Orthodontic Treatments in Turkey

What Is Orthodontics? Correction of Crooked Teeth

Orthodontics is the specialized branch of dentistry that focuses on the alignment of teeth on the jawbone, the relationship between the upper and lower jaws during occlusion, and the skeletal harmony of the lower facial structure. In society, orthodontic treatments are often perceived merely as cosmetic procedures aimed at achieving an “aesthetic smile.” However, within modern clinical dentistry, orthodontics is recognized as one of the most fundamental preventive disciplines that ensures the healthy function of the oral and maxillofacial system.

Correcting crowded or misaligned teeth is not solely about improving appearance in the mirror; it is a medical necessity that helps prevent premature tooth decay, periodontal diseases, and irreversible damage to the jaw joints over time. Since 2003, our clinical experience has consistently demonstrated that no dental structure lacking proper occlusion can maintain long-term oral health.

Beyond Aesthetics: Hidden Problems Caused by Dental Crowding

When teeth overlap, rotate, or become crowded, they create a physical barrier that directly compromises oral hygiene. No matter how regularly the teeth are brushed, toothbrushes and dental floss cannot effectively reach the inaccessible areas created by crowding. Bacterial plaque and tartar rapidly accumulate in these “dead zones,” eventually leading to gum recession and interproximal cavities.

In addition, improper alignment between the upper and lower teeth causes chewing forces to be distributed unevenly, placing excessive stress on certain teeth. Over time, these overloaded teeth may develop cracks, fractures, or bone loss around their roots. Orthodontic treatment aligns the teeth into their ideal positions, evenly distributing chewing forces throughout the mouth and significantly extending the lifespan of your teeth.

How Do Teeth Move Within the Jawbone? (Biological Remodeling)

One of the most common questions our patients ask is: “How can a solid tooth, firmly anchored within the jawbone, actually move?” The answer is neither magic nor forceful manipulation; it is entirely based on the body’s natural capacity for cellular renewal.

Through orthodontic braces or clear aligners, a gentle, continuous, and controlled force is applied to the teeth. According to established medical literature, the jawbone cells in the direction toward which the tooth is moving gradually dissolve through a process called resorption, creating space for the tooth to advance. Simultaneously, new bone cells are formed in the area left behind by the moving tooth through a process known as formation. In other words, teeth progress within the jawbone by continuously reshaping the surrounding bone structure.

Because this process of “biological remodeling” requires time, orthodontic treatments are spread over several months. Applying excessive or overly aggressive force can disrupt this delicate biological balance; therefore, in our clinic, we always prioritize tissue-friendly techniques and the use of optimal orthodontic forces.

Temporomandibular Joint (TMJ) Health and Bite Disorders (Malocclusion)

In medical terminology, the condition in which the upper and lower teeth fail to fit together harmoniously like interlocking gears is referred to as a “bite disorder” or “malocclusion.” When the teeth do not occlude properly, the muscles and structures of the temporomandibular joint (TMJ)—which connects the lower jaw to the skull—must exert excessive effort to perform normal chewing functions, often forcing the jaw out of its natural position.

Over time, this asymmetric strain may lead to clicking or popping sounds in the jaw joint, muscle spasms, waking up feeling fatigued, and even chronic neck pain and headaches. Orthodontic treatment corrects the occlusal relationship between the upper and lower jaws, relieving unnecessary stress placed on the TMJ and surrounding muscles. For this reason, orthodontics is not only a critical branch of dentistry, but also one of the most important balancing treatments for the entire head and neck anatomy.

Orthodontics at Any Age: Is Tooth Movement Possible in Adults?

One of the most common misconceptions—frequently addressed even by major healthcare platforms—is the belief that orthodontic treatment can only be performed during childhood or adolescence. In reality, bone regeneration and cellular remodeling continue throughout human life. Therefore, as long as the jawbone and surrounding gum tissues remain healthy, orthodontic treatment can be successfully performed at the ages of 20, 40, or even 60.

Because adult bone structure is generally denser, tooth movement may occur somewhat more slowly compared to younger patients. However, the final outcome remains equally effective from both a medical and aesthetic perspective. In our clinic, many adult patients who initially seek aesthetic smile design or dental implant treatments first undergo short-term orthodontic therapy to optimize tooth positioning and preserve their natural teeth whenever possible.

