Most patients begin orthodontic
treatment between ages 9 and 16, but
this varies depending on each
individual. Because teenagers are still
growing, the teen years are often the
optimal time to correct orthodontic
problems and achieve excellent results.
Most orthodontic problems are
inherited. Examples of these
genetic problems are crowding, too much
space between teeth, protruding upper
teeth, extra or missing teeth and some
jaw growth problems.
Other malocclusions (crooked teeth)
are acquired. In other words, they
develop over time. They can be
caused by thumb-sucking or
finger-sucking as a child, mouth
breathing, dental disease, abnormal
swallowing, poor dental hygiene, the
early or late loss of baby (primary)
teeth, accidents, poor nutrition or some
medical problems.
Sometimes an inherited malocclusion
is complicated by an acquired problem.
But whatever the cause, the orthodontist
is usually able to treat most conditions
successfully.
Treatment is important because
crooked or crowded teeth are hard to
clean, and that may contribute to tooth
decay, gum disease, and tooth loss.
A bad bite can also cause abnormal wear
of tooth surfaces, difficulty in chewing
and/or speaking, excess stress on
supporting bone and gum tissue, and
possible jaw joint problems. Without
treatment, problems may become worse.
Orthodontic treatment to correct a
problem may prove less costly than the
additional dental care required to treat
the problems that can develop in later
years.
Then there’s the emotional side of an
unattractive smile. When you are
not confident in the way you look, your
self-esteem suffers. Teen-agers
whose malocclusions are left untreated
may go through life feeling
self-conscious, hiding their smiles with
tight lips or a protective hand.
How do braces
feel?
Most people have some discomfort after
their braces are first put on or when
adjusted during treatment. After the
braces are on, teeth may become sore and
may be tender to biting pressures for
three to five days. Patients can usually
manage this discomfort well with
whatever pain medication they might
commonly take for a headache. The
orthodontist will advise patients and/or
their parents what, if any, pain
relievers to take. The lips, cheeks and
tongue may also become irritated for one
to two weeks as they toughen and become
accustomed to the surface of the
braces. Orthodontic wax applied to an
offending bracket will help relieve
discomfort. Overall, orthodontic
discomfort is short-lived and easily
managed. Once patients have become
accustomed to their braces, they may
even forget they have them on.
Are there
less noticeable braces?
Today’s braces are generally less
noticeable than those of the past.
The brackets are smaller and are bonded
directly to the teeth, minimizing the
“tin grin.” Brackets can be metal
or clear depending on the patient’s
preference. In some cases,
brackets may be bonded behind the teeth
(lingual braces). Some of today’s wires
are made of "space age" materials that
exert a steady, gentle pressure on the
teeth, so that the tooth-moving process
may be faster and more comfortable for
patients. A type of clear orthodontic
wire is currently in an experimental
stage. Another option may be the
use of a series of plastic tray aligners
instead of traditional braces to correct
some problems. Your orthodontist
will advise which type of orthodontic
appliance will best correct your
problem.
Do teeth
with braces need special care?
Yes. Patients with braces must be
careful to avoid hard, sticky, chewy and
crunchy foods. They must not chew on
pens, pencils or fingernails because
chewing on hard things can damage the
braces.
Damaged braces will almost always
cause treatment to take longer, and will
require extra trips to the
orthodontist’s office.
Keeping the teeth and braces clean
requires more precision and time, and
must be done every day if the teeth and
gums are to be healthy during and after
orthodontic treatment. Patients who do
not keep their teeth clean may require
more frequent visits to the dentist for
a professional cleaning. The
orthodontist and staff will teach
patients
how to care for their teeth, gums and
braces during treatment. The
orthodontist will tell patients (and/or
their parents) how often to brush, how
often to floss, and, if necessary,
suggest other cleaning aids that might
help the patient maintain good dental
health.
A good reason to keep teeth, gums and
braces clean during orthodontic
treatment is that clean, healthy teeth
move more quickly! This will help
keep treatment time as short as
possible.
Patients who are active in contact
sports, whether in organized programs or
just games in the neighborhood, should
wear a mouth guard. Talk with your
orthodontist about the kind of mouth
guard to use while braces are on.
What is
patient cooperation and how important is
it during orthodontic treatment?
Good “patient cooperation” means that
the patient not only follows the
orthodontist’s instructions on oral
hygiene and diet, but is also an active
partner in orthodontic treatment.
