Separation before installing braces - an alternative to tooth extraction

Teeth filing technology has been used in dental practice since the beginning of the 19th century. At that time, this procedure was used as a preservative during the treatment of caries.

With the improvement of therapy methods and the expansion of the list of instruments used, this treatment technology was abandoned, however, in some situations, filing is still used.

Indications

There are opposing opinions among dentists regarding the procedure, but there are situations in which filing is necessary:

1. When installing crowns. For reliable fixation of the crown, it must fit tightly to the tooth surface.
   Since the anatomical shape of each molar or incisor is not ideal, grinding down of the upper layers of their hard tissue is required. This allows you to give your own bone organ the correct geometric shape, thanks to which the manufactured product is firmly fixed and does not stand out among other elements of the jaw row.
2. For fixing veneers. Ceramic plates fixed to the surface of your own teeth have a certain thickness.
   Therefore, in order for the installed microprostheses to fit firmly and not protrude beyond the boundaries of the native units, a small amount of hard tissue is ground off from the vestibular side of the elements of the jaw row.
3. Preparation for inlays. If it is necessary to mask the cavity formed as a result of carious lesions, ceramic or metal inlays can be used.
   Their fixation requires the creation of side walls and the formation of the required depth near the cavity.
4. In case of installation of an orthodontic structure. Cutting down a small thickness of the top layer of the tooth allows you to make room for correcting the position of the remaining elements of the row without the need to remove them.
   In addition, this option is often used in cases of increased crowding of teeth, since it facilitates the placement of fastening elements of the bracket system on them.
5. If there is damage to the enamel. Chips on the surface of the front incisors can be made less noticeable by slightly filing down the enamel.
   This improves the aesthetics of the appearance of the jaw row and eliminates the need for composite restoration.
6. In case of elongated incisors. If the front teeth are longer than the rest of the row, this can not only cause psychological discomfort, but also interfere with correct diction or complete chewing of food.
   To solve the problem, in some cases, filing the length of organs protruding from the common line is used.
7. At sharp angles. The anatomical structure of the anterior incisors is not always ideal. If there are sharp corners, dentists may recommend filing them down, which will increase the aesthetic appearance of the entire jaw row.

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Veneers and teeth grinding are the main problems

Veneers are thin plates of ceramic or reflective composite materials used to correct the shape or color of teeth. Microprostheses have many advantages - high aesthetics, durability and reliability. But at the same time, the overlays have a significant drawback, which often becomes a reason for patients to refuse the procedure. We are talking about such an important stage as preparing the tooth before installing veneers.

Interesting fact!

Veneers were first invented in America in the 30s of the twentieth century. At first they were made to order for Hollywood stars, so that they would shine not only with their talents, but also with their perfect, dazzling smiles. However, at that time they were glued to the teeth for only a few days with a special adhesive mixture. Compared to modern orthopedic designs, these were primitive and crude onlays for quick correction of teeth during filming.

Contraindications

The necessity and admissibility of filing teeth is determined by the dentist individually in each case, since the procedure is quite labor-intensive and can be traumatic in some situations.

For this reason, sewing hard fabric is contraindicated in the following situations:

• increased abrasion of enamel;
• hyperesthesia;
• bruxism;
• presence of bad habits - frequent chewing of seeds and nuts, opening bottles with teeth;
• high risk of injury to the incisors, for example, boxing and other types of wrestling.

Where can I straighten my teeth and how long will it take?

It is better to choose a dental clinic for bite correction carefully. Ask your friends and acquaintances if they can recommend where to straighten your teeth. Get acquainted with clinic websites and reviews of doctors’ work. A little research will save you from possible disappointment. An extremely low price should alert you: in such cases, the clinic probably simply does not indicate the cost of additional procedures.

The duration of treatment and price depend on the diagnosis made by the orthodontist. Usually, the doctor can immediately determine exactly in what period it will be possible to straighten the teeth and how much time it will take. Usually, on average, it takes 1.5 – 2 years to straighten teeth with braces. It is impossible to say which braces straighten teeth faster. All braces are effective. Except that with plastic braces, treatment may take longer - they break, and the doctor has to replace parts of the structure, and this delays the treatment time. If you only need to fix one or two teeth and you decide to get veneers, the entire treatment is unlikely to take more than 2 weeks.

There are many ways to straighten your teeth. You just have to decide to change your smile, and after a while you will definitely achieve it. The question of whether teeth need to be straightened should not even arise. Of course you need it! With a beautiful smile, most likely, your attitude towards yourself and the world will change for the better!

In the modern world, teeth straightening is a standard procedure that millions of people of different ages undergo. The fact is that a beautiful smile is not only the key to personal success, but also a means of maintaining health. Some dental abnormalities can cause diseases of various body systems. If you are looking after your health, you should not ignore the presence of dental anomalies. Straightening your teeth and making your smile perfect is not so difficult, and the result will delight you for the rest of your life!

Technique

The procedure for filing teeth is carried out in several stages:

1. Preparation. At the first meeting, the dentist assesses the condition of the patient’s jawbone elements, determines whether there is a need for cutting down hard tissue and whether there are contraindications to the procedure.
2. Identifying problem areas. Using carbon paper, a liquid aerosol or a wax plate, the dentist determines the overestimated areas of the tooth. Areas that require sanding will be colored more intensely.
3. Sawing. The filing procedure may vary slightly depending on the goal to be achieved and the shape of the tooth being processed.
   So, when treating chewing molars, the dentist carefully grinds off the top layer of enamel from the surface of the tubercles. When cutting down the front incisors, multidirectional movements are carried out.

In some cases, it may be necessary to preliminary make a diagnostic model based on casts of the patient’s jaw rows.

