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Although well positioned teeth, a functional occlusion and a pleasant smile will bring you countless benefits, you must be informed that any dental or medical treatment has certain inherent risks and limitations. However, this should not be the only consideration in deciding to benefit or not from orthodontic corrections. The significant esthetic and functional improvements resulting from an orthodontic treatment should greatly outnumber the potential risks listed herafter ??:
It is impossible to list all the circumstances and conditions that may occur and affect the dentition and jaw function during an orthodontic treatment. We describe here the most usual risk factors. If you have any questions or concerns concerning your orthodontic treatment, do not hesitate to mention it so that we can satisfactorily answer all your questions.
Tooth devitalization
- A tooth having received a blow or having been somehow traumatized can become devitalized and “die”.
- This can happen soon after the impact or months or even years later.
- Sometimes the exact cause of a tooth loosing its vitality (most often a trauma) may be unknown to the patient and may not be detectable by the orthodontist before the beginning of treatment.
- A tooth may therefore “die” without any apparent reason, whether orthodontic treatment is undertaken or not.
- A sign that this is happening is that the affected tooth will change color and become darker.
- There may or may not be increased tooth sensitivity or other symptoms associated with this condition.
- This problem is rare but if it happens, it will require a root canal treatment to save the tooth. If necessary, we will refer you to your general dentist so that he/she can make the appropriate recommendations.
- It is very rare to loose a tooth for that reason.
Tooth resorption
Occasionally, the root tips of certain teeth can shorten or become blunt during treatment. This is called “root resorption. Light resoption is fairly common during orthodontic treatment but doesn’t affect the quality or lifespan of a tooth. However, severe resorption, although rare, can cause the loss of a tooth. When significant resorption is detected, the orthodontist may have to modify the treatment plan in order to minimize its impact while still achieving acceptable results. It must be understood that orthodontics is not the only cause of root resorption. Trauma, blows to the teeth, impacted teeth, endocrinal or hormonal imbalances, heredity and other unknown factors may also initiate this condition with or without orthodontic treatment. The quality of the teeth and their roots is evaluated prior to treatment and is regularly verified during treatment with radiographs.
Temporo-mandibular joint dysfunction
The jaw joint located near the ears are called “temporo-mandibular joints” (TMJ). This joint is the most complex of the human body, comprising two joints (right and left) which must function in harmony, in 3 dimensions and with a certain synchronism.
Certain persons have very sensitive jaw joints that can be affected by even the slightest irregularities and imperfections in their bite (occlusion). Some may suffer from limited jaw opening, others from cracking/popping or clicking noises accompanied by pain in their TMJs. One or many of these symptoms may exist before orthodontic treatment or may appear during or after treatment. This condition is also present in the general population who never underwent orthodontics. Correcting dental malpositions can often improve TMJ function but no guaranty can be given that TMJ symptoms will improve or be eliminated with orthodontics. For different reasons, certain symptoms, such as clicking noises, may persist or even appear during treatment even if orthodontics is not the causative factor.
Retention and relapse
Teeth are not anchored in bone as if they were stuck in concrete. They are part of a dynamic and complex masticatory system. Teeth are constantly under the influence of the many forces acting upon them so that there always exists a slight tooth mobility that is considered normal. With or without orthodontics, the stability of the teeth greatly depends on the influence of the muscular environment surrounding them (tongue, cheeks, lips, muscles of mastication, etc.).
In order to insure optimal stability and “retain” the corrections obtained at the end of orthodontic treatment, we use retention appliances or retainers which must which be worn as prescribed. Even if most of the corrections are usually stable, there may be some relapse of one or a few teeth. If the relapse is significant, additional retention measures or further corrections may be required.
Some tooth malpositions, especially the most severe ones, may have a greater tendency to reappear. Severe rotations and lower anterior crowding are such examples. Tooth position can change at any time during a patient’s life. That’s why it is indicated that most patients wear retainers for a year or more after their treatment to help stabilize tooth position and postpone the appearance of changes that may naturally occur. We always attempt to do the orthodntic corrections with the greatest care and suggest to closely monitor the results When, retention is discontinued, even after many years, it is always possible, even normal, to observe some degree of relapse. Proper cooperation during the retention period may reduce these risks to a minimum. If you notice significant changes in the position of your teeth after treatment, please communicate with us.
Growth and development
Certain types of orthodontic problems can only be successfully treated it the patient has a favorable growth pattern. This is particularly important in skeletal imbalance cases where there is a significant imbalance between the jaws. Deficient or excessive growth may have a significant impact on the treatment plan and the quality of the results.
Certain changes caused by late growth can occasionally disturb the best of treatment plans. Someone having had a normal growth pattern may not exhibit this ?? normality veri ??fy terminology??) throughout his/her growth period. If the growth of a jaw becomes disproportionate as compared with that of the opposing jaw, the relationship between the jaws can become unbalanced and the original treatment plan objectives may not be attainable. This may force the orthodontist to modify his treatment plan and propose compromises or treatment alternatives. Excessive residual growth, after completion of treatment, may also affect the stability of the results.
Abnormal growth patterns and oral habits such as chronic digit sucking and excessive tongue pressure applied against the teeth may also make orthodontic corrections more difficult or jeopardize the stability of the results during the retention period.