Orthodontic Treatment Options: Metal, Ceramic, and Lingual Bracket Systems

In order to move teeth safely within the jawbone and establish the vital balance of proper occlusion, a continuous, controlled, and highly precise force must be applied to the teeth. While the primary source of this force is memory-shaped, heat-activated orthodontic archwires, the small attachments that transfer this force directly to the tooth roots are called brackets.

In our clinical practice, different bracket systems are selected according to the patient’s aesthetic expectations, the severity of dental crowding, and the underlying bone structure. Regardless of the material used, our primary medical objective remains the same: to safely complete the biological remodeling process of tooth movement within the bone and to achieve a perfectly balanced bite fully compatible with the temporomandibular joint (TMJ).

Traditional Metal Braces: The Gold Standard of Orthodontic Biomechanics

Despite the rapid advancement of digital and aesthetic orthodontic technologies, traditional metal braces continue to be regarded as the medical “gold standard” in orthodontics. Manufactured from high-quality stainless medical steel, their greatest clinical advantage lies in the extremely low friction coefficient between the bracket and the archwire.

Reduced friction optimizes what is known in orthodontics as “sliding mechanics,” allowing teeth to move through the bone far more smoothly and efficiently, with minimal resistance to the applied force. In addition, the structural durability of metal brackets is exceptionally high, making the risk of breakage or detachment nearly negligible.

Metal braces provide maximum biomechanical control and precision, particularly in the treatment of severe dental crowding, horizontally impacted teeth embedded within the bone, and skeletal bite discrepancies between the upper and lower jaws, such as Class II and Class III malocclusions.

Ceramic Braces: The Integration of Aesthetics and Functionality

Many adult patients feel hesitant about wearing highly visible braces in their social and professional lives, which has made ceramic (clear) bracket technology a standard protocol in modern orthodontics. These brackets are manufactured from translucent medical-grade ceramics or sapphire crystals that blend naturally with the color of the tooth enamel and allow light transmission. Instead of the metallic gray appearance associated with traditional braces, they provide a far more aesthetic look that harmonizes with the natural teeth.

From a clinical and biomechanical perspective, ceramic brackets function according to the exact same principles as metal braces in terms of force transmission and tooth movement. However, due to their glass- or ceramic-based structure, they are inherently more fragile than metal brackets. For this reason, patients undergoing treatment with ceramic braces must adhere much more strictly to dietary precautions, particularly avoiding hard, crunchy, or seed-containing foods throughout the course of treatment.

For patients with high aesthetic expectations who are not suitable candidates for clear aligner therapy, ceramic braces represent one of the most ideal and reliable clinical solutions.

Lingual Orthodontics: A Completely Invisible Treatment Approach

Another way to carry out orthodontic treatment completely unnoticed from the outside is by placing the brackets and wires on the inner (lingual) surfaces of the teeth rather than on the front (labial) surfaces. This system is known as “Lingual Orthodontics.”

Unlike the smooth outer surfaces of the teeth, the inner surfaces are anatomically far more irregular and asymmetrical. For this reason, lingual brackets cannot be manufactured as standard appliances. Instead, they are custom-designed individually for each patient using three-dimensional digital impressions and produced through advanced robotic laboratory systems to ensure a perfect anatomical fit.

From an external perspective, lingual orthodontics provides a truly invisible treatment experience. However, it is important to remember that the inner surfaces of the teeth occupy the tongue’s natural movement and functional space. As a result, the primary clinical challenge of this system is the adaptation period required for the tongue to become accustomed to the brackets and wires. During the initial stages of treatment, patients may experience slight speech difficulties or temporary pronunciation challenges, particularly with sounds such as “S,” “T,” and “D.”

Additionally, because orthodontic force is applied from the inner side of the teeth outward, biomechanical planning becomes significantly more complex and requires a high level of orthodontic expertise and precision.

A Common Patient Misconception: “Which Type of Braces Straightens Teeth Faster?”

One of the most common misconceptions among patients visiting our clinic is the belief that metal braces straighten teeth “much faster” than ceramic braces. According to established medical literature, the primary factor determining the speed of orthodontic treatment is not the bracket material itself. The true determining factors are the patient’s jawbone density, cellular regeneration rate (metabolism), and the anatomical structure and length of the tooth roots.

