In this post, we provide a thorough overview of orthodontic treatment. In dentistry, certain conditions and abnormalities can only be corrected through orthodontics, which makes it a highly specialized and essential field. Here, we explain what dental orthodontics is, review the different types of treatment, outline the treatment process, compare various techniques, answer the most common questions, and highlight key points you need to know.
What Is Orthodontics?
Orthodontics is a specialized branch of dentistry concerned with the diagnosis, prevention, and treatment of specific jaw and dental abnormalities, including misaligned or widely spaced teeth, forward or backward jaw positioning, bite problems, and functional disorders.
Why Is Orthodontic Treatment Necessary and Essential?
Contrary to common belief, orthodontics is not merely a cosmetic treatment. It is a comprehensive form of therapy that treats or helps prevent several serious issues at the same time, including:
- Digestive problems
- Speech disorders
- Psychological issues
- Progressive tooth decay
- Gum damage
- Aesthetic concerns
Jaw and dental abnormalities often interfere with proper chewing, leading to persistent digestive problems. Improper tooth alignment also causes excessive wear and friction, which can result in significant dental damage.
Furthermore, jaw and dental disorders tend to worsen over time. Without treatment, patients are likely to face increasingly complex problems that can seriously affect their quality of life. Those who require orthodontic treatment may also experience headaches, back pain, and neck pain if these conditions are left untreated.
Before-and-After Dental Orthodontics by Professor Jamilian
To see more orthodontic case examples, you can visit the orthodontics Before and After Photo Gallery. You will find a larger number of orthodontic cases involving both teeth and jaws out there. Depending on the type of dental or jaw abnormality, different treatment approaches are selected. Here, you can see images of teeth requiring orthodontic treatment. Your own condition may be similar to one of these cases. In such situations, you can clearly observe the improvement and successful outcomes of treatment.
Which abnormalities can orthodontics treat?
Conditions that are directly treated by an orthodontist fall into two main categories: dental abnormalities and jaw abnormalities Jaw malocclusion.
Dental abnormalities
For normal function, teeth should be aligned evenly and sit next to each other without excessive spacing. In some people, however, factors such as jaw discrepancies or harmful oral habits disrupt this natural alignment and lead to the following conditions.
- Tooth rotation, where a tooth has turned around its own axis.
- Overbite, when the upper teeth excessively overlap the lower teeth in a vertical direction.
- Underbite, often described as a “bulldog” appearance, in which the lower teeth are positioned far ahead of the upper teeth and the upper jaw is set too far back.
- Anterior crossbite, where one to three upper teeth are positioned behind the lower teeth when the mouth is closed.
- Posterior crossbite, in which the back teeth of the upper jaw, including molars and premolars, are positioned inside the lower teeth instead of outside them.
- Overjet, a condition in which the upper front teeth protrude too far forward or the lower teeth do not extend forward enough.
- Openbite, which refers to a lack of contact between the upper and lower teeth in the front, back, or sides. In people with an anterior open bite, when the molars come together, the upper and lower front teeth do not touch, leaving a visible gap between them.
- Misplaced midline, where the center line of the upper teeth does not align with the center line of the lower teeth.
- Spacing, meaning excessive gaps between teeth, which may result from tooth loss, incomplete tooth development, or failure of a tooth to develop at all.
- Crowding, a condition in which too many teeth occupy a dental arch, causing them to overlap and become misaligned.
Jaw abnormalities
Severe and complex jaw problems often require jaw surgery. However, some jaw abnormalities can be treated to a large extent with orthodontics, including:
- Protrusion of the upper jaw (Class II)
- Protrusion of the lower jaw (Class III)
- Discrepancies in jaw growth
- Skeletal open bite
- Skeletal deep bite
- Jaw deviation
Types of orthodontics methods and techniques
Currently, patients have multiple options for orthodontic treatment. Depending on the type of abnormality and individual preferences, one of these options can be chosen. In general, orthodontics methods include the following:
- Fixed Orthodontics
- Removable Orthodontics
- Invisible Orthodontics
Fixed orthodontics treatment method
The main defining feature of fixed orthodontics is that the patient cannot remove the orthodontics appliances during treatment. The appliance remains in the mouth 24 hours a day until the end of the treatment period.
Based on factors such as the material of the orthodontics appliances, its position in the mouth, the adjustment mechanism, and similar considerations, fixed orthodontics includes the following types:
- Metal braces
- Ceramic braces
- Self-ligating systems
- Lingual orthodontics (behind-the-teeth braces)
Removable orthodontics
Unlike fixed appliances, removable orthodontic devices can be taken out when necessary, such as during eating or brushing. This type of orthodontics is also provided using different methods:
- Simple plates
- Functional appliances (Twin Block, Bionator, Activator)
Simple plates are used only to treat mild dental problems. In contrast, functional appliances are capable of treating more complex dental abnormalities as well as certain jaw abnormalities.
Invisible orthodontics
Invisible orthodontics also includes several different types. In some options, such as ceramic braces and removable orthodontics, the orthodontics appliance designed so that they are not easily noticeable or recognizable in the mouth. In lingual orthodontics, the appliance is installed on the inner surface of the teeth, making it completely invisible from the outside.
This invisible type is ideal for individuals who, due to professional, social, or personal reasons, prefer not to use traditional orthodontics.
Which type of orthodontics is more suitable?
Each orthodontics technique and method has its own advantages and disadvantages. Therefore, no single method can be recommended as the best choice for everyone. Factors such as the type and severity of the abnormality, the patient’s age, treatment costs, and personal preferences all play an important role.
In cases of very severe dental and jaw problems, fixed metal orthodontics is usually the first choice. For mild to moderate conditions, patients generally have more flexibility in choosing the treatment method.
Structure of orthodontics appliances
The structure of orthodontics appliances varies depending on the type of device used. Fixed and removable orthodontic appliances differ significantly from one another. In particular, removable appliances are designed to be comfortable for the patient and easy to insert and remove without difficulty.
Components of fixed orthodontics appliances
Fixed orthodontics appliances consist of the following parts:
- Brackets: small components bonded to the surface of the teeth, made of materials such as metal, ceramic, composite, and others.
- Archwire: a thin wire that passes through all the brackets.
- Ligatures: made of metal or plastic, used to hold the archwire securely inside the brackets.
- Interarch elastics: rubber bands that connect the upper jaw teeth to the lower jaw teeth.
- Hooks: attached to the brackets and used to hold the interarch elastics.
In addition to the components listed above, other parts may be added to fixed orthodontics appliances depending on the type of abnormality, such as adjustment screws. Brackets are responsible for transferring force to the teeth, while the main force is generated by the orthodontic archwire.
Components of removable orthodontics appliances
Removable appliances also consist of multiple components, but they differ from fixed appliances in one key way: all parts are integrated into a single unit. In fact, all components are embedded within an acrylic plate. As a result, the patient deals with one larger, unified appliance that can be removed from the mouth when necessary and reinserted afterward. The basic components of removable orthodontics appliances include:
- Acrylic plate: the main rigid part of the appliance, made from acrylic resin.
- Retentive wires: hold the appliance in place on the teeth.
- Active wires: move the teeth in specific directions.
- Expansion screws: usually located in the center of the plate and used to widen the upper or lower dental arch.
Functional removable orthodontic appliances, in addition to the components above, also include extra elements such as:
- Inclined planes: helping position the lower jaw forward when closing the mouth.
- Mandibular advancement rails or plates: used in appliances such as the Bionator or Activator.
- Framework wires: used to guide tongue position, regulate mouth breathing, or control oral habits.
Stages of orthodontics treatment from start to finish
Orthodontics treatment begins with an initial consultation and clinical examination. If necessary, the orthodontist will order radiographs and digital scans. Based on the type and severity of the abnormality, as well as the patient’s personal situation and preferences, the appropriate orthodontic technique is selected. The orthodontist then designs a precise and structured treatment plan accordingly.
Patient preparation
Before the appliance is placed in the mouth and the main phase of treatment begins, one or more of the following procedures may be required, depending on the patient’s condition:
- Tooth extraction
- Treating tooth decay prior to orthodontics
- Scaling
- Correction of oral habits (thumb sucking, mouth breathing, etc.)
- Dental laminates, implants, or restorative dental procedures
- Mini-screws (Mini Screw / TAD)
Placement of the orthodontics appliances
During a visit lasting approximately 30 minutes, the orthodontics appliances is placed in the mouth. In fixed orthodontics, brackets are securely bonded to the surface of the teeth using specific techniques. In removable orthodontics, aligners or plates are provided to the patient, who must wear them according to a defined treatment schedule.
Orthodontics adjustment sessions
After the appliance is installed, follow-up visits are scheduled at regular intervals. During these sessions, the orthodontist monitors treatment progress, addresses any appliance-related issues, and makes necessary adjustments. Patients using invisible orthodontics receive new sets of aligners during these visits.
Completion of orthodontics treatment and appliance removal
The final stage of orthodontic treatment involves several steps, including:
- Final evaluation of tooth alignment, proper bite, coordinated midline, and overall results.
- Removal of brackets using specialized instruments.
- Cleaning adhesive residue from the tooth surfaces.
- Examination of gum and tooth health.
- Prescription of medication or use of microabrasion if needed.
- Taking impressions for retainers (retention phase).
- Professional scaling or polishing, if required.
- Scheduling follow-up visits based on the patient’s condition.
Possible side effects of orthodontics treatment
Patients who do not properly follow oral hygiene instructions and safety guidelines during orthodontics treatment are at high risk of the following complications:
- Tooth decay
- Gum damage
- Pain and infection
- Appliance breakage
- Root resorption
- White spot lesions on teeth
- Disruption of the treatment plan, among others
How much does orthodontics treatment cost?
The cost of orthodontics treatment depends on several factors, including treatment duration, the type of orthodontics appliance, and maintenance or repair costs. In general, metal braces are the most cost-effective option in terms of design and fabrication. Due to the materials used, ceramic braces are more expensive than metal ones. Removable orthodontics is typically the most expensive option, as it requires the production of multiple molds and aligners using complex computer-based calculations. In 2025, the base cost of fixed metal orthodontics is estimated at around 40 million tomans per jaw. This amount can vary significantly depending on the type and severity of the orthodontic condition.
Orthodontics at different ages
Orthodontics treatment works by moving the teeth and jaw bones very gradually. The younger the patient, the easier these movements are to achieve, and treatment can begin before the abnormality becomes more severe. Clinical and scientific evidence shows that the best age for orthodontics is from around seven or eight years onward.
That said, orthodontic treatment in adults is still effective and often necessary, but the treatment period is usually longer. In addition, the risk of worsening abnormalities is higher, and in some cases jaw surgery may be required. With a doctor’s diagnosis, removable orthodontics can be started at a young age (from around 7 years old), whereas fixed orthodontics requires the permanent teeth to be fully erupted (generally from age 10 and above).
Lingual (behind-the-teeth) orthodontics requires a much higher level of patient cooperation and is therefore usually recommended for adults rather than children. Ceramic braces are also more commonly suggested for adolescents and adults, as they require greater care and have a higher risk of breakage in children.
Frequently asked questions about orthodontics
Patients using removable orthodontics generally have no dietary restrictions. However, with fixed orthodontics, patients should avoid hard and sticky foods. Ceramic brackets are more fragile and have a higher risk of breaking.
A loose or detached bracket is considered an orthodontic emergency. In this situation, the patient should contact their orthodontist immediately to arrange an urgent appointment. Any delay or negligence can disrupt the treatment plan and prolong the overall treatment time.
