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Gigi Bongsu Tumbuh Amat Menyakitkan

Assalamu’alaikum

Hampir 2 bulan berlalu selepas saya mencabut braces dan memakai retainer. Pada awalnya, memakai retainer memang terasa agak rimas kerana ia menyebabkan perkataan yang disebut kurang jelas, seperti tersasul dan kalau nak mengaji atau presentation mesti saya akan tanggalkan retainer untuk sebutan yang lebih lancar.

Sehingga ke hari ini, saya sudah semakin biasa memakai retainer malah jika retainer tidak berada di dalam mulut, pasti akan merasa kosong.

Walaupun begitu, masalah yang baru pula timbul. Gigi bongsu saya sudah mula nak keluar. Gusi membengkak besar tetapi tidak bernanah. Seperti ada ketumbuhan kecil di dalam tekak akibat daripada pertumbuhan gigi bongsu. Kepala pening, badan tidak selesa dan yang paling merisaukan saya, gigi bongsu akan menolak gigi-gigi bawah yang lain dan berlaku pergerakan pada struktur gigi. Mujur saya ada retainer.

Saya pernah terbaca satu artikel bahawa jika seseorang hendak memakai braces, adalah lebih baik jika tunggu dulu gigi bongsu keluar dan buang gigi bongsu kerana jika kita pakai braces sebelum gigi bongsu keluar, potensi untuk gigi bergerak semula adalah tinggi disebabkan gigi bongsu tersebut menolak gigi-gigi yang lain.

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Hukum Memakai Pendakap Gigi (Braces)

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Islam agama yang menggalakkan keindahan, dalam masa yang sama ia mengajar umatnya untuk sentiasa bersyukur dengan apa yang telah Allah kurniakan kepada diri mereka. Manusia diciptakan dengan sebaik-baik kejadian, Apa yang ada pada batang tubuh kita, itulah yang terbaik. Kita sewajarnya bersyukur dengan apa yang telah Allah kurniakan

Di zaman kini, dengan pelbagai teknologi, manusia sudah mampu untuk menjadikan wajah mereka kelihatan lebih cantik daripada yang asal.Ini menimbulkan persoalan, apakah hukumnya di sisi syara’. Antara isu yang sering ditanyakan ialah apa hukumnya memakai pendakap gigi.

Rasulullah SAW bersabda: Allah melaknat perempuan yang menyambung rambut dan perempuan yang minta disambungkan rambut, perempuan yang bertatu dan yang minta ditatu, perempuan yang mengikir gigi dan yang minta dikikir giginya, dan perempuan yang mencabut bulu muka dan bulu kening.
(Al-Bukhari dan Muslim).

Rasulullah SAW juga pernah melaknatnya, seperti tersebut dalam hadisnya:

“Dilaknat perempuan-perempuan yang menjarangkan giginya supaya menjadi cantik, yang mengubah ciptaan Allah.” (Riwayat Bukhari dan Muslim)

Yang disebut ‘al-Falaj’, yaitu meletakkan sesuatu di sela-sela gigi, agar kelihatan sedikit jarang.. Kemudian dia meletakkan sesuatu di celahan gigi itu, supaya giginya menjadi jarang. Perbuatan ini dianggap suatu penipuan dan berlebih-lebihan dalam berhias yang sama sekali bertentangan dengan jiwa Islam yang sebenarnya. Perlu diingat, hal menjarangkan gigi ini adalah ‘trend’ Jahiliyah di zaman Jahiliyah dan ia dianggap cantik.

Hadis ini secara umumnya menjadi hujah untuk menyatakan bahawa memakai pendakap gigi adalah sesuatu yang terlarang. Namun, ilmuan Islam telah membahagikan hukum pemakaian pendakap gigi kepada dua hukum, harus dan haram.

Jika dirujuk kepada umum hadis, ianya telah sabit keharaman sekiranya apabila ia dilakukan semata-mata untuk kecantikan dan menjadikan wajah lebih menarik. Imam an-Nawawi Rahimahullah menyebutkan sebab atau ‘illah diharamkan kerana adanya unsur di atas, khasnya kerana kecantikan. Tetapi jika dilakukan kerana keperluan perubatan, atau terdapat cacat pada gigi atau yang seumpamanya, tidaklah mengapa. (Syarah Sahih Muslim: 7/361).

