If your teeth do not have enough space to be straight, there are various ways to obtain the necessary space:
Widening the arch
This is done with a removable or fixed brace and can generate a few millimeters of space. It is usually done in the mildest of cases and is not usually used in combination with extractions.
Tipping the front teeth forwards
This is also done with a removable or fixed brace and can generate a few millimeters of space. Tipping front teeth can make them appear less aesthetic and therefore this method of gaining space is not always used.
Moving the back teeth backwards
This requires the use of headgear or miniscrews. Both treatments are possible in selected cases. Headgear and miniscrews may not appeal to everyone and therefore, you may choose to go with another option.
Reducing the width of the teeth
This is known as inter-proximal reduction of the enamel (IPR). It involves using a thin small 'file' which is passed between the contact points of the teeth - the same place where you would pass floss. It is usually the thickness of a couple of sheets of paper. It is not painful to carry out and the procedure takes about 10 minutes to perform. You do not usually experience any sensitivity afterwards because only the outer enamel layer has been reduced and this does not have any nerves. There is little evidence to suggest that it makes the teeth more vulnerable to problems later on in life.
IPR can generate up to about 4mm of space depending on the number of teeth it is performed on. Commonly, it is carried out on the six anterior teeth. Immediately after the IPR is done, you may notice small gaps between the teeth but these will disappear within a few days.
Extraction of teeth
Despite modern techniques, it is still sometimes necessary to extract teeth in order to make room for the others to straighten. Fortunately, nowadays, fewer and fewer extractions are being done for orthodontic reasons.
If teeth need to be extracted in your case, if possible, we will try to extract those teeth which already have fillings, crowns or gum problems.
Extraction of teeth is carried out by your regular dentist usually with local anaethetic (and sedation if you are apprehensive about having extractions). Normally, a general anaesthetic is only recommended for teeth which are impacted.