Brackets merely serve as attachments; the real work is performed by intelligent archwires—primarily nickel-titanium alloys—that are activated by body temperature. Although metal brackets possess a lower friction coefficient, this typically results in only a minor difference of a few weeks in the overall treatment duration.

In our clinical philosophy, the priority is not speed, but achieving safe biological tooth movement without damaging the jawbone or causing root resorption. The choice of bracket system should therefore be determined through a balance between the patient’s social and aesthetic priorities and the clinician’s medical and biomechanical requirements.

Digital Orthodontics and Clear Aligner Technology

One of the most significant reflections of the digital revolution in modern dentistry has emerged within the field of orthodontics through clear aligner systems. In the past, the only way to move teeth was by bonding metal or ceramic appliances onto the tooth surfaces. Today, however, these purely mechanical approaches have evolved into highly sophisticated treatment protocols driven by “biological software” and three-dimensional printing technologies.

Within our clinical vision, clear aligner therapy is not merely an aesthetic alternative that remains invisible from the outside. It is an advanced medical protocol incorporating high-level engineering, where the direction, angle, and intensity of force applied to each tooth are calculated by computer systems with micron-level precision.

By offering both exceptional social comfort and highly predictable treatment outcomes, clear aligner technology represents the future of modern orthodontics.

Clear Aligner Biomechanics: How Do Teeth Move Without Braces?

One of the questions our patients are most curious about is how teeth can move and straighten without the presence of wires or tightening mechanisms. Clear aligners are a series of custom-made trays fabricated from medical-grade thermoplastic materials that precisely fit over the teeth.

The system functions according to a highly controlled medical principle: each aligner in the series is designed to represent a tooth position approximately 0.25 millimeters more aligned than the current position of the teeth. The moment the aligner is placed, this subtle difference in shape begins to apply a gentle, continuous biomechanical force to the teeth.

Within approximately 7 to 10 days, the teeth gradually adapt to this new position and the intended movement occurs. The patient then progresses to the next aligner in the sequence, and this step-by-step process continues until the teeth reach their final ideal positions and optimal occlusion within the jawbone.

Because the orthodontic force is distributed across a much broader surface area—covering the entire tooth rather than a single attachment point as with traditional braces—the resulting cellular movement around the tooth roots is exceptionally balanced, controlled, and biologically safe.

3D Digital Scanning and Treatment Simulation

The greatest medical advantage of clear aligner therapy is its ability to eliminate uncertainty throughout the treatment process. In traditional orthodontic treatment with braces, patients often have to imagine the final outcome of a treatment lasting several years based solely on the clinician’s explanations. In digital orthodontics, however, the diagnostic process begins with advanced intraoral scanners.

A precise three-dimensional topographic map of the teeth and oral structures is digitally created and transferred into specialized orthodontic software. Our specialist orthodontists then plan the movement of each tooth within the jawbone, the occlusal relationship, and the overall facial aesthetics with millimeter-level precision.

Through what is medically referred to as “orthodontic simulation,” patients are able to visualize the entire treatment journey before it even begins. Using detailed three-dimensional animations, you can observe how your teeth will change week by week throughout the process and preview your final ideal smile months in advance on a digital screen.

Oral Hygiene and Social Comfort During Treatment

In traditional bracket systems, braces are fixed directly onto the teeth, making the removal of trapped food particles a time-consuming process that requires specialized cleaning brushes and meticulous care. When adequate oral hygiene is not maintained, white spot lesions (early signs of tooth decay) and gum inflammation around the brackets become almost inevitable. Clear aligner technology fundamentally eliminates this issue through its removable design.

Patients can easily remove their aligners while eating and enjoy all types of foods—including hard or crunchy items—without the dietary restrictions associated with traditional braces. After meals, they simply brush and floss their teeth normally before reinserting the aligners.

Furthermore, the ability to temporarily remove the aligners during important meetings, presentations, or special social events provides adult patients with a level of social and psychological comfort that conventional braces cannot offer. In addition, emergency situations commonly associated with fixed braces—such as protruding wires or detached brackets—are completely eliminated within the clear aligner system.

Clinical Limitations: Are Clear Aligners Suitable for Every Case?