Ia akan menjadi lebih terlarang apabila ia dilakukan untuk menipu manusia lain supaya kelihatan lebih muda dan lebih cantik. Contohnya memakai pendapat gigi agar kelihatan lebih cantik ketika mahu meminang seorang wanita dan sebagainya. Dr. Abdullah al-Faqih dan komiti fatwanya menyatakan: Jika seseorang melakukannya untuk menipu atau memperdaya sesiapa yang melihatnya, samaada ia bertujuan untuk perkahwinan atau sebagainya, maka ia terlarang.

Namun pemakaian pendakap gigi dihukumkan haru sekiranya ianya bertujuan selain daripada tujuan diatas. Hukumnya harus apabila ia dilakukan untuk menutup keaiban yang ada pada wajah seseorang. Contohnya, kedudukan gigi yang terlalu berbeza daripada orang ramai sehingga menimbulkan ketakutan kepada orang yang melihatnya. Dr. Yusuf al-Qaradawi berkata: Seandainya orang tersebut mempunyai kecacatan yang menjijikkan pandangan, misalnya kerana ada daging tambah yang boleh menimbulkan sakit jiwa dan perasaan, tidaklah berdosa untuk berubat selagi dengan tujuan menghilangkan kecacatan atau kesakitan yang boleh mengancam hidupnya. Ini kerana Allah tidak menjadikan agama untuk kita dengan penuh kesukaran (Al-Halal wal Haram Fil Islam).

Ia juga dibenarkan untuk dilakukan apabila untuk memperbaiki kedudukan gigi yang berubah selepas berlakunya kemalangan. Kumiti fatwa pimpinan Dr. Abdullah al-Faqih menyatakan: Tidak salah untuk memakai pendakap gigi jika ia bertujuan untuk membetulkan kedudukan gigi ketempat yang asal selepas berlakunya kemalangan (islamweb.net, fatwa no: 88719).

Ia juga dibenarkan apabila dilakukan atas sebab kesihatan, atau sebab keperluan, contohnya susunan gigi yang menyebabkan sukar untuk mengunyah makanan atau menyebabkan masalah kesihatan di dalam mulut. Syeikh Faizal al-Moulawi , Naib Pengerusi Majlis Fatwa Eropah berkata : Pendakap gigi bagi tujuan kesihatan adalah dibenarkan menurut syara’, bahkan ia juga diperlukan.

Sebenarnya tujuan pemakaian pendakap gigi bukan bertujuan hanya semata-mata untuk mencantikkan. Fungsi asal pendakap gigi bukan bertujuan untuk menjarangkan gigi atau mencantikkannya. Tetapi lebih kepada memudahkan fungsi gigi itu sendiri yg mungkin sebelum ini bengkang-bengkok yang memungkinkan berkumpulnya bakteria atau gigi tak tersusun yang mana mengakibatkan makanan selalu terlekat. Antara contoh lain tujuan pemakaian pendakap gigi ialah bagi mengelakkan gigi bawah yang tergigit langi-langi yang boleh menyebabkan ulser. Begitu juga gigi yang terbuka yang boleh mempengaruhi fungsi pengahadaman. Ada juga gigi yang berlapis sehingga berlaku ketidaksempurnaan ketika meberus gigi dan mengakibatkan masalah gusi dan bau mulut. Malah ada gigi yang kelihatan jongang yang bersangatan sehinggakan menimbulkan keaiban kepada dirinya.

