Essential Considerations for Orthodontics and Dentures: A Comprehensive Guide

Orthodontics (Invisalign), periodontal integration, and maxillary removable dentures causing difficulty in eating?

1.
Is it necessary to be free of periodontal disease in order to undergo orthodontic treatment (Invisalign)?
2.
Should cavities be filled and a periodontal treatment plan completed before starting orthodontic treatment?
3.
Can unhealthy last molars be extracted and bone anchors placed to move the anterior teeth forward? I do not have wisdom teeth, and the last molars are unstable (bone loss, unable to bite through noodles or food).
Will this lead to a "braces face" or affect my breathing?
4.
Are cavity fillings and periodontal treatments arranged by the orthodontist, or should I seek different specialists at different clinics?
5.
I previously underwent periodontal treatment and flap surgery in one area and had bone grafting done two years ago.
Now, various dentists who reviewed my X-rays say that area has the worst periodontal condition, and the bone graft did not work.
How long will it take before I can truly proceed to orthodontic treatment?
PS1.
I grind my teeth and unconsciously push my tongue against my teeth while sleeping (sometimes waking up in pain).
Will this affect orthodontic treatment, and how can I address the tongue thrusting issue?
PS2.
Why do many photos of completed orthodontic treatments show a wider face?
PS3.
What is the cost of Invisalign treatment?
Regarding my mother’s upper removable dentures, the clinic that received government subsidies did not take X-rays or assess her oral condition, only using a bite tray to create the dentures.
They have been adjusted multiple times but still cause pain when eating.
She has not been able to eat properly for months.
How can this situation be resolved? Additionally, what is the correct process for making dentures?

xiang jiao zheng, 40~49 year old female. Ask Date: 2023/04/15

Dr. Zeng Guanghui reply Dentistry

1.
It is essential to complete the treatment of periodontal disease before orthodontic treatment.

2.
Prior to orthodontic treatment, any cavities should be filled, and periodontal disease treatment must be completed.

3.
It is advisable to consult an orthodontist regarding the orthodontic plan.

4.
You can ask the orthodontist for recommendations and arrangements.

5.
If periodontal health is unstable, it is best to have a dentist evaluate whether to retain teeth in poor condition before considering orthodontic treatment.

Director Tseng Guang-Hui, Department of Dentistry, Nantou Hospital.

Reply Date: 2023/04/15

More Info

When considering orthodontics and dentures, there are several essential factors to keep in mind, especially regarding the prerequisites for orthodontic treatment and the proper procedures for denture fabrication. Here’s a comprehensive guide addressing your questions:
1. Orthodontic Treatment and Periodontal Health: It is crucial to have healthy gums and no active periodontal disease before starting orthodontic treatment, including options like Invisalign. If periodontal disease is present, it can lead to complications during treatment, such as tooth mobility and potential loss of teeth. Therefore, a thorough periodontal evaluation and treatment are necessary prior to orthodontic intervention.

2. Addressing Cavities and Periodontal Issues: Before commencing orthodontic treatment, any cavities must be treated, and a comprehensive periodontal plan should be completed. This ensures that the teeth are in optimal health, which is essential for the success of orthodontic treatment. Neglecting these issues can lead to further complications during the alignment process.

3. Extraction of Unhealthy Teeth: If you have a non-functional last molar with poor bone support, it may be advisable to extract it. However, this decision should be made in consultation with your orthodontist and possibly a periodontist. They can assess the situation and determine if removing the tooth will facilitate better alignment of the remaining teeth without compromising your bite or facial aesthetics.

4. Coordination of Care: The responsibility for coordinating care between different specialists, such as orthodontists, periodontists, and general dentists, typically falls on the orthodontist. They will often refer you to other specialists as needed and help manage your treatment plan. It is essential to communicate openly with your orthodontist about any previous treatments and current dental issues.

5. Timeframe for Orthodontic Treatment: If you have undergone periodontal surgery and the condition of your gums is still poor, it may take additional time to stabilize your periodontal health before orthodontic treatment can begin. The duration will depend on the healing process and the effectiveness of any treatments you have received. Regular follow-ups with your periodontist will help monitor your progress.

6. Bruxism and Tongue Thrusting: If you experience bruxism (teeth grinding) or tongue thrusting, these habits can indeed affect your orthodontic treatment. They may lead to misalignment or discomfort. Addressing these issues may involve behavioral therapy, the use of a night guard, or other interventions recommended by your dentist or orthodontist.

7. Facial Aesthetics Post-Orthodontics: Concerns about facial changes after orthodontic treatment are common. While some patients may notice changes in their facial structure, these are typically positive and contribute to improved aesthetics. However, significant changes depend on individual factors, including the severity of the initial malocclusion and the type of treatment used.

8. Cost of Invisalign: The cost of Invisalign treatment can vary significantly based on the complexity of the case and the region. In Kaohsiung, prices may range, so it’s best to consult with local orthodontic practices for specific quotes.

9. Denture Fabrication Process: For your mother’s situation with upper dentures, the proper process should include a comprehensive evaluation, including X-rays and impressions of the mouth. This ensures that the dentures fit correctly and function well. If the current dentures are causing pain and discomfort, it may be necessary to revisit the dentist for adjustments or a complete re-evaluation.

In summary, successful orthodontic and denture treatments require careful planning, coordination among dental professionals, and attention to overall oral health. Addressing any underlying issues before starting treatment is crucial for achieving the best outcomes. Regular communication with your dental care team will help ensure that you receive the most appropriate care tailored to your needs.

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