- What is Orthodontics?
- Why have orthodontic treatment?
- What are the most commonly treated orthodontic problems?
- How is orthodontic treatment undertaken?
- Are there less noticeable braces?
- Do braces hurt?
- How long does treatment last?
- Is it important to cooperate during treatment?
- How do I care for my braces and teeth?
- Are there risks to having orthodontic treatment?
- What happens after fixed brace removal?
- What if I break my brace?
What is Orthodontics?
- Orthodontics is the branch of dentistry that specialises in the diagnosis, prevention and treatment of dental and facial irregularities.
- Malocclusion, literally meaning ‘bad bite’, is the technical term used to describe teeth that are not straight or teeth that do not bite correctly.
Why have orthodontic treatment?
Orthodontic treatment can help in several ways:
- Crowded or crooked teeth are more difficult to clean and maintain over a long period of time. Difficulties with maintaining good oral hygiene may lead to tooth decay or periodontal (gum) disease, and eventual tooth loss. Orthodontic treatment can straighten teeth, making it easier to clean and maintain them.
- Malocclusions can lead to excessive tooth wear, abnormal strain on the jaw muscles and joints, and inefficient chewing. Orthodontic treatment can help achieve a balanced even bite, thereby reducing the strain on muscles and joints of the jaws and reducing the risk of abnormal wear.
- There is an increased risk of sustaining trauma to upper front teeth that stick out. Orthodontic treatment can reduce the prominence of upper front teeth and therefore reduce the likelihood of injuring them.
- Orthodontic can improve the appearance of the teeth. The value of an attractive smile should not be underestimated. A pleasing smile is a vital asset to one’s self-esteem, and a person’s self-confidence often improves as orthodontic treatment brings the teeth, lips and face into a harmonious balanced relationship.
Orthodontic treatment can be an outstanding investment in the overall health and psychological well being of an individual.
What are the most commonly treated orthodontic problems?
- Protruding upper front teeth;
- Open bite;
- Deep bite.
How is orthodontic treatment undertaken?
Orthodontic appliances (or braces):
- are custom-made;
- are prescribed and designed according to the problem being treated;
- apply gentle forces, using special wires, in a carefully controlled direction to precisely move the teeth through the supporting bone to a new more desirable position.
There are three main types of braces:
- Removable Appliances:
- are used to undertake simple tooth movements;
- have delicate wires and springs that move teeth using gentle pressure;
- can be used in younger patients who may still have baby teeth present;
- are removed for sports and tooth brushing.
- Functional Appliances:
- are usually removable;
- are also known as growth modification appliances;
- can be used to guide the growth and development of jaws in children where there may be a discrepancy in the size of upper to lower jaw.
- Fixed Appliances:
- are bonded/cemented to the teeth for the duration of treatment;
- comprise small attachments (brackets and bands) linked together using special orthodontic wires;
- are usually made of stainless steel, but tooth coloured brackets are also available as a more aesthetic alternative;
- are normally fixed to the outside of teeth (labial appliances), but special fixed braces that are stuck to the inside of teeth (lingual appliances) are also available.
Some patients may need to wear headgear and/or elastics to achieve the desired result. These can be applied and removed by the patient. Headgear usually needs to be worn at night-time.
Are there less noticeable braces?
- Modern orthodontic brackets are generally less noticeable than those of the past. Aesthetic brackets, made from tooth coloured ceramic or plastic, are much less obvious than braces made from stainless steel;
- Appliances are also available that can be fixed to the inside of teeth (lingual appliances);
- New wires with tooth coloured coating are also available and are less noticeable than uncoated wires;
- Clear removable appliances that work as a series of nearly invisible removable aligners are also available (e.g.. Invisalign, Simpli5).
Do braces hurt?
When braces are initially fitted, or after they have been adjusted, there may be some discomfort and tenderness. This usually lasts 3-5 days. If necessary, pain relief medication normally used for headaches may help When a brace is newly fitted it may take several days for the skin inside the mouth to adjust to the new brace. If there is rubbing or irritation, you can use a pea-sized piece of the protective orthodontic wax to cover the offending part of the brace to make the surface smother.