Sekiranya berlaku kes-kes sedemikian, maka Islam tidak melarang mana-mana insan yang berusaha menghilangkan kecacatan dengan pemakaian pendakap gigi. Ini sesuai dengan garis panduan yang telah difatwakan oleh Syeikh Dr Yusuf al-Qaradhawi :

“Adapun kalau ternyata orang tersebut mempunyai cacat yang kiranya akan dapat menjijikkan pandangan, maka waktu itu tidak berdosa kepada mereka yang berbuat demikian untuk tujuan menghilangkan penyakit yang bersarang dan mengancam hidupnya. Kerana Allah tidak menjadikan agama buat kita ini dengan penuh kesukaran. (Al-Mar’ah Bainal Baiti Wal Mujtama’: halaman 105)

Maka disini, hukum pemakaian pendakap gigi berkait rapat dengan niat ataupun tujuan si pemakai tersebut. Berdasarkan Qawaid fiqh: Al-Umur Bimaqasidiha (Segala sesuatu tergantung kepada tujuannya). Sepertimana firman Allah SWT :

“Barangsiapa mengkehendakki pahala dunia Kami berikan pahala itu dan barangsiapa mengkehendakki pahala akhirat Kami berikan pahala itu. Dan Kami memberikan balasan kepada orang-orang yang bersyukur.” (Ali Imran:145)

Juga hadis Nabi SAW yang bermaksud :

“Hanyasanya setiap amalan itu dengan niat, dan hanyasanya setiap orang akan meperolehi apa yang diniatkannya. Maka barangsiapa yang hijrahnya kerana Allah dan RasulNya, maka hijrahnya iu kepada Allah dan RasulNya….” (Bukhari dan Muslim)

Apa yang disebutkan di atas tidaklah hanya terikat pada isu memakai pendakap gigi sahaja. Bahkan ia berkait rapat dengan semua aspek untuk mencantikkan tubuh atau melakukan pembedahan keatas tubuh badan. Yang hanya dibenarkan ialah apabila ia dilakukan untuk menghilangkan keaiban yang benar-benar mengaibkan, atau untuk kesihatan dan menghilangkan kesukaran yang timbul atas kecacatan tersebut, ataupun ia dilakukan untuk mengembalikannya kebentuk asal kerana kecacatan tersebut timbul selepas berlakunya kemalangan.

Ada pun semata-mata untuk kecantikan dan menjadikan diri lebih menarik, ia sesuatu yang terlarang. Selain daripada isu pendakap gigi, isu-isu lain yang perlu diambil perhatian sepertimana di dalam hadis di atas ialah isu mencukur kening. Hukum asalnya adalah haram kecuali jika kening tersebut benar-benar mengaibkan seperti dua kening yang bersambung, atau pun kerana ia menganggu penglihatan contohnya bulu mata yang terlalu panjang sehingga mengganggu mata.

Ada pun semata-mata untuk kecantikan, menipiskan, atau menjadikan diri lebih menarik, ia sesuatu yang terlarang.

Prinsip di atas juga perlu diaplikasikan keatas isu pembedahan plastic keatas tubuh. Untuk melakukannya hendaklah ia mematuhi prinsip-prinsip di atas dan ditambah satu syarat lagi, ia hendaklah tidak mendatangkan kemudharatan yang lebih besar selepas pembedahan atau ketika pembedahan dilakukan.

Walaupun pemakaian pendakap gigi bergantung kepada niat si pemakai, namun berbeza dengan amalan popular proses kecantikan masyarakat Melayu, iaitu pemakaian susuk. Hakikatnya susuk haram sama sekali tidak kira apa niat ia dipakai.

Ini kerana susuk mengandungi unsur sihir, Kerana si pemakai susuk telah meletakkan susuk itu sebagai setara dengan kekuasaan Allah iaitu dengan mengagungkan kebesaran makhluk lain selain dari Allah SWT. Sedangkan sihir merupakan satu perbuatan syirik dan termasuk di antara dosa-dosa besar.

Rasulullah s.a.w bersabda: Jauhilah tujuh dosa besar. Para sahabat bertanya: Apakah tujuh perkara itu, ya Rasulullah? Jawab Nabi: Menyekutukan Allah, sihir; membunuh jiwa yang diharamkan Allah kecuali kerana hak, makan riba, makan harta anak yatim, lari dari peperangan, menuduh perempuan-perempuan baik (berzina) (Riwayat Bukhari dan Muslim).

Allah mahukan umat sentiasa segak dalam personaliti yang unggul. Agar tampil memabawa imej Islam yang tampan. Bukan umat yang selekeh ditelan kepurbaan. Allah juga tidak menghukum umat dari terus berada dalam keaiban sepanjang hayat. Namun Allah juga mahukan umat belajar erti menerima sesuatu ketetapan tanpa sebarang unsur pendustaan.

