Unfortunately many patients, and even dentists, do not understand what quality orthodontics is. Let me explain the simpler concepts, using the models along the top of this page as examples (I did not treat these models).
As orthodontists we have three treatment objectives:

1. To straighten the teeth

2. To correct the bite relationship, or if there has been atypical growth to improve the bite relationship as much as possible.

3. To have the teeth fitting into the face, ie looking natural.

Let us discuss these.

Straightening teeth - there is never an excuse not to leave the patient with straight teeth. However straight teeth also means the teeth must be angled correctly, most teeth have a slight forward tilt, a slight tilt to the midline, and their heights are not flat. Notice the model on the top left of this page, her second tooth is slightly shorter (as it should be) than the others. If all the teeth were at the same level it makes the patient look older. It is becoming too common now for the orthodontist to use the drill to level the teeth when the braces are removed.

Straightening also means correcting the back teeth. For some reason some orthodontists in Newcastle (and Australia wide) do not want to straighten the back teeth. I consider this lazy, and also greedy. When patients seek treatment they want all their teeth corrected as it is very important for function and hygiene. Over the past 2 months (written September  2010) I have had two patients from other orthodontic practices seek second opinions about their orthodontic result as they were told they were to have their braces removed. In both cases the back teeth had serious problems. Orthodontic fees do not vary greatly, find the orthodontist who will do the job correctly. 

Correcting the bite relationship - there are many orthodontists who will not do their best to correct the bite relationship. Discuss this with your orthodontist before you commence treatment. The last thing you want to hear after treatment is being told that the agreement was to straighten the teeth only.

After treatment the teeth must fit into the face as best as possible. Of course there are a range of factors that come into play here. Look as the model on the top right, the one in the orange top. She has what is called a high lip line, so her tooth display is greater and I can even see some gum. This is something we can improve with treatment, but cannot always take away. Also look at the model on the top left again. Her teeth are  a bit more prominent or forward than the textbook recommends. However this looks very attractive for her, but not everyone wants that appearance and in particular many males do not want that protrusion. The orthodontist must understand this. Remember, orthodontics is an art, not a production line. Lastly look at the male on the top right. He has a narrower smile, we do not see 6 teeth across the front of his mouth, and there are dark corners to the smile. He almost certainly had extractions as part of his orthodontic treatment. This is something I try to avoid. Please get a second opinion before you have extractions.

Quality orthodontics is planning the treatment to fit the patient, not making the patient fit the production line run by the orthodontic practice. In Newcastle some orthodontists run production lines that, although extremely profitable, are of questionable legality.