Orthodontist is the Solution to all your orthodontic needs. We have a dedicated set-up to deliver seamless and time-saving procedures incorporating the most hygienic, safe and comfortable practices. At Mittal’s Advanced Dental & Orthodontic Clinic we treat orthodontic problems in children and adults with regular metal braces, tooth-coloured or clear braces and with invisible lingual braces. Orthodontic treatment is used to improve the appearance, position and function of crooked or abnormally arranged teeth. The benefits of orthodontic treatment include a healthier mouth, a more pleasing appearance, and teeth that are more likely to last a lifetime. Orthodontic treatment can straighten the teeth and move them into a better position. Dr. Sushil Mittal is highly qualified Senior Orthodontist, is committed to offer you high quality treatment solutions at affordable rates.

The American Association of Orthodontists as well as Indian Orthodontic Society recommends that all children have an Orthodontic screening no later than age 7. The usual policy of wait and watch until all permanent teeth come into the mouth (12 to 13 years), often results in a sacrifice of four healthy permanent teeth as well as compromised and camouflaged late Orthodontic treatment. This can be avoided by starting treatment at the right time. Ideally, a child must be brought in for an Orthodontic check up when he/she is 7 - 8 years old. (Sometimes even earlier in case of harmful habits such as thumb/finger/lip sucking or nail biting or major facial defects such as hare-lip or cleft lip-palate). Active Orthodontic treatment usually starts later and the child is kept under observation till the time is right.

Early Orthodontic intervention is needed in two circumstances:-
1. To correct disproportionate jaw growth - When either the upper or lower jaw is growing too much or too little, or in the wrong direction, Orthodontic plates can be given to redirect growth. These plates are effective only in actively growing children.
2. To correct habits like thumb sucking, mouth breathing, tongue thrusting, nail biting etc. as these habits can apply unfavorable forces in teeth and make them either more prominent or crooked. In such situations habit breaking appliances are given as soon as possible.

Advantages of Early treatment (also called as Phase I treatment) In a large number of patients a successful Phase I treatment ensures that all permanent teeth get accommodated and more often there is no need to extract permanent teeth at a later stage.

Front teeth that protrude forward are likely to get injured leading to several dental procedures, for example broken / chipped teeth may require specialized treatment i.e. root canal treatment. Early Orthodontic treatment corrects such teeth rapidly thereby preventing permanent damage.

When a patient gets rid of his buck-toothed, bunny-rabbit appearance, it is a tremendous facial improvement and is always accompanied by wonderful personality changes. Thus, there is not only a dental but also a mental advantage. In mouths where teeth are unable to find room they may remain trapped inside the jaws; when discovered, these teeth require specialized treatment. These conditions go unnoticed if you wait till 12 years of age to see an Orthodontist

With improvement in technology and materials more and more adults are considering treatment.

Most adults consider seeing an orthodontist for two reasons:

(1) Their dentist has told them that their teeth are crooked, a problem which will eventually affect their oral health; and/or
(2) They are unhappy with the appearance of their face. Large spaces between their teeth, crooked lower teeth, and a protruding over-bite or buck teeth are a few of the most common complaints.

Common questions that come in mind when an adult considers seeing an Orthodontist:-

Am I too old for Orthodontics?

There is no age limit for Orthodontics. Teeth and tissue are essentially the same in both adults and children. Orthodontists can successfully realign crooked teeth or a protruding overbite regardless of your age.

How long will it take?

Treatment, or Orthodontic correction, can vary from the comparatively simple closing of front space in a few months, to the realignment of unsightly and disfiguring teeth, to a complete rehabilitation of a neglected mouth that could take up to two years or longer. Most Orthodontists agree that adult treatment will usually take from 10 to 20 percent longer due to the difference in the physiologic responses of the tissues in the mouth of an adult as compared with a ten or twelve year old. Simply put, an adult's bone structure is more dense and firmly set, so a slightly longer response time to tooth movement can be expected.

How much will it cost?

Adult Orthodontic fees are only slightly higher than those required for younger patients.

How do Orthodontists straighten teeth?