Sumber.

Kaedah Pemasangan Pendakap Gigi

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1. Pra-pendakap gigi (konsultasi)

Pakar Orthodontik akan mengenal pasti jenis rawatan yang diperlukan. Sekiranya masalah serius, bebarapa batang gigi perlu dicabut. Doktor akan melakukan ujian sinar-x gigi untuk menentukan pelan jenis rawatan. Seterusnya acuan gigi akan dihasilkan bagi kajian modul.

2. Pendakap gigi dipasang Pemakai perlu menjalani rawatan berskala setiap empat hingga enam minggu untuk melihat perkembangan rawatan. Doktor akan melakukan penyenggaraan pendakap gigi setiap kali rawatan. Ada pemakai menunjukkan perkembangan yang baik dan mereka tidak memerlukan rawatan yang lama (tidak sampai dua tahun).

Ada juga pemakai yang tidak mengambil berat menyebabkan rawatan tidak berkesan dan mengambil masa yang lebih panjang. Setiap rawatan hanya mengambil masa 10 hingga 15 minit.

Ketika pemakaian pendakap gigi, pemakai perlu menjaga kebersihan mulut dengan baik. Mereka perlu memberus setiap kali selepas makan dan mengamalkan diet rendah gula.

3. Selepas pemakaian

Apabila doktor menentukan susunan gigi telah rata, pendakap gigi akan dibuka. Ada pemakai memerlukan masa tidak sampai dua tahun dan ada juga sehingga tiga tahun bergantung juga kepada umur. Selepas pendakap gigi ditanggalkan, mereka perlu memakai retainer. Dr. Fatimah menyarankan pemakaian retainer 24 jam untuk enam bulan pertama. Selepas itu, mereka hanya perlu memakai pada waktu tidur.

“Pemakaian retainer bergantung kepada doktor, saya lebih gemar menyuruh memakai seumur hidup untuk kesan yang lebih baik,” katanya.

Menurut beliau lagi, terdapat kes masalah susunan gigi berulang disebabkan keengganan memakai retainer.

Masalah rahang serius

Dr. Fatimah berkata, terdapat kes serius di mana individu mempunyai rahang panjang menyebabkan susunan gigi bawah mereka terkedepan.

Bagi memperbaiki masalah itu katanya, memerlukan orthognatic surgery yang melibatkan kos dan risiko lebih tinggi.

“Pembedahan jenis ini lebih rumit kerana ia melibatkan prosedur yang banyak dan boleh dianggap pembedahan plastik.

“Ia melibatkan pemotongan bahagian rahang bawah dan sangat berisiko kerana ia mempunyai kaitan dengan keseluruhan struktur wajah dan juga otak,” kata beliau.

Pengalaman memakai pendakap gigi

Model majalah dan peragaan, Sofea Nursolehhatun, mula memakai pendakap gigi lebih setahun yang lalu.

“Saya mempunyai masalah gigi atas yang sedikit jongang dan susunan gigi bawah tidak rata. Pada mulanya saya terfikir pemakaian pendakap gigi pasti menjejaskan kerjaya namun sebaliknya berasa lebih selesa dengan penampilan terkini,” kata gadis berusia 21 tahun itu.

Menurut beliau, bentuk mukanya berubah setelah memakai pendakap gigi dan dia berasa lebih yakin dengan keadaan itu.

Sofea juga kini semakin bijak memberi ‘pose’ terbaik agar pendakap gigi itu kurang kelihatan setiap kali mengadakan sesi fotografi.

“Mungkin ada yang menganggap pendakap gigi ini menjejaskan penampilan seseorang model, tetapi saya pula tidak kisah asalkan hasil nanti memuaskan hati,” katanya.

Sumber.

During Braces: The Treatment Process (Part 6)

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How are Braces Attached ?


The process of attaching braces to the teeth has changed significantly in the last 30 years. This is mainly due to the introduction of materials and methods that allow effective bonding of the braces directly to the enamel. As recently as 20 years ago, it was common for orthodontists to place bands, or rings, around each and every tooth. This provided an effective means of attachment, but tended to show quite a bit of metal.

