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:

• Examination
• Panoramic x-ray
• Cephalometric x-ray
• Facial and dental photographs
• Impression or “molds” of the teeth
• Wax bite registration

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.

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