Patients who are prone to get mouth ulcers will often get ulcers when a brace is fitted. These often resolve after a few days once the skin in the mouth gets used to the brace.
How long does treatment last?
There are a range of treatment times from 9 months to 3 years or more. The average treatment time is 18 months.
Actual treatment time depends upon several factors:
- Initial severity of problem. Milder problems will require less time to treat;
- Patient cooperation;
- Some patients respond faster to treatment than others.
Is it important to cooperate during treatment?
Cooperation is essential to achieve the desired objectives.
Successful treatment results can only be achieved through teamwork. Patient (parent's) and orthodontist working together.
How do I care for my braces and teeth?
- Maintaining excellent oral hygiene is more important then ever for orthodontic patients;
- Tooth decay, decalcification, bad breath and gum disease can arise if teeth are not kept meticulously clean during orthodontic treatment;
- It is essential to brush your teeth twice a day with fluoride toothpaste;
- A fluoride containing mouthwash is also recommended for orthodontic patients;
- Special toothbrushes are available to allow teeth to be kept clean when you have fixed braces. These will be shown to you and will be available from our reception;
- Removable braces are removed for cleaning, and a normal toothbrush and toothpaste can be used;
- Orthodontic braces are delicate and must be treated with care. Breakages during treatment will extend the duration of treatment;
- Avoid eating hard or sticky foods (toffees, boiled sweets, chewing gum, crusts etc.) to prevent breakages;
- Cut food into small pieces before placing in mouth rather than using front teeth to bite into foods;
- Avoid foods with high sugar content, fruit drinks or fizzy drinks as frequent consumption of these types of food can lead to risk of developing permanent marks on your teeth;
- You must continue to visit your own dentist at regular intervals during orthodontic treatment.
Are there risks to having orthodontic treatment?
- If you do not keep your teeth clean during orthodontic treatment you are at risk of developing permanent marks on your teeth (decalcification) as seen on the adjacent picture, tooth decay or gum disease. These problems are all preventable if you take care of your teeth and gums;
- If you have too may fizzy drinks (diet and non-diet) or eat sugary foods/sweets frequently during treatment, there is risk of developing permanent marks on teeth. Fizzy drinks (carbonated drinks) are acidic and lead to damage to enamel of teeth. Sugary foods allow rapid build up of plaque, which in turn produces acid that leads to enamel damage;
- Teeth that have previously sustained trauma (i.e. have been knocked), may discolour and/or become non-vital. These teeth will need further treatment, usually undertaken by your own dentist. It is important to let your orthodontist know if you have previously sustained trauma to your teeth;
- All orthodontic treatment causes changes to roots of teeth. These are usually minor and of no significance. Rarely, orthodontic treatment may lead to root-shortening (root-resorption) which is more significant. It is often possible to predict if you are at particular risk of root shortening.
What happens after fixed brace removal?
- After completion of fixed brace treatment, you will be provided with retainers to wear. Retainers are designed to keep your teeth straight.
- Retainers can be:
- Removable: Can be removed for brushing, sports and eating
- Fixed: Usually attached to the inside of the front teeth
- Your orthodontist will discuss which retainer type is appropriate for you.
- Retainers are just as important as the braces in the overall treatment plan. It is important to wear retainers as instructed. If you do not wear retainers as instructed, your teeth are at risk of movement.
- Changes in position of teeth can continue throughout life and are part of the normal ageing/maturation process. Therefore, you should wear retainers at night times for as long as you want to maintain alignment of teeth.
What if I break my brace?
- You should contact us as soon as possible if you think your brace is broken. We will advise you what to do.
- In the meantime:
- If part of the fixed brace is broken and is causing irritation or rubbing, then apply the protective orthodontic wax to cover the offending component of the fixed brace to make the surface smoother.
- If your removable brace is broken do not wear it if it is uncomfortable or is at risk of being dislodged.
- If your head brace is broken or keeps on coming loose, stop wearing it and contact as soon as you can for advice.
- During an emergency visit, the orthodontist will make your brace comfortable. The broken brace may not be repaired till a later visit.