The resulting gypsum sample is subjected to careful inspection and evaluation filing. Carborundum cutters or diamond burs are used as instruments for the operation

The procedure often ends with polishing and remineralization of the treated units. The dentist applies a certain composition containing a complex of useful substances to the enamel to increase the strength of the outer layer of the tooth and reduce permeability .

What are the alternatives to teeth straightening?

Filing is a violation of the integrity of the tooth, so in the future it is possible to increase tissue sensitivity. If the patient has minor cosmetic defects (for example, incisors of different heights), orthodontic treatment can be done without drilling. Before straightening your teeth, you need to consider all correction options: mouthguards, trainers, braces, aligners, and also compare the prices of teeth filing and orthodontic bite correction.

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Increased sensitivity after the procedure

Many patients who have had their teeth filed complain of increased sensitivity, especially when eating hot and cold dishes and hard foods.

Dentists explain this phenomenon as follows. Dentin, located under the enamel, is penetrated by many tubules, inside of which nerve endings are located. As the thickness of the enamel decreases, pressure changes occur, which can cause pain when taking certain foods.

To reduce tooth sensitivity after the procedure, dentists recommend temporarily avoiding too hard foods, dishes with high and low temperatures, and acidic drinks.

During oral hygiene, you should use a brush with soft bristles and therapeutic and prophylactic toothpaste, rinses for sensitive teeth.

If sensitivity does not disappear a week after filing, you should contact your dentist.

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How to straighten teeth for an adult?

Usually, correcting the bite and straightening the teeth is usually done in childhood. At an early age, these are removable structures, for example, trainers, lip bumpers or stretching plates; starting from the age of 10–11, braces can be installed. In some cases, you can do without braces, but the orthodontist will again tell you about this. For adults, it is more difficult to carry out the procedures. The fact is that at the age of 25, a person’s bone sutures harden, and any manipulations with the bite and other problems begin to take quite a lot of time. But this does not mean that you should give up dreams of a perfect smile. Answer to the question: “Is it possible to straighten teeth at 30 and beyond?” - of course, yes. At the first appointment, the orthodontist will tell you how to straighten teeth for an adult and what exactly to use in your case.

At home

Fear of doctors and thoughts about the pain of professional manipulations often lead to patients trying to cope with the existing problem on their own. Teeth filing is also no exception.

Dentists share their experience that people often come to appointments whose enamel has been severely damaged by attempts to cut off part of it with various improvised tools in the desire to improve the aesthetic appearance of the jaw row with prominent front teeth or the presence of chips.

In addition to the problem of high sensitivity, these patients experience cracks in the hard tissue, as well as dentin damage, which develops as a result of bacteria entering the dentinal tubules through open pores.

The consequence of such independent actions can be the development of caries, pulpitis and numerous complications that can lead to partial or complete tooth destruction.

Dentists categorically prohibit performing teeth filing procedures at home. Only a specialist can determine the need for an operation to remove a section of enamel and carry it out efficiently, without the risk of complications.

How is turning for veneers carried out?

The reliability of the installation of microprostheses depends on the quality of preparation of the dental surface. Traditionally, the stage of grinding teeth before veneers proceeds as follows. First, the doctor determines the thickness of the enamel layer on the vestibular surface of the teeth that will need to be removed. Next, the dentist makes grooves with a special tool and, focusing on them, grinds down the required amount of dental tissue. In this case, near the gum, the preparation is performed in the form of a grooved ledge. Then the doctor moves on to treating the side surfaces. It can be carried out in two ways: by maintaining the contact points between the teeth or by slightly “grabbing” their lingual surface. The first option is good for preserving the integrity of the dentition, the second has a positive effect on the appearance of future veneers. As for the incisal edge of the teeth, the need for grinding it is directly related to the model of the veneer and the technical requirements for its installation.

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Mikhailov Andrey Vladimirovich

Surgeon, Orthopedist, Implantologist

Price

The cost of filing teeth depends on the reasons for which it is carried out and what result is needed to achieve:

• preparation for caries - from 200 to 350 rubles per row element;
• treatment of enamel after removing braces – 550-650 rubles;
• identification of traumatic occlusion and grinding of one tooth – 200-300 rubles;
• cutting down a tooth for a crown – 130-200 rubles;
• filing a molar under an orthodontic structure – 150-200 rubles.

Find out how teeth are prepared in the video.

When does separation become necessary?

The procedure is offered to clients of modern dental centers in cases where for effective treatment it is necessary to change the size and shape of the dental crown or to obtain the necessary free space for moving teeth. The need for separation usually arises when replacing teeth with crowns and installing bridges; for orthodontic treatment of impacted (not fully erupted) teeth and for the correction of malocclusions in Moscow with braces.

Orthodontists offer separation as an alternative to tooth extraction in several cases.

1. Most often, when the cause of a dental defect is crowding of the upper, lower or both dentitions.
2. Sometimes - when the width of the lower and upper incisors does not match, which causes the closure of the front and lateral teeth to be disrupted.
3. For patients with trapezoidal crowns that widen towards the bottom. After grinding, the aesthetics of their smile improves, as the teeth take on the correct shape and look more attractive.

Metal and ceramic braces can return teeth to physiological positions only if there is free space in the dentition for correct, physiological placement. In some cases, when the lack of space is large enough, it can be obtained by removing teeth. But in many patients, when removing “eights” or premolars, there will be an excess of space. It is enough for them to remove up to 0.25 mm of tooth enamel from the side edges of each crown. Thus, due to the separation of one tooth, 0.5 mm will be released, two teeth - already 1 mm, and six - as much as 3 mm. In some situations, this provides a significant benefit in treatment and allows you to avoid the traumatic removal of molars, incisors or premolars.