Successful orthodontic treatment is a
"two-way street" that requires a
consistent, cooperative effort by both
the orthodontist and patient. To
successfully complete the treatment
plan, the patient must carefully clean
his or her teeth, wear rubber bands,
headgear or other appliances as
prescribed by the orthodontist, avoid
foods that might damage braces and keep
appointments as scheduled. Damaged
appliances can lengthen the treatment
time and may undesirably affect the
outcome of treatment. The teeth and jaws
can only move toward their desired
positions if the patient consistently
wears the forces to the teeth, such as
rubber bands, as prescribed. Patients
who do their part consistently make
themselves look good and their
orthodontist look smart.
To keep teeth and gums healthy, regular
visits to the family dentist must
continue during orthodontic treatment.
How long does
treatment take?
Although every case is different,
generally speaking, patients wear braces
from one to three years. Treatment
times vary with factors that include the
severity of the problem, patient growth,
gum and bone response to tooth moving
forces and how well the patient follows
the orthodontists’ instructions on
dental hygiene, diet and appliance wear
(patient cooperation). Patients who
brush and floss thoroughly and
regularly; avoid hard, sticky, crunchy
and sticky foods; wear their rubber
bands and/or headgear as instructed; and
keep their appointments usually finish
treatment on time with good results.
After the braces are removed, most
patients wear a retainer for some time
to keep or “retain” the teeth in their
new positions. The orthodontist will
determine how long the retainer needs to
be worn. Most patients remain under the
orthodontist’s supervision during the
retention phase to ensure that the teeth
stay properly aligned.
Why are
retainers needed after orthodontic
treatment?
After braces are removed, the teeth can
shift out of position if they are not
stabilized. Retainers are designed to
hold teeth in their corrected, ideal
positions until the bones and gums adapt
to the treatment changes. Wearing
retainers exactly as instructed is the
best insurance that the treatment
improvements last longer. It is normal
for teeth to change with increasing age.
Will tooth
alignment change later?
Studies have shown that as people age,
their teeth may shift. This variable
pattern of gradual shifting, called
maturational change, probably slows down
after the early 20s, but still continues
to a degree throughout a lifetime for
most people. Even children whose teeth
developed into ideal alignment and bite
without treatment may develop
orthodontic problems as adults. The most
common maturational change is crowding
of the lower incisor (front) teeth.
Wearing retainers as instructed after
orthodontic treatment will stabilize the
correction and can prevent most of this
change.
What about
the wisdom teeth (third molars) - should
they be removed?
Research suggests that wisdom teeth do
not necessarily cause teeth to shift.
In most cases, removal of wisdom teeth
is done for general dental health
reasons rather than for orthodontic
health. Your orthodontist, in
consultation with your family dentist,
can provide guidance regarding removal
of wisdom teeth.
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Note
the white decalcification spots
on these teeth.
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Note
the reddened areas of gum where
the gum meets the teeth.
This is gingivitis.
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What happens
to teeth and gums if they are not kept
clean during orthodontic treatment?
Teeth can develop white spots,
called “decalcification,” when an
individual’s teeth are susceptible or
when oral hygiene has been poor. If
plaque is not regularly removed, the
patient can develop gum disease. This
is why the orthodontist, orthodontic
staff, the dentist and dental hygienist
stress dental hygiene—for the good of
the patient’s dental health. (see
photos of decalcification and gum
disease at right)
What can I do
to get my braces off sooner?
Follow the instructions your
orthodontist gives you with regards to
oral hygiene (keeping your teeth and
gums clean) and wearing your appliances
(e.g.: elastics, headgear, etc.)
Your cooperation may help speed up your
treatment.
What will
I look like with braces on?
Much will depend on the kind of braces
used for your treatment. Many
patients have silver-colored brackets
and wires while others may have
tooth-colored brackets or clear plastic
aligners. Braces are much less
noticeable today than they were
when each tooth had a metal band around
it. These are photos of a
patient the day his braces were placed.
Do you
have any suggestions on what foods I CAN
eat?
Choose foods that are softer.
Right after you get braces or whenever
they are adjusted, you may want foods
that require little or no chewing such
as soup and macaroni and cheese.
Cut or tear sandwiches and pizza rather
than biting into them.
What
happens if something breaks?
If a portion of the appliance breaks,
let your orthodontist know so that
arrangements can be made for repairs.
For more information see "Orthodontic
Emergencies and Other Problems".
My child
wants to get his/her tongue pierced.
Will this interfere with orthodontic
treatment?
Tongue-piercing jewelry may contribute
to breakage of appliances and to tooth
and gum damage from contact with the
stud.