 

In 1955, Dr. Buonocore published an article detailing his observation that conditioning the enamel before bonding increased the effectiveness of the attachment. It was found that the pretreatment caused microscopic changes in the enamel, allowing the bond materials to flow into the enamel, giving a micromechanical attachment. This concept was mostly used for dental fillings, but was later applied to orthodontics.

 

The back sides of the braces have a mesh design. When glue is placed onto the bracket and against the tooth, the combination of the conditioned enamel and the mesh base of the bracket provide a very good attachment.

 

The placement of the braces and the bonding procedure as used today generally follows these steps:

 

  • The teeth are polished with a non-flavored paste (this is similar to a dental polish after a cleaning).
  • A cheek retractor (shown below) is placed to provide a dry field and make it easier to visualize the teeth.
  • The teeth are lightly air-dried, and the conditioner is placed onto the front surfaces of the teeth for about 30 seconds.
  • The conditioner is rinsed and the teeth are again dried using suction and air.
  • A primer is painted onto the teeth.
  • The bonding cement is placed onto the back sides of the braces, which are then placed onto the teeth.
  • The brackets are placed in a very precise position onto the teeth, and excess bonding cement is removed.
  • If the bonding cement is light sensitive, a bright blue light is used to “cure” the glue. Some bonding agents do not require a light since they have a chemical cure.
  • The cheek retractor is removed and the wires are placed
The entire bonding procedure can take anywhere between 10-20 minutes. The length is primarily due to the time required to properly position the braces, and time required for the curing light. Recent advances in the curing lights have allowed use of LED lights, which narrow the wavelength of the light. This reduces the time needed to cure the glue. Older Halogen lights require about 15-20 seconds for each bracket, whereas an LED light would require only half of the time. Plasma lights require even less time (about 3 seconds per bracket).

 

Bonding braces is quite painless, although the length of time required for the procedure is perhaps a bit annoying. The cheek retractors, which are so essential to a successful bonding procedure, can stretch the cheeks and lips and make the whole mouth feel very dry when the bonding is completed. The lips and cheeks recover very quickly, however, and the dryness can be remedied with a rinse (which also helps to remove the bad taste).

 

A dry field is very important since the materials used for bonding require a clean enamel surface. Many of the primers and some types of glue are water tolerant (hydrophilic), but do not perform very well with saliva contamination. Proteins in saliva have a tendency to bind very quickly to the enamel surface and forms a layer know as a pellicle. The pellicle interferes with proper bonding. Consequently, the enamel surface needs to remain protected from the tongue, cheeks, and lips during the entire bonding procedure.

 

Many orthodontists will still place bands (rings) on the back molars. The bands were the treatment of choice for all teeth as recently as 20+ years ago. Despite the advances in the bonding materials and effectiveness, many find there are still advantages to using bands on the molar teeth.

 

An advantage of using molar bands includes an increased stability of attachment on a large tooth in a very highly active part of the mouth. They also provide additional attachments on the tongue side of the band, as well as attachment tubes for headgear and other appliances. The process of placing bands on the molars involves the following:

 

  1. Separators are placed 1 week prior to the appointment of band placement.
  2. The separators are removed, revealing space between the back molar teeth.
  3. Bands, which come in a variety of sizes, are selected to fit each individual tooth.
  4. A bite stick is used to help properly place and position the band on the tooth (figures 42 and 43). By having the patient bite together with the stick, less strain is placed on the jaw while positioning the band. The orthodontist will first position the stick, and then let the patient know when and how hard to bite.
  5. Once the bands are selected and fit to the molars, they are removed and dried.
  6. The inner portion of the band is lined with band cement, and then it is positioned on the tooth
  7. If the cement is light sensitive, a light will be used to cure it.

During Braces: The Treatment Process (Part 5)

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Separators


Many orthodontists will use bands on the back molar teeth to provide additional support and to allow for different attachments. The bands are essentially metal rings that completely surround the teeth. Since most people’s teeth do not have spaces between them, it would be nearly impossible or very difficult to place bands without spaces. It would also likely be painful for the patient. Therefore, one of the first steps in the process of placing braces is the separator, or “spacers” appointment. The appointment is needed a week prior to placing bands in order to provide room between the teeth.

