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Dec 17, 2016

Common questions

Questions below are meant for child orthodontics but are in general applicable to adults

What are some possible benefits of orthodontics?

  • A more attractