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Risks and Benefits of Orthodontic Treatment

While the benefits of having healthy teeth and a pleasing smile are well-known, it is important to be aware of the limitations and potential risks associated with orthodontic treatment. Although these risks are rarely significant enough to deter treatment, they should be considered when deciding to undergo orthodontic care. Orthodontic treatment generally proceeds as planned; however, the response to treatment and results cannot be guaranteed.


Orthodontics plays a crucial role in improving overall oral health. It helps create balance and harmony between the teeth and face, resulting in a beautiful, healthy smile. An attractive smile can enhance self-esteem, potentially improving the quality of life. Properly aligned teeth are easier to brush and floss, reducing the risk of tooth decay and gum disease.

However, due to individual conditions and natural limitations, each specific benefit may not be attainable for every patient. The unknown factors in any orthodontic correction are the patient’s response to treatment and their cooperation throughout the process.


All forms of medical and dental treatment, including orthodontics, come with some risks and limitations. In orthodontics, complications are generally infrequent and usually minor when they do occur. Nonetheless, they should be considered when making the decision to undergo treatment. The major risks involved in orthodontic treatment may include, but are not limited to:

1. Decalcification

Tooth decay, gum disease, and permanent markings (decalcification) on the teeth can occur if patients consume foods or drinks high in sugar and acid (e.g., sweets, fizzy drinks). This tooth scarring can also happen if patients do not maintain proper oral hygiene. These problems can occur without orthodontic treatment, but the risk is greater for those wearing braces.

2. Root Shortening

Some patients may experience shortening of the roots during orthodontic treatment. This risk varies among individuals and may have minimal consequences, but in some cases, it could affect the longevity of the teeth involved. Previous trauma to teeth, nail biting, or pen chewing can exacerbate root shortening.

3. Oral Hygiene

Orthodontic tooth movement can affect periodontal health, particularly if there is a pre-existing condition. Good oral hygiene is essential to prevent periodontal disease (inflammation of the gums and loss of supporting bone). Orthodontic treatment generally lessens the likelihood of tooth loss or gum infection due to misalignment.

4. Relapse Tendency

Teeth may have a tendency to shift positions after orthodontic treatment. This is usually minor and can be minimized by wearing retainers as instructed. Factors such as wisdom teeth eruption, growth changes, mouth breathing, and certain oral habits can affect the stability of the results.

5. Jaw Joint Problems

Occasionally, problems may arise in the temporomandibular joints (TMJ), causing pain, headaches, or ear issues. These problems can occur with or without orthodontic treatment and may improve, worsen, or remain unchanged during treatment.

6. Loss of Tooth Vitality

Teeth that have been previously traumatized or have large fillings may experience nerve damage. Orthodontic tooth movement can aggravate this condition, potentially leading to loss of vitality and the need for root canal treatment in rare cases.

7. Post-Adjustment Pain

Tenderness is common after brace adjustments, with the duration of discomfort varying among patients. Typically, this tenderness lasts 24 to 48 hours. Any unusual symptoms or issues with the appliances should be reported to the clinic promptly.

8. Unfavourable Growth

Abnormal growth of teeth or jaws can limit the effectiveness of orthodontic treatment. Disproportionate growth during or after treatment may alter the bite, necessitating additional treatments or surgery. Such growth changes are beyond the control of the orthodontist.

9. Treatment Time

The total time required for treatment may exceed initial estimates. Factors such as bone growth variations, patient cooperation, oral hygiene, broken appliances, and missed appointments can extend the treatment duration and affect the final results.

10. Adjunctive Dental Care

Achieving the most ideal result may require additional restorative dental treatments due to variations in tooth size and shape. Common treatments include cosmetic bonding, crown and bridge restorative care, and periodontal therapy.

11. Perfection

While perfection is the goal, achieving it is not always possible due to human factors, growth and development issues, genetics, and patient cooperation. Orthodontics is an art, not an exact science, so a functionally and aesthetically adequate result should be considered acceptable. Patients are encouraged to communicate their expectations and concerns throughout the treatment process.

By understanding the risks and benefits associated with orthodontic treatment, patients can make informed decisions and work collaboratively with their orthodontist to achieve the best possible outcomes.