Patients must learn proper oral hygiene techniques when wearing orthodontics appliances. Brushing and flossing methods are different from normal conditions and require special orthodontic toothbrushes and floss. Appropriate mouthwashes should also be used to prevent discoloration and damage to appliance components.
During the first few days of treatment, patients may experience slight changes in speech, such as lisping. However, after a short adjustment period, most patients adapt to the brackets and can pronounce words normally. This adjustment period may be slightly longer with lingual (behind-the-teeth) orthodontics.
The timing of follow-up visits depends on the patient’s condition and the type of orthodontics appliance. With fixed orthodontics, visits are usually scheduled every 4 to 6 weeks. For removable orthodontics, appointments are typically every 6 to 8 weeks. At the end of each visit, the orthodontist determines the exact date of the next appointment.
Orthodontics fees vary depending on whether fixed or removable appliances are used. To get an estimate, patients can contact the clinic directly. Prices may also change during the year due to variations in material costs. For this reason, the exact cost of orthodontics treatment is determined after a clinical examination. At Dr. Jamilian’s orthodontics clinic, installment payment options are available.
The choice between removable and fixed orthodontics depends on the type and severity of the abnormality, the patient’s age, financial considerations, and personal preference. In severe cases, fixed braces are usually recommended, sometimes as the only viable option. In mild to moderate cases, patients have more flexibility. Based on these factors, the treating orthodontist will recommend the most appropriate option.
Invisible orthodontics offers the advantage of greater confidence, as patients feel less restricted in social situations. However, metal braces are generally more durable and resistant than invisible options. In particular, lingual invisible orthodontics is more prone to detachment and damage due to higher pressure behind the teeth. Additionally, treatment with lingual invisible orthodontics often takes longer than standard braces placed on the front of the teeth.
Orthodontics treatment does not cause constant pain. However, after each adjustment, patients may feel pressure or mild to moderate discomfort. This sensation is temporary and usually subsides within three to five days. To manage orthodontics pain, common pain relievers such as acetaminophen can be used.
The duration of orthodontics treatment depends on the patient’s age, level of cooperation, and the type of treatment method used. For mild abnormalities, treatment usually takes between 6 and 12 months. Moderate cases can typically be treated within 1 to 2 years. In severe cases, the treatment period may last 2 to 3 years. In approximately 90 percent of patients, treatment duration ranges between 1.5 and 2.5 years.
Fixed orthodontics is performed using brackets and wires. However, invisible removable orthodontics, commonly known as Invisalign, uses clear aligners and is designed to correct dental misalignment without traditional braces.
Yes. If preventive measures are not followed after treatment and the patient does not use a retainer, there is a risk of relapse. During the first six months, the retainer must be worn full-time, followed by 1 to 2 years of nighttime use only. In addition, harmful oral habits such as teeth grinding or sucking on objects must be eliminated.
Orthodontic treatment costs are covered by some supplementary insurance plans that have contracts with Professor Jamilian’s clinic. Patients are advised to contact their insurance provider to learn about the details of their coverage. Insurance providers that have contracts with the clinic include Bank Mellat, Bank Sepah, Bank Tejarat, Bank Keshavarzi, and others.
Conventional orthodontics treatment generally makes facial features more balanced and symmetrical, so any change in appearance is typically an improvement. Significant facial changes usually occur with jaw surgery, particularly when one of the jaws is positioned too far forward or backward.
Orthodontics fees vary depending on whether fixed or removable appliances are used. To get an approximate cost, patients can contact the clinic directly. Prices may also change during the year due to variations in material costs. For this reason, the exact cost of orthodontic treatment is determined after a clinical examination. At Dr. Jamilian’s orthodontic clinic, installment payment options are available. In 2025, the base cost of fixed metal orthodontic treatment starts from approximately 40 million tomans per jaw.
