Shankar Dental Clinic

In our society, initial impressions in any relationship is based mainly on looks and only later as the relationship evolves does good character, loyalty, understanding and love become the major factors and looks recede. At least initially , before any relationship evolves, how you look plays a major role.

A major cause for poor facial esthetics is crooked teeth ( dental malocclusion deformity) and in some severe cases even the entire jaw may be crooked and need correction ( Skeletal deformity). The branch which deals with straightening crooked teeth is called Orthodontics and the specialist doctor dealing with this is called an Orthodontist. To qualify to be a Orthodontist in India you need to undergo a further 3 years of specialized training after the 5 year undergraduate BDS degree. After the specialized training and passing all the relevant examinations, a MDS degree in Orthodontics and Dentofacial Orthopedics is awarded. This is a registrable degree with the Dental Council of India. All our doctors are fully qualified /certified postgraduates with over 20 years of clinical experience post-graduation. They also have undergone extensive hands-on training in the full range of orthodontics to provide you with the best results.

There are basically 3 main types of treatment options for patients with facial deformity and crooked teeth:

These are appliances that can be removed by you and cleaned. They are used for minor movements of teeth. Functional appliances are slightly more complex than simple removable appliances and use the power of your muscles and growth to produce changes in your teeth.

These are the most commonly used type of appliance . They are fixed to the teeth and can be used to perform complex movements of the teeth.They are generally more expensive but can produce movements that are usually not possible with removable appliances. Orthodontic treatment usually takes between 6 months to 3 years based on the complexity of treatment that you need. You will need monthly checkups during this period to adjust the appliances that you are wearing and also to monitor your progress. There is usually no pain involved in orthodontic treatment though you may need to have some teeth removed prior to commencement of your orthodontic treatment ( for example to create space between your teeth in case of severe crowding). Treatment also cannot be done on decaying teeth and therefore you may need fillings and tooth scaling and polishing before and during your treatment. There is also a choice of metal and ceramic brackets available-the ceramic brackets are cosmetically more pleasing as they are tooth coloured and nearly invisible . We usually use 3M orthodontic kits and wires (imported from USA/ Germany) for best results.

Lately, we also provide a more aesthetic modality of treatment called Invisalign. These are quite similar to fixed appliances but instead of a wire, we use transparent splints. Aesthetics during treatment is the main benefit from this modality of treatment. Even though a majority of the work is done in the lab prior, treatment however is still best done under a fully qualified and certified orthodontist for best results.

In certain patients the deformity may not be confined to only the teeth but affect the jaws (underlying bone) as well. Small abnormalities can be corrected with orthodontics alone (using fixed and removable appliances). More serious problems require corrective surgery together with orthodontics to move all or part of the upper jaw, lower jaw or both into a more normal position. In these cases the patient will need both orthodontics and orthognathic surgery (Corrective jaw surgery) to correct the bone as well as the teeth. Treatment usually involves orthodontic treatment followed by surgery and then some final orthodontics. Surgery is undertaken under general anaesthesia. The operation may take from one hour in simple procedures to several hours with more complicated surgical procedures. Surgery is usually done from inside the mouth leaving no visible external scars. Your stay in the hospital will vary from 2-7 days based on the type of operation you had and also on how quickly you recover.

This young man presented to us with gross spacing between his teeth and impacted canines. He underwent orthodontics with us ( 3M 0.022 MBT straight wire technique—non extraction) for a period of 12 months followed by a retention phase. Results as you can see are fantastic and he had a vast improvement in esthetics, function and confidence as well. Fixed Orthodontics is a painless treatment modality and when done by properly qualified and trained orthodontists, results are excellent.

This young man presented to us with multiple retained milk teeth (deciduous) with a localized cross-bite. He underwent fixed orthodontic treatment with us (3 M Metal 0.022 MBT straight wire technique - non extraction) for a period of 14 months followed by a retention phase. Results were very good and the patient and his parents were very happy with the outcome.

Pre-treatment with retained deciduous teeth and localized cross- bite

During-treatment with fixed appliances

Post treatment showing excellent bite and esthetics

This patient presented to us with a scissor type bite. He underwent fixed orthodontics using straight wire technique ( 3M 0.022 MBT kit with non extraction and bite plane). There was a dramatic improvement in both the esthetics and function ( ability to chew food)The total treatment time was around 14 months and he was stable post orthodontics with no relapse.

This young man presented to us with untreated craniosynostosis and had a severe midface deficiency. Ability to chew food was compromised and he had a poor esthetic appearance. He underwent orthodontics with us. During the orthodontic treatment we corrected his constricted maxilla using SARPE ( Surgically Assisted Rapid Palatal Expansion using a hyrax appliance at a Le Fort I level). Once all the teeth were aligned, the maxillary retrognathism was corrected via orthognathic surgery ( Le Fort I maxilla with BSSO mandible). On follow-up, his treatment was stable with no relapse seen and He has had a vast improvement in esthetics and function and is able to eat a normal diet.

This patient presented to us with severe mandibular retrusion with bi-maxillary protrusion of her teeth. She underwent orthodontics (3M kit with 0.022 MBT - extraction ) followed by mandible advancement osteotomy via a bilateral sagittal split osteotomy (BSSO). Post treatment the entire treatment was stable with no relapse.