Specialist Orthodontics

For a winning natural smile

Orthodontics is the way of improving the appearance by straightening crooked/irregular teeth with braces. Whilst years ago, it was something generally carried out on teenage children, nowadays many adults also seek orthodontic treatment. There really is no upper age limit to when orthodontics can be carried out, (whilst occasionally, very simple orthodontics with removable appliances is carried out on  7-8 yr olds). Depending on the initial problem, often orthodontics alone can provide the answer. Sometimes it can be used in connection with other cosmetic dentistry procedures, by placing the teeth and spaces in the ideal positions, to improve or minimise the procedures that may otherwise be necessary eg providing the correct spacing to allow optimal implant placement and subsequent appearance.

Some orthodontics (often referred to as cosmetic orthodontics) can be carried out by suitably trained general dentists, such as Ian Brignall or Mac Ogretme, while other cases need treatment by a specialist orthodontist (someone who only does orthodontics).

Benefits of orthodontics: include:

  • Good appearance, great smile and improved self esteem
  • Straight teeth are easier to clean reducing the risk of decay and gum disease
  • Reduced risk of accidental injury to protruding teeth
  • Re-arranging teeth to improve the bite
  • Preparation of teeth for future restorative care.

Traditionally, people think of braces as metal brackets bonded to the upper and lower teeth (fixed appliances; often known as “train-tracks”), and whilst for teenagers on the NHS, this may well still be the case, it is not essential for it to be like this. Fixed appliances are without doubt a very reliable way of moving teeth, and if required, can use clear/tooth coloured brackets, which improves the appearance whilst being worn, enormously. Their biggest benefit is that whilst most removable appliances are capable to tipping teeth in various directions or derotating twisted teeth, fixed appliances can move the tooth bodily, alter root angulation, correct rotations, intrude long teeth and extrude short teeth. They can correct even the most severe of cases. Fixed appliances require great skill from the clinician and are best carried out by a specialist.

We are delighted to have Dr. Nicola Crawford, a hospital Consultant orthodontist and orthodontic specialist, working with us at Atkinson Brignall seeing private patients. An orthodontist is a specialist in the diagnosis, prevention and treatment of dental and facial irregularities. They undergo additional years of specialised education beyond their general dental training, and have the greatest experience of aligning and straightening teeth to deliver both function and aesthetics.

A popular alternative to fixed braces now are clear aligners, the brand leader of which is Invisalign.

With Invisalign, traditionally, impressions are taken, sent to the company, and computerised images of your teeth are produced, both as they are to start, and in a straightened form. This is called the ClinCheck, so you can see the proposed end result and make changes before you start treatment. A number of clear aligners are then made, each of which is worn 22 hrs/day for 7-10 days before moving on to the next. By the end of all the aligners, the teeth should have straightened, though occasionally a few extra aligners (a “refinement”) may be needed. Invisalign do various products, i7 (7 aligners) for very mild cases, Lite (up to 14 aligners if greater movement is required), Full (an unlimited number of aligners for more complex cases) and Teen (a special product for teenagers). Most specialist treatment using Invisalign will involve use of either Invisalign Full or Teen. “Cosmetic orthodontics” will involve, i7, Lite or Full.

As a forward thinking Practice, to aid patient comfort, rather than the need to do impressions, we are now the proud owners of a new sophisticated intra-oral scanner.  The iTero Element Scanner is a state-of-the-art digital impression system that eliminates the need for messy putty in your mouth. With our iTero Element Scanner, we can digitally capture a detailed 3D model of your teeth and gums. Not only is this process far more comfortable than the old putty based impressions, but it’s faster and may offer a superior clinical endpoint.

The iTero scanner can even   produce a quick simulated outcome of what corrected teeth might look like after treatment, which we can email to you!






Further details about Invisalign can be found at: Invisalign Orthodontics

For completeness, although it is something we do not currently offer, it is only right for us to mention “lingual orthodontics”, one brand of which is “Incognito”. With this approach, special metal brackets are placed on the inner aspect of the teeth rather than the outer, with a wire joining the brackets. This has all the capabilities of traditional fixed appliances with nothing for anyone else to see.   Although, the most invisible of all appliances, patients needs to be prepared for the greater bulk on the inner aspect of the teeth around the tongue and palate, and for the very significant extra costs involved.


Whatever type of brace is used to align the teeth, there is always the risk of relapse. Teeth will move back towards where they came from unless they are held in place by a “retainer”. Retention nowadays is considered as something that should be considered as a long-term obligation – “retention for life”. Retainers can be removable, often similar to an Invisalign aligner, which work well if worn as directed, or sometimes fixed, with a thin wire bonded to the inner aspect of the front teeth, which are working 24/7. Fixed retainers are almost always possible on the lower teeth and sometimes on the upper. Depending on movements, a removable retainer may still sometimes be needed in addition. It is very important that retainers are worn as advised.

It is important to ensure you/your child continue to have regular dental examinations during any orthodontic treatment.