Choosing Cosmetic Tooth Movement Appliances

How often have you had patients come in and ask if you could just straighten one tooth to give them a better-looking smile? It’s a fact that most adults are unwilling to undergo complete orthodontic care. Yet, many of them would love you to do something to improve the way their teeth look. Fortunately, there are many minor tooth movement procedures that you can do that will give your patients the esthetic result they are looking to achieve. In this, and succeeding issues of Aurum Ceramic/Classic News, we will explore some of the more common orthodontic procedures used every day to help you give your patients the beautiful smile they want.

Most esthetic tooth movement procedures can be accomplished with either fixed or removable appliances. In cases where either appliance will accomplish the same result, the following checklist will help you decide which approach may be best suited for your patient.

Fixed appliances are best used when:

1. Bodily movement of the teeth is needed.
2. Wearing anterior brackets and wires are acceptable to the patient.
3. The patient has excellent oral hygiene making the possibility of decay minimal.
4. Patient cooperation in wearing a removable appliance is doubtful.
5. There are enough teeth present to create a proper anchorage unit.

Removable appliances should be used when:

1. Bodily movements of the teeth are not required, as removable appliances mainly provide a tipping action.
2. Esthetics is important. The patient needs an inconspicuous appliance that can occasionally be removed.
3. Bracketing teeth is inappropriate. For example, placing brackets on porcelain veneers or crowns is contraindicated, as the bonding process will damage their finish.
4. The patients do not have enough teeth to use as an anchor. A removable appliance allows you to use the soft tissue, teeth and the appliance to form an anchor against your active tooth movement.
5. The patient is cooperative and responsible; i.e. they will wear the appliance as prescribed and will guard against loss or breakage.

CARE FOR THE APPLIANCES
Both fixed and removable appliances need special care. Some of the most common problems are:

1. Fixed orthodontic appliances will demand special oral hygiene care. We recommend the use of fluoride to help prevent caries activity.
2. It is a good idea to give your patient some Brace Relief (a medicated orthodontic wax) to protect tissues from being irritated by the braces and wires.
3. Never allow a removable appliance near high temperatures or to dehydrate for more than 24 hours.
4. All appliances should be kept moist when not in use. The patient should place the appliance in the retainer case with a small piece of wet paper towel.
5. All appliances should be cleaned daily. A soft brush and toothpaste, or soaking in a sonic cleaner with Retainer Brite™, is all that is needed.
6. Removal of an appliance is best accomplished by using equal pressure on both sides of the mouth. This will minimize the chance of damage to the resilient portion of the appliance.
   

Swing Lock Retainer		Spring Hawley Retainer
Saggital Appliance