Common Orthodontic Procedures: Explained

Orthodontics is a specialized area of dentistry focused on diagnosing, preventing, and correcting misaligned teeth and jaws. While often associated with cosmetic improvements, orthodontic care also plays a key role in improving oral function, preventing future dental issues, and supporting long-term health. Treatments can address crowding, spacing, bite irregularities, and facial asymmetry using a variety of tools and techniques tailored to individual needs.

Orthodontic procedures range in complexity from simple space correction to full bite realignment. Many treatments are phased, starting with diagnostics and planning before transitioning into active movement and retention. Whether for children, teens, or adults, modern orthodontics offers options that are more comfortable, efficient, and discreet than ever before.

Traditional Braces: Still a Gold Standard

Traditional metal braces remain one of the most widely used and effective methods for correcting a wide range of orthodontic concerns. They consist of small brackets bonded to the teeth, connected by a wire that is periodically tightened to guide tooth movement. Elastic bands may also be used to assist in correcting jaw alignment.

This method allows for precise control over each tooth’s movement and is often recommended for more complex cases. While metal braces are the most recognizable, clear or ceramic braces offer a more discreet alternative using tooth-colored materials. Both versions use the same mechanics to achieve results.

Braces typically stay in place for 18 to 24 months, although treatment time varies based on the severity of the issue. Patients attend regular adjustment appointments to ensure steady progress and to replace worn elastics or wires as needed.

Invisalign and Clear Aligners

Invisalign is a clear aligner system designed to gradually shift teeth using removable, nearly invisible trays. These trays are custom-made for each patient and replaced every one to two weeks to continue guiding teeth into better alignment. Invisalign is best suited for mild to moderate crowding, spacing, and bite issues, although some complex cases may also qualify.

Because they are removable, aligners offer the convenience of eating and brushing without restrictions. This makes them an appealing choice for many adults and teens who want a more subtle treatment option. However, aligner success depends heavily on compliance—they must be worn 20 to 22 hours per day to be effective.

Technological advancements in 3D imaging and planning software allow providers to map out the entire treatment course before it begins, giving patients a clear vision of their future smile and making the process highly predictable.

Palatal Expanders for Jaw Development

Palatal expanders are devices used to widen the upper jaw, typically in growing children. When the upper jaw is too narrow, it can lead to crowding, crossbites, and breathing difficulties. The expander is custom-fitted to the upper molars and gradually widened using a small key, encouraging the bones to grow apart over time.

This treatment is most effective before the growth plates in the jaw fuse—usually before adolescence. Once expansion is complete, the device is left in place for a few months to stabilize the new position. Expansion may be a preliminary step before braces or other treatments, especially in younger patients with significant crowding or skeletal imbalances.

In some adult cases, surgical intervention may be necessary to achieve a similar effect, as the upper jaw bones are fully fused and cannot be expanded through orthodontics alone.

Retainers for Long-Term Maintenance

After braces or aligners come off, retainers are used to hold the teeth in their new positions. This phase—called retention—is critical for preventing relapse. Teeth naturally have a tendency to shift back after treatment if they’re not stabilized properly.

There are two main types of retainers: removable and fixed. Removable retainers are worn at night and taken out during the day, while fixed retainers involve a thin wire bonded to the back of the front teeth. The choice depends on the patient’s needs, habits, and the provider’s recommendation.

Retainers may need to be worn long-term to maintain results. Even years after treatment, occasional wear is often advised to keep the bite stable and prevent minor shifting over time.

Orthodontic Appliances Beyond Braces

Orthodontic care includes a variety of appliances beyond traditional braces and aligners. These devices are often used to address specific developmental or functional concerns and may be temporary or integrated into a longer treatment plan.

Examples of common appliances include:

• Elastics: Rubber bands that connect brackets to correct bite alignment
• Headgear: An external device that guides jaw growth and positioning
• Herbst Appliance: Used to treat overbites by adjusting jaw position
• Forsus Springs: A fixed appliance that helps align the upper and lower jaws
• Space Maintainers: Used in children to hold space after premature tooth loss

Each appliance has a unique purpose and is selected based on the specific orthodontic challenge being addressed. Providers monitor the fit and function of these devices throughout treatment to ensure they are effective and comfortable.

Surgical Orthodontics for Complex Cases

In some situations, orthodontic problems are skeletal in nature and cannot be corrected with appliances alone. Surgical orthodontics—also known as orthognathic surgery—may be necessary when there is a significant jaw discrepancy that affects chewing, breathing, or facial symmetry.

This approach involves coordinated care between an orthodontist and an oral surgeon. Braces are typically worn before and after surgery to align the teeth properly once the jaw is repositioned. Surgery is usually performed after growth is complete and only when other methods cannot produce the desired outcome.

Though not common, surgical orthodontics can dramatically improve function and aesthetics for patients with complex needs. Recovery includes a period of healing followed by final orthodontic adjustments.

Early Interceptive Treatment in Children

Also known as Phase 1 orthodontics, early interceptive treatment involves addressing bite and jaw issues in children before all permanent teeth have erupted. It may include the use of expanders, limited braces, or space maintainers to guide jaw development and reduce the severity of future problems.

This early phase is often followed by a second round of treatment (Phase 2) in adolescence to fine-tune tooth alignment. The goal of early intervention is to take advantage of a child’s natural growth patterns, making future treatment more efficient and sometimes shorter in duration.

Parents are encouraged to have their children evaluated by an orthodontic provider by age 7 to determine if early treatment may be beneficial. While not all children will need intervention at this age, timely monitoring helps avoid complications later.

Choosing the Right Path

Understanding the various orthodontic procedures available can help patients feel more informed and confident when exploring their treatment options. From traditional braces to surgical solutions, each tool has a specific role in addressing dental and skeletal alignment issues. Treatment plans are highly individualized, taking into account age, facial structure, dental health, and personal preferences.

While the process may seem complex at first, advancements in technology and planning have made modern orthodontics more predictable and patient-friendly than ever. Working with a skilled provider ensures that every step—diagnosis, treatment, and retention—is guided by experience and customized for success.

Resources
Proffit, W. R., Fields, H. W., & Sarver, D. M. (2013). Contemporary Orthodontics.
Ackerman, J. L., & Thornton, B. (1992). The emerging orthodontic–surgical treatment decision. American Journal of Orthodontics and Dentofacial Orthopedics
Littlewood, S. J., et al. (2006). Retention procedures for stabilizing tooth position after treatment with orthodontic braces. Cochrane Database of Systematic Reviews