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January 14, 2019The most frequent problems that occur during orthodontic treatment
1. DECALCIFICATIONS OF THE ENAMEL AND DENTAL CAVITIESE
If the oral hygiene is improper, the teeth are not brushed frequently enough or the brushing technique is incorrect, white opaque stains appear, representing the first stage of the dental cavity. The consumption of excessively sweetened foods or beverages may lead to decalcifications of the enamel, which appear as white stains on the teeth, particularly in the area between the bracket and the gum. The same problems may appear without orthodontic treatment, but the risk increases in the case of a person wearing orthodontic braces, due to the fact that hygienization is more difficult around brackets.
2. RADICULAR RESORPTION (SHORTENING OF THE ROOT)
The dental roots of certain patients become shorter (become resorbed) during the orthodontic treatment. The exact cause of radicular resorption is unknown, and the orthodontist cannot predict which patients are predisposed to this complication. It is considered that there is a genetic predisposition for this complication. Usually, it has no significant consequences, the shortening of the root is small, under 2 mm. In 1-5% of orthodontic patients, it may become a hazard to the longevity of the involved tooth on the arch, the shortening of the root is high, over 4 mm or a third of the initial length. The teeth becomes mobile and requires fixation on other teeth.
This mostly appears at the level of the upper incisors, then the lower ones or mandibular first molars.
Since it cannot be foreseen which patients are susceptible to radicular resorption, a radiography of the incisors is recommended, 6 months into the orthodontic treatment.
If the resorption is detected during the treatment, the orthodontist may recommend a break in the treatment or the removal of the orthodontic braces prior to the completion of the treatment.
3. PERIODONTAL DISEASE
Damage to the tissues supporting the teeth (gum, periodontal ligaments, bone) may appear or worsen during the orthodontic treatment due to several factors, the most frequent factors being the absence of proper oral hygiene. If the bacterial plaque is not removed daily by using effective hygienization methods, the inflammation of the gum may occur, as well as a loss in the height of the bone supporting the teeth.
In some cases, the insufficient thickness of the gum may lead to the appearance of gingival recession during the orthodontic treatment, requiring a gingival graft intervention. This situation is more frequent while extending the arch, to align cramped teeth. By moving the teeth towards the exterior of the arch, the bone and gum are narrowed and gingival recession appears. Grafting may be recommended in the beginning, during or after the orthodontic treatment. In extremely rare cases, if the periodontal issues can no longer be controlled, the orthodontic treatment may be interrupted until periodontal stabilization is achieved.
4. LOSS OF DENTAL VITALITY
A tooth that was traumatized by a previous accident or a tooth that had a deep cavity prior to coronary obturation may have dental pulp lesions. The orthodontic dental movement may worsen such lesions, in some cases leading to the need for an endodontic (root canal) treatment for that tooth.
