From threads made out of catgut (animal intestines) to almost invisible retainers and braces, orthodontics has come a long way.
The preoccupation of people desiring the perfect smile, straightening their teeth and aligning their jaws dates back to the time of the pharaohs.
Archaeologists have unearthed Egyptian mummies with connections inserted in the jaw, believed to have been aimed at bringing the teeth together. The cord used in the process was made out of catgut.
It wasn't until the early 1800s that traditional dental braces were invented, and through the following decades much progress has been made to make the procedure less discomforting and more invisible. It is now at point where it is almost routine procedure.
According to the Egyptian Orthodontic Society, orthodontics is the branch of dentistry that specialises in the diagnosis, prevention and treatment of dental and facial irregularities.
The practice of orthodontics requires professional skill in the design, application and control of corrective appliances to bring teeth, lips and jaws into proper alignment and to achieve facial balance.
Straightened and aligned teeth are key to not only to a dashing smile, but also to improving oral hygiene and general health.
"Orthodontic problems can be due to hereditary causes. However, bad oral habits may lead to dental problems. These, if neglected or badly treated, can be aggravated and become complicated, which may lead to orthodontic problems," says Prof. Dr Wael Refai, vice dean for environmental affairs and community service and head of the department of orthodontics at Minia University.
Refai stresses that nutrition has to become a greater area of concern, especially among parents, by encouraging their children to eat salads and non-carcinogenic food, while also bearing in mind that fibrous food may induce gingival massage.
Refai lists four points that anybody considering orthodontic braces should be aware of:
Check what is hanging on that wall
Masters and doctors degrees are the official qualifications given by Egyptian universities for someone to be able to legally practice orthodontics. Other degrees have to be checked by the supreme council of universities.
This point has to be stressed, since many doctors intend to get a license or fellowship from foreign universities. All certificates have to be under the authority of a university, which is the sole source that has the right to give certificates.
Accordingly, patients have to be assured of whether the doctor is qualified or not.
Concerning orthodontics, the Egyptian Orthodontic Society has a record of all qualified Egyptian orthodontists and has a website for this. The patient can enter and check if the doctor is qualified or not.
Know your options
Orthodontic treatment can be performed using removable or fixed appliances. The fixed appliances include the brackets (braces) and wires.
Orthodontics in Egypt is at the same level as it is in most developed countries. Ceramics, screws, invisible and lingual orthodontics are all used in Egypt and have been for years.
All new trends and recent technologies are used and are depended upon during treatment and surgery.
Understand what is at stake and know your expectations
Before starting any kind of orthodontic treatment, a fully detailed file of the patient needs to be made.
This file includes casts, photos, radiographs, personal, medical and dental histories.
Accordingly, the type and expected duration of treatment can be explained to the patient.
Unfortunately, no one can deny that the treatment is costly. This is because the materials used are highly expensive. It has to be noted that some of the non-qualified practitioners use cheaper materials that can cause adverse effects.
In his research, Dr Refai proved that certain kinds of arch wire used by many practitioners may cause deleterious effects. It also has to be noted that when using fixed appliances, the patient must be expected to be seen every three weeks on average.
Dispel myth from fact:
It is true that sometimes the treatment may cause facial changes. This is a fact. For this reason, skeletal and soft tissue analysis have to be performed before starting treatment.
For example, when using functional appliances which advance the mandible, the facial profile changes.
Orthognathic treatment (orthodontics in combination with surgery) has a significant impact on the face. The lip competence (lips contacting each other) has to achieved at the end of the treatment and extraction may be performed to achieve this goal.
That extractions is a necessity in all cases is a myth. Not all cases need extraction. It is performed when the arch can’t support all the teeth or when the teeth are protruded in both the upper and lower arches, a condition called (bimaxillary protrusion).
That braces increase the likelihood of decay and cavities is also a myth.
Nevertheless, the patient has to be very cooperative. They need to brush their teeth at least three times per day. Otherwise, plaque accumulation will take place, increasing caries susceptibility.
Moreover, gingivitis and periodontitis could take place which may cause tooth looseness in severe cases.
It is also a myth that there is an age limitation for orthodontic treatment. There is a common perception that orthodontic treatment can’t be performed after a certain age. However, again, this is wrong.
Orthodontics is feasible at any age. However, a point here has to be clarified. If there is a skeletal problem (protruded or retruded jaw), intervention has to take place early as possible i.e. before puberty because the treatment is simple at that age.
If orthodontics are required after puberty, orthognathic treatment must to be carried out.
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