As a large and institutionally responsible healthcare provider, our foremost obligation to patients is transparency. Clear aligner systems are highly advanced treatment modalities capable of successfully managing more than 80% of orthodontic cases today. However, in severe skeletal jaw discrepancies, cases requiring orthognathic surgery, or situations involving teeth that remain completely horizontally impacted within the bone, the biomechanical force generated by clear aligners alone may not be sufficient.

In our clinic, the choice of orthodontic treatment is determined not only by the patient’s preferences, but also by the findings obtained through comprehensive clinical and radiological evaluations. The true key to orthodontic success is not attempting to apply a supposedly “miraculous” appliance to every patient, but rather selecting the most appropriate medical solution—whether braces or aligners—according to the individual’s anatomical and functional needs through precise treatment planning.

Patient Compliance, Dietary Protocols, and Oral Hygiene in Orthodontic Treatment

Within our institutional clinical philosophy, orthodontics is not merely a procedure performed by the clinician in the treatment room; it is a long-term healthcare partnership built on close cooperation between the orthodontist and the patient. Whether advanced clear aligner systems or traditional metal braces are used, the success of the carefully designed biomechanical treatment plan depends heavily on the patient’s daily discipline, oral hygiene, and compliance with clinical instructions.

For the cellular remodeling process within the jawbone to continue uninterrupted, the orthodontic forces applied to the teeth must remain consistent and controlled as planned. Failure to follow treatment protocols during the orthodontic process can lead not only to prolonged treatment duration, but also to irreversible enamel demineralization, permanent white spot lesions, and gum inflammation that may compromise otherwise healthy teeth.

Nutrition with Fixed Braces: Preventing Biomechanical Disruptions

Patients wearing metal or ceramic braces are advised to avoid hard, crunchy, and sticky foods—such as walnuts, plums, chewing gum, or caramel—or to consume them only after cutting them into very small pieces throughout the course of treatment. The purpose of this recommendation is not simply to inconvenience the patient or to avoid the cost of repairing broken brackets; it is based on an important medical reality.

Brackets bonded to the tooth surface with specialized dental adhesives serve as the “force transmission centers” through which the orthodontic archwire delivers controlled biomechanical force to the teeth. If a hard food causes a bracket to detach, the mechanical force applied to that particular tooth immediately drops to zero within seconds.

Once the force is interrupted, the biological bone remodeling activity around the tooth root also comes to an abrupt halt. During the days that pass before the patient notices the detached bracket and returns to the clinic, the tooth becomes uncontrolled and may begin shifting back toward its previous misaligned position—a process known as relapse. In other words, every broken bracket effectively resets part of the biological treatment process and can unnecessarily prolong orthodontic treatment by several months.

Discipline and Time Management in Clear Aligner Therapy

The freedom offered by clear aligner therapy—the ability to remove the aligners whenever desired—is both its greatest advantage and its most significant clinical challenge. For the tooth movements planned by orthodontic software to occur successfully, the aligners must apply continuous force to the teeth for an average of 20 to 22 hours per day.

Aligners should only be removed while eating, consuming hot beverages such as tea or coffee, and performing oral hygiene procedures like brushing and flossing. If a patient decides, “Today is a special occasion, I won’t wear my aligners at all,” the bone cells surrounding the tooth roots can no longer perceive the gentle and continuous orthodontic pressure required for movement. Without this pressure, the teeth simply do not move toward the intended position.

Even more critically, when the patient attempts to switch to the next aligner stage, the teeth may not have advanced sufficiently, causing the new aligners to fit improperly and disrupting the entire digitally planned treatment sequence. For this reason, clear aligner therapy is a medical protocol in which a significant portion of the biomechanical responsibility depends directly on the patient’s personal discipline, consistency, and time management.

Oral Hygiene in Orthodontics: White Spot Lesions and Gum Health

The presence of metal wires, brackets, and auxiliary orthodontic attachments inside the mouth creates extensive retention areas where bacterial plaque and food debris can easily accumulate. Standard tooth brushing alone is never sufficient to properly clean beneath and around orthodontic appliances. If meticulous oral hygiene is not maintained, acidic plaque deposits around the brackets begin dissolving calcium from the tooth enamel.

This condition, known in medical literature as a “White Spot Lesion,” represents the earliest stage of tooth decay. Once orthodontic appliances are removed, these lesions may remain as permanent chalky white stains on the enamel, creating both aesthetic and structural concerns.

To minimize this clinical risk as much as possible, patients undergoing fixed orthodontic treatment are medically advised to use not only conventional toothbrushes, but also specially selected interdental brushes and pressurized oral irrigators (water flossers). In addition, specialized orthodontic flossing systems such as super floss should be incorporated into daily oral hygiene routines to preserve gum health and maintain optimal “pink aesthetics” throughout the treatment process.

Intermaxillary Elastic Use and Temporomandibular Joint Harmony

As orthodontic treatment approaches its final stages, patients are often instructed to use small rubber bands known as intermaxillary elastics, which connect the upper and lower teeth. While braces primarily align the teeth within each individual jaw, these elastics coordinate the relationship between the upper and lower jaws, establishing proper occlusal balance and creating optimal chewing mechanics.

The use of intermaxillary elastics is a critical medical step in positioning the temporomandibular joint (TMJ) correctly and ensuring functional harmony between the jaws. These elastics must be worn exactly in the directions prescribed by the orthodontist and for more than 20 hours per day, being removed only during meals.

Irregular or inconsistent use may prevent the upper and lower jaws from achieving proper occlusion, resulting in a treatment outcome that remains functionally incomplete despite otherwise successful tooth alignment.

Post-Orthodontic Retention (Stabilization) and Our Clinical Standards

Although the removal of braces or the placement of the final clear aligner may appear to patients as the completion of orthodontic treatment, from a medical perspective it actually marks the beginning of the second and most critical phase of the process: the retention stage.

Even though the teeth have been successfully moved into their ideal positions, the surrounding jawbone and gum tissues have not yet fully adapted to this new alignment. Within our institutional clinical philosophy, preserving the achieved occlusal balance, functional harmony, and aesthetic outcome for a lifetime is managed with the same level of medical precision and seriousness as the active phase of orthodontic treatment itself.

Tooth Memory and the Risk of Relapse

The microscopic fibers known as the periodontal ligament, which connect the tooth roots to the jawbone, function much like elastic bands. When teeth are moved into new positions through orthodontic force, these fibers become stretched and continue to retain a “memory” of their original positions for a certain period of time.

If the teeth are left unsupported immediately after braces or aligners are removed, these stretched fibers begin pulling the teeth back toward their previous misaligned positions—a phenomenon known in medical literature as “relapse.”

For the periodontal fibers to fully relax and biologically reorganize around the new tooth positions through remodeling, approximately one year is generally required. The protective protocols implemented to prevent this biological relapse process are referred to as retention therapy.

Dual-Phase Retention: Fixed Retainers and Essix Aligners

To ensure the stability of the achieved healthy occlusion and aesthetic outcome, a strict dual-phase retention protocol is implemented in our clinic without compromise:

1. Fixed Lingual Retainer: Immediately after the completion of treatment, a special medical-grade wire—approximately the thickness of a hair—is bonded to the lingual (tongue-facing) surfaces of the anterior six upper and lower teeth. This wire is completely invisible from the outside and functions by connecting the teeth together, preventing even the slightest micrometric movement. It is not perceived by the tongue and does not affect speech. Provided that the patient maintains proper oral hygiene, it is recommended to remain in place for many years, and in some cases, even for life.
2. Essix (Night) Retainers: In addition to the fixed retainer, clear, rigid thermoplastic retainers (Essix trays) are fabricated to cover the entire dental arch, including the posterior teeth. Patients are instructed to wear these retainers for 12–14 hours daily during the initial months following treatment completion, and thereafter consistently at night during sleep as a medical necessity.

Orthodontics is not merely about correcting misaligned teeth; it is about reconstructing the harmonious relationship between the upper and lower jaws (occlusion), maintaining temporomandibular joint (TMJ) health, and restoring facial harmony. The advanced systems we have detailed throughout this guide—including friction-optimized metal brackets, aesthetic ceramic systems, and micron-precision clear aligner technology—are applied by our specialist orthodontic team within our clinic.

With clinical experience dating back to 2003 and a preventive healthcare philosophy, we aim not only to provide straight teeth, but to deliver a lifelong functional balance that allows you to chew comfortably and smile with confidence.

Frequently Asked Questions