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Orthodontia, also known as orthodontics and dentofacial orthopedics, is a specialty field of dentistry. An orthodontist is a specialist who has undergone special training in a dental school or college after they have graduated in dentistry. It was established by the efforts of pioneering orthodontists such as Edward Angle and Norman William Kingsley. The specialty deals primarily with the diagnosis, prevention and correction of malpositioned teeth and the jaws.
The history of orthodontics has been intimately linked with the history of dentistry for more than 2000 years. Dentistry had its origins as a part of medicine. According to the American Association of Orthodontists, archaeologists have discovered mummified ancients with metal bands wrapped around individual teeth. Malocclusion is not a disease, but abnormal alignment of the teeth and the way the upper and lower teeth fit together. The prevalence of malocclusion varies, but using orthodontic treatment indices, which categorize malocclusions in terms of severity, it can be said that nearly 30% of the population present with malocclusions severe enough to benefit from orthodontic treatment.
Orthodontic treatment can focus on dental displacement only, or deal with the control and modification of facial growth. In the latter case it is better defined as “dentofacial orthopedics”. In severe malocclusions that can be a part of craniofacial abnormality, management often requires a combination of orthodontics with headgear or reverse pull facemask and / or jaw surgery or orthognathic surgery.
This often requires additional training, in addition to the formal three-year specialty training. For instance, in the United States, orthodontists get at least another year of training in a form of fellowship, the so-called ‘Craniofacial Orthodontics’, to receive additional training in the orthodontic management of craniofacial anomalies.
Typically treatment for malocclusion can take around 2 years to complete, with braces being altered slightly every 6 to 8 weeks by the orthodontist. There are multiple methods for adjusting malocclusion, depending on the needs of the individual patient. In growing patients there are more options for treating skeletal discrepancies, either promoting or restricting growth using functional appliances, orthodontic headgear or a reverse pull face mask. Most orthodontic work is started during the early permanent dentition stage before skeletal growth is completed. If skeletal growth has completed, orthognathic surgery can be an option. Extraction of teeth can be required in some cases to aid the orthodontic treatment. Starting the treatment process of overjets and prominent upper teeth in children rather than waiting until the child has reached adolescence has been shown to reduce damage to the lateral and central incisors. However the treatment outcome does not differ.