 

 


 

 


Separators are small elastics (rubber bands) that are first stretched out with a special separator instrument. Then, they are simply flossed into the contact where space is needed. While the separator is being placed, the patient may feel slight pressure or a “pushing” sensation – this is due to the pressure needed to allow the rubber band to squeeze through the contact of the teeth. Sometimes, as the separator begins to touch the gum tissue, a “pinch” feeling may be noticed. This sharp feeling will usually go away within a minute or two.

 

 


Once the separators are in place, the patient will notice that they feel as though a piece of food is caught between their teeth. Usually within 4-6 hours after placement, the soreness from tooth pressure/movement will begin. The dull ache feeling will normally worsen over the next day or two, and will then subside. During those first couple of days, over the counter pain medication can be used to help with the pain. Ask the orthodontist for their recommendation regarding pain control.

During Braces: The Treatment Process (Part 4)

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Risks and Limitations of Braces

Any medical or dental procedure is not without risks. While the risks of braces may not be as significant as a severe reaction to an anesthetic in surgery, there are rare complications that can result in considerable problems. The following is a summary of a few possible complications from braces, although an orthodontist should be consulted for specific risks and limitations for a particular patient.

Results and Outcome
While every treatment is performed with the intention of improving the bite and alignment, there are limitations between individuals that may be beyond the control of the patient and orthodontist. This would include growth and development of the jaws, which ultimately has an effect on the tooth/bite position. Areas that are under the control of the patient (i.e. cooperation) will also affect the final outcome, but will be beyond the control of the orthodontist.

Length of Treatment
Most comprehensive orthodontic treatment plans will last approximately two years. There is significant variability in each patient in how fast the teeth move, as well as cooperation and growth issues. Therefore, the orthodontist will give an estimate on treatment length for each individual, but this may change as the treatment progresses.

Relapse
Relapse is the movement and shifting of teeth after the braces are removed. Patients are usually provided retainers following treatment to prevent relapse (more detail on retainers and retention can be found in chapter 4). If the retainers are not worn as instructed by the orthodontist, the risk of relapse is very high, especially immediately after the braces are removed. There is a tendency for teeth to move even a few years after braces, which is due to normal age related changes. These changes occur to varying degrees in almost every patient. Long term use of retainers would be needed to prevent this from happening, or else slight misalignment would need to be accepted.

Root Resorption
Root resorption is a shortening of the roots during braces. In some patients it can be seen as nothing more than a slight blunting of the root tips. This will generally not result in any long term problems for those teeth. A rare situation will develop in some patients where up to one-half or more of the root shortens away. This could significantly affect the long-term health and stability of the affected teeth. The exact cause is not completely known at this time, and there is no effective way of predicting if it will occur. Although, it is known that braces over a long period of time (i.e. over 2-3 years) will increase the chances of root resorption. Many orthodontists will take initial, mid-treatment, and final panoramic x-rays to determine if root resorption has occurred during treatment.

Decalcification and Cavities
The importance of excellent oral hygiene cannot be stressed enough for patients that have braces. The results of improper care are devastating to the health and appearance of the teeth. White marks (decalcification) and cavities can form on the teeth rather quickly if food and plaque is not removed on a regular basis. Prevention by thorough brushing, flossing, a low sugar diet, and use of a daily fluoride rinse can significantly reduce the chances of decalcification.

Periodontal Problems
Besides the risk of cavities, the health of the tissues and supporting bone around the teeth can also be affected by oral hygiene. Patients that have active periodontal disease are not good candidates for orthodontic treatment. Treatment followed by evaluation for stable periodontal health is needed before treatment begins. Frequent evaluation and maintenance visits during treatment may also be recommended to monitor the gum tissue and health of the supporting tissues. Consult with an orthodontist, general dentist, and/or periodontist for more specific recommendations.

Ankylosis
Another rare but serious complication during braces is ankylosis. Ankylosis is a fusion of the tooth root to the bone. If a tooth has fused to the underlying jaw bone, braces will be unable to move the tooth. In fact, all of the surrounding teeth will start to move around the ankylosed tooth. This is a serious complication that would not allow proper alignment of the teeth and bite. A history of trauma where a tooth had completely come out of the mouth and been reimplanted by a dentist has a high rate of ankylosis. Other than that, it is difficult to predict whether a tooth has become ankylosed prior to braces. X-rays and clinical examination may provide diagnosis of ankylosis only in certain situations.

