thorough pretreatment analysis and discussion with a dentist.

The keys to success with orthodontic treatment are proper pretreatment diagnosis of the problem by the dentist, the dentist's attention to the patient's concerns, and compliance by the patient. Keeping with traditional braces involves excellent home care and regular visits to evaluate progress and adjustments by the dentist. Clear aligners need the exact compliance as conventional braces and need to be worn 20-22 hours a day. Lack of compliance will lead to delays in treatment, possible cavities, and poor outcomes.

In summary, orthodontic care dramatically benefits the patient for an attractive smile and overall health and well-being. Treatment may be a combination of dental choices, not just orthodontic movement of teeth, to accomplish the desired results. To do it right, work with a dentist who is a qualified provider of orthodontic treatments.

Dr. Robert A. Gallegos is a Fellow in the Academy of General Dentistry, Visiting Faculty at Spear Education, Alumnus of Pankey Institute, Invisalign Provider, member of 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.MiddleburgSmiles.com.