Teeth Alignment in Adults

Believe it or not, it’s not actually cost. We look at the track record of the product, that’s the most important. And also we look at the customer support. Because sometimes there are some administrative things that we need help with, or if the shipment gets lost or delayed, we need to change the treatment. It’s good if the customer service is good and they’re reachable, so that’s basically the main thing. And the cost is secondary, but we usually look at the cost and then price the treatment accordingly.

I wouldn’t call it permanent, I would call it fixed. Because it’s glued there so the patient cannot remove it, but the fixed retainers are only for the front teeth. Because that’s what the patients usually care about. And the reason why I like those is that, again, there are no compliance problems. The removable retainers, it’s very common for patients to say “I forgot to wear it” for one or two nights and then it becomes one week, and when they travel, and they left the retainer in the plane or the hotel, or somebody threw it away.

It is not a good idea to do braces on teeth with veneers. Veneers are usually beautifully glazed (coated with a thin layer of glass) if they are made of porcelain to give a stain-resistant uniform surface. If the veneer is made of composite, the surface will have been carefully polished to give a beautiful shine. Whenever something needs to be glued on to a surface (a tooth surface or a veneer surface), the surface needs to be roughened. This means that the glaze needs to be removed or the polished surface needs to be roughened (the shine is removed).

The biggest difference would be compliance. I had some clear aligner patients who were like “I’m only going to wear this for 8 hours”. Then I’m like “okay cool, then you’d have to wear that aligner for one month instead of two weeks”. That’s the main difference. Because the tooth doesn’t know what’s pushing it. It’s just like something is pushing it so it’s going to move in the direction. Clear aligners are good at doing some things, like compared to braces.

Depends on how old the child is. I would say one thing to look out for is hygiene. If your child has really good brushing, their teeth are clean, every time they go for scaling their dentist is not saying “oh you have plaque” that kind of thing, then I would say yes they can probably go for it. But it depends on your child and your dentist will probably advise you because they will know your child since they have been seeing you for a very long time and they will know when you should do braces.

First of all, overjet is not a disease, everyone has overjet. If you mean excessive overjet, which means like protrusion of the teeth -- if it’s mild, sometimes I’ll just accept it and make the teeth straight. Sometimes some people will have teeth that’s like Bugs’ Bunny teeth, then when you align everything it doesn’t look so out of place and the patient’s happy. But the more severe cases you may need to have like four extractions done.

You can use elastics for all kinds of things. You can use it to close the bite, you can use it to shift the jaw forward and backwards. Elastic is a very broad term, so it depends again on the case, what your dentist is trying to achieve. Basically elastics just pull things together so you can use it in lots of different applications. Whether it really affects the jawbones, probably not too much. It’s more like it moves the teeth more than the jaw bone. It’s quite hard to actually get bone movement in an adult. As for the jaw, the lower jaw may slide.

Invisalign is the world leader and their treatment planning algorithm is very good, so that’s the main strength of it. There’s Zenyum, which is not exactly the same because it can treat very limited cases. I am on Zenyum but I haven’t actually had a case to play with. But yes, for Zenyum I’m actually quite strict with the selection criteria. Then there’s also WhiteSmile Clear, which is based in Malaysia. It looks very promising, I’ve seen orthodontists use it with really good results for extractions and stuff like that.

This comes down to the treatment plan, because in some cases we may see very mild crowding. That means that the teeth are not very overlapped, they are pretty straight. All you need to do is straighten them up and the case will look nice. But for a lot of our Asian population, it’s very normal to have protruding lips. So that means that from the side view, they come out, and they do stick out quite a bit. For some people, it’s a concern.

Your dentist or orthodontist will be able to advise you. There is no one correct treatment plan or singular superior orthodontic system because these are just tools in your dentist's toolbox. Selecting the correct tool(s) depends on the case at hand. What is more important is that you trust your dentist's judgment in selecting the right treatment for you. Very often, what the patient has in mind, may be quite different from what is actually possible.