While the risks may cause significant problems if they do occur, the probability of occurrence is usually low. Therefore, most patients find that the risks are not significant enough to forego treatment. Each patient/parent must weigh the risks and benefits, and decide for themselves if they warrant foregoing treatment.

Sumber.

During Braces: The Treatment Process (Part 3)

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Treatment Planning and Consultation


Following the records appointment, the orthodontist will evaluate the information obtained and develop a course of treatment. Although some treatment options may have been discussed at the initial exam, a plan cannot be finalized until all the information has been reviewed.

 

The consultation appointment is usually scheduled a few weeks following the records appointment. This provides the time necessary to receive the models back from the lab, as well as time for the orthodontist to prepare a treatment plan. The appointment is usually about ½ hour long and will include discussion of the following:

 

  1. Diagnosis
  2. Treatment plan
  3. Alternate treatment options
  4. Risks and complications/Informed consent
  5. Financial arrangements
  6. Due to the nature of the topics discussed, a parent or legal guardian will need to be present if the patient is a minor. Besides the legal necessity, a parent will likely need to know the proposed treatment options and risks to make an informed decision about treatment.

 

The diagnosis will generally include a discussion of the problems with the bite, crowding, spaces, impacted and missing teeth, overbite, rotations and misalignment, symmetry issues, tooth size differences, jaw position, and growth concerns etc. These should be discussed in some detail, referencing the photographs, x-rays, and models of the teeth taken during the records appointment.

 

 

The treatment plan is designed to address the issues discussed in the diagnosis. The specific appliances and treatment recommendations, the length of treatment, and the need for cooperation by the patient are also discussed.

 

 

Alternative treatment options, including non-treatment, will also be discussed. It is important to be aware of all the options prior to deciding on a specific treatment course. There may be significant advantages and disadvantages to the various options, which may help in the decision-making process (the risks and complications associated with braces is addressed in greater detail in the next chapter). Some patients may have many options, whereas others may have only a couple. This will vary depending on the circumstances involved with each patient. If there is any confusion, ask the orthodontist for clarification.

 

The final item discussed involves the financial arrangements. A contract that contains the fee and payment information will need to be discussed, agreed on, and then signed by the patient or parent.

>During Braces: The Treatment Process (Part 2)

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>Treatment Planning and Consultation

Following the records appointment, the orthodontist will evaluate the information obtained and develop a course of treatment. Although some treatment options may have been discussed at the initial exam, a plan cannot be finalized until all the information has been reviewed.

The consultation appointment is usually scheduled a few weeks following the records appointment. This provides the time necessary to receive the models back from the lab, as well as time for the orthodontist to prepare a treatment plan. The appointment is usually about ½ hour long and will include discussion of the following:

  1. Diagnosis
  2. Treatment plan
  3. Alternate treatment options
  4. Risks and complications/Informed consent
  5. Financial arrangements
  6. Due to the nature of the topics discussed, a parent or legal guardian will need to be present if the patient is a minor. Besides the legal necessity, a parent will likely need to know the proposed treatment options and risks to make an informed decision about treatment.

The diagnosis will generally include a discussion of the problems with the bite, crowding, spaces, impacted and missing teeth, overbite, rotations and misalignment, symmetry issues, tooth size differences, jaw position, and growth concerns etc. These should be discussed in some detail, referencing the photographs, x-rays, and models of the teeth taken during the records appointment.

The treatment plan is designed to address the issues discussed in the diagnosis. The specific appliances and treatment recommendations, the length of treatment, and the need for cooperation by the patient are also discussed.

Alternative treatment options, including non-treatment, will also be discussed. It is important to be aware of all the options prior to deciding on a specific treatment course. There may be significant advantages and disadvantages to the various options, which may help in the decision-making process (the risks and complications associated with braces is addressed in greater detail in the next chapter). Some patients may have many options, whereas others may have only a couple. This will vary depending on the circumstances involved with each patient. If there is any confusion, ask the orthodontist for clarification.