Tooth movement is actually a normal response to light pressures exerted on teeth. Pressure is applied by using a variety of Orthodontic hardware (appliances), the most common being a brace or bracket attached to the teeth and connected by wires. By tightening the wires the teeth receive pressure.

Will it hurt?

Discomfort, which usually lasts for 48 to 72 hours, occurs as a result of braces. The teeth are comfortable after this period. Each subsequent monthly appointment may result in minor short term discomfort due to wire tightening.

Why should I be concerned about a bad bite?

Bad bites can be detrimental to a patient's health. Restorations, crowns or bridges are often impossible for a dentist to perform without prior repositioning of the teeth by an Orthodontist. Properly aligned and supported teeth are healthier, easier to clean, and therefore more likely to last longer.

Will I look funny?

No. Minor corrections can be accomplished with braces completely concealed within the mouth. More involved treatment may require braces on the teeth to successfully move them to the desired positions. Ceramic brackets, which are similar in color to teeth, are less obvious to the casual observer and offer the versatility of regular stainless steel braces.

What about surgical correction?

Surgical intervention called Orthognathic surgery can offer dramatic results in certain cases where jaw relationships are so severely malposed that tooth movement alone cannot accomplish desired changes. This treatment requires close cooperation between your Orthodontist and the Oral (Maxillofacial) surgeon. If indicated this can be a viable alternative to conventional Orthodontic treatment.

How often will I need office visits?

In the initial stage, the appointments are more frequent. Once the appliances (braces) are fabricated and in place, the adjustment appointments are scheduled at approximately once in three weeks.

Will improvement be permanent?

The combined experience of Orthodontists across the world, point to a 95 percent permanent improvement rate. Teeth, like all parts of the body, are constantly changing and adapting. Minor movement or relapse must be expected, but conscientious wear of retainers following treatment can minimize these changes.

Bad bites (malocclusion) and crooked teeth are usually corrected by an Orthodontist. Abnormalities of the jaw are usually corrected by an Oral & Maxillofacial Surgeon. When both conditions exist, it is common to find an Orthodontist and Oral Surgeon working together to correct the deformity.

What is Surgical Orthodontics?

Surgical Orthodontics is a form of dental surgery to correct severe cases of bad bites, irregular teeth and jawbone abnormalities.

When is Surgical Orthodontics required?

The upper and lower jaws are the bases upon which the teeth are aligned. When the jaws are too far apart, the proper bite cannot be achieved with braces alone. The Orthodontist then embarks upon a treatment mode that plans for future surgical intervention. Surgery is the only treatment option in these severe cases.

What is the treatment approach?

Most Orthodontic patients undergo an initial period of orthodontic treatment to align the teeth (anywhere between 4 to 12 months) so that they will fit properly after surgery is completed. Surgery usually is not scheduled until the teeth have been properly aligned.

Orthodontic appliances used to align teeth prior to surgery are left in place during the surgical procedure to aid in stabilizing the teeth and jawbones. After surgery there is a period of follow-up Orthodontic treatment to achieve final alignment of the teeth, thus complementing the new facial symmetry.

Can surgery be avoided?

In younger patients, future facial growth combined with timely Orthodontic intervention can sometimes correct protrusion and/or retrusion of the jawbone. An Orthodontist working with children as young as age 7, can use one of several Orthodontic appliances to direct bone growth, thus eliminating the need for surgery in some patients. However, in adults, and in those patients who have completed their bone growth, the improper tooth/bone relationship is frequently treated with surgery.

Are there any risks?

The portion of surgical orthodontic treatment provided by an Oral Surgeon entails the usual risks inherent with any type of surgery.

However, Surgical Orthodontic procedures are not new or experimental; they are routinely performed in offices or hospitals on a regular basis. If you or a member of your family are about to undergo Surgical Orthodontic treatment, your Oral Surgeon would explain the risks, to set your mind at ease.

Eating with Braces What can you eat? Let's talk about what you shouldn't eat! If you've been wanting to drop a few Kg’s, the first week wearing braces is just your chance! For the first day or so, stick to soft foods. Avoid tough meats, hard breads, and raw vegetables. Before long, you'll be able to bite a cucumber again. But you'll need to protect your Orthodontic appliances when you eat, for as long as you're wearing braces.