The final item discussed involves the financial arrangements. A contract that contains the fee and payment information will need to be discussed, agreed on, and then signed by the patient or parent.

Sumber.

During Braces: The Treatment Process (Part 1)

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Orthodontic Records


After the information gathering has been accomplished and an orthodontist is selected, the treatment process begins. The start of the braces process generally begins after the patient and parents have met with the orthodontist for an initial exam, and have decided that treatment is necessary. The next step is typically an appointment for orthodontic records.

 

The records are a vitally important part of the treatment process. They will provide the orthodontist with much needed information about the patient to make an accurate diagnosis and develop an appropriate treatment plan. Orthodontic records are usually comprised of the following:

 

  1. Examination
  2. Panoramic x-ray
  3. Cephalometric x-ray
  4. Facial and dental photographs
  5. Impression or “molds” of the teeth
  6. Wax bite registration
  7. The clinical exam is an extension of the examination performed at the initial exam. A more thorough review of the dental, soft tissue, and jaw problems are recorded to form the basis of the diagnosis.

 

A panoramic x-ray is crucial to fully visualize the entire upper and lower teeth and jaws (shown below). The x-ray gives the orthodontist information about the jaw bone, roots, jaw joint, as well as evaluating for the presence of extra teeth, impacted teeth, or missing teeth.

 

A cephalometric x-ray is another x-ray taken during the records appointment. This x-ray provides important information regarding the position of the jaws and front teeth, as well as providing a baseline starting point to monitor growth in younger patients.

 

Models of the teeth are made by taking impressions or “molds” of the upper and lower teeth. The models of the teeth are vital for the orthodontist during the treatment planning process.

 

To make the models, an impression of the teeth is made by placing a soft alginate material in a tray, placing the tray in the mouth, and then waiting about one minute while the material sets up. Alginate feels very similar to pudding or mashed potatoes when it is first placed in the mouth. Once it starts to set up, it has a more rubbery consistency. After it is removed from the mouth, plaster is poured into the impression. The plaster model is then trimmed to show how the teeth bite together. Some orthodontists have the plaster models scanned digitally, which provides an accurate reproduction of the model. This technology also allows accurate measurements, visualization, and storage.

Taking Care of Braces

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It is not nearly as complicated to take care of your braces as it might seem before you get them. When you first get them fixed to your teeth, the list of things you need to do to care for your mouth can be extensive and feel overwhelming. Thankfully, taking care of braces can be broken down into two basic categories: dental hygiene and diet discipline.

Your dental hygiene is especially important when you have braces. That quick pass over your teeth that you would do before (it’s okay, we all do it) isn’t going to be at all helpful now. Now you need to brush. Floss and use a mouth rinse every single day. It is also helpful to employ a water pik. Because braces make your teeth move, they aren’t going to get the nutrients that they would normally get from your jaw and the tissues that are surrounding your teeth’s roots. Not just that but glue will be slowly but surely eating away at the enamel on your teeth which makes them weaker than usual. Your orthodontist is going to give you a dental hygiene protocol that you need to follow to keep your mouth healthy. Follow it to the letter.

There are two major components of diet discipline. First is that you really do need to avoid all of the foods that are on the list of “no foods” that your orthodontist gave you after you had your braces put on. This list is going to include sticky snacks like caramel and gum. It will also give you a guide for how to prepare foods that you used to eat whole so that you can still eat them (thinly sliced apples instead of whole apples, carrot sticks, instead of those baby carrots, etc). Pay attention to these guidelines and adhere to them. Sticky foods can pull brackets off of your teeth and damage your wires. Harder foods can put too much pressure onto your teeth as you chew them (which is why you slice them up, to make them more manageable).

Not only should you avoid specific foods and prepare certain foods in certain ways, you also need to make sure that you’re eating a calcium rich diet and eating lots of things that are good for your teeth. Dairy products and leafy greens are good. Whole grains are good. You need to fortify your teeth and gums from the inside as well as from the outside with proper dental hygiene.

It isn’t as hard as it seems to learn how to properly care for your teeth. Sure it might be time consuming but that is time well spent if it helps you have a healthy and attractive smile, right?

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