Foods to Avoid
• Chewy foods
• Crunchy foods: popcorn, chips
• Sticky foods: éclairs, mars, 5-star, aampapar, chewing gum
• Hard foods: nuts, candy, ice cube
• Foods you have to bite into: corn on the cob, apples, carrots
• Chewing on hard things (for example, pens, pencils or fingernails) can damage the braces. Damaged braces will cause treatment to take longer.
General Soreness

When you get your braces on, you may feel general soreness in your mouth and teeth may be tender to biting pressures for three to five days. This can be relieved by rinsing your mouth with a warm salt water mouthwash. Dissolve one teaspoonful of salt in a glass of warm water, and rinse your mouth vigorously. If the tenderness is severe, take aspirin or whatever you normally take for headache or similar pain. The lips, cheeks and tongue may also become irritated for one to two weeks as they toughen and become accustomed to the surface of the braces. You can put wax on the braces to lessen this. We'll show you how!

Loosening of Teeth

This is to be expected throughout treatment. Don't worry! It's normal. Teeth must loosen first so they can be moved. The teeth will again become rigidly fixed in their new corrected positions.

Care of Appliances

To successfully complete the treatment plan, the patient must work together with the Orthodontist. The teeth and jaws can only move towards their corrected positions if the patient consistently wears the rubber bands, headgear or other appliances as prescribed. Damaged appliances lengthen the treatment time.

Brushing

It's more important than ever to brush and floss regularly when you have braces, so the teeth and gums are healthy after Orthodontic treatment. Patients who do not keep their teeth clean may require more frequent visits to the dentist for a professional cleaning. Adults who have a history of gum disease should also see a Periodontist during Orthodontic treatment.

Retainer Instructions
1) Wear your retainers full time, until your Orthodontist instructs otherwise.
2) Take your retainers out when eating, and always put retainers in their case! (Most appliances are lost in school lunch rooms or restaurants.)
3) Clean retainers thoroughly once a day with a toothbrush and toothpaste. Use warm but not hot water. Brushing retainers removes the plaque, and eliminates odors.
4) When retainers are not in your mouth they should ALWAYS be in a retainer case. Pets love to chew on them!
5) Initially, you may find it difficult to speak. Practice speaking, reading, or singing out loud to get used to them faster.
6) Retainers are breakable, so treat them with care. If retainers are lost or broken call us immediately.
7) If you have any questions or concerns about your retainers, or your retainers need adjusting, call us. Do not try to adjust them yourself. 8) Always bring your retainers to your appointments.
9) Retainer replacement is expensive... with proper care they will last for years!
10)Remove retainers when swimming.
11)Keep retainers away from hot water, hot car dashboards, pockets, the washing machine, and napkins.
Removable Expander Instructions

1) Wear your expander all the time. That means all day, during meals, and while sleeping.
2) Remove your expander only to brush your teeth. Brush your expander at least twice a day with a toothbrush and toothpaste.
Fixed Expander Instructions

1) Turn your expansion screws as instructed. Insert the key into the hole and turn towards the arrow.
2) If you are unable to keep your scheduled appointment, stop turning the expander.

Sports

If you play sports, it's important that you consult us for special precautions. In case of any accident involving the face, check your mouth and the appliances immediately. If teeth are loosened or the appliances damaged, phone at once for an appointment. In the meantime, treat your discomfort as you would treat any general soreness.

Loose Wire or Band

Don't be alarmed if a wire or band comes loose. This happens occasionally. If wire protrudes and is irritating, use a blunt instrument (back of spoon or the eraser end of a pencil) and carefully, gently push the irritating wire under the archwire. Simply get it out of the way. If irritation to the lips or mouth continues, place wax or wet cotton on the wire to reduce the annoyance. Call our clinic as soon as possible for an appointment to check and repair the appliances. If any piece comes off, save it and bring it with you to the office.

Emergency Care

As a general rule, an emergency appointment may be made when there is severe pain, a loose band, a broken wire or something sticking out that you can't take care of. It's important to know the names of the parts of your appliances. It will help, when you phone the clinic, to be able to identify what part is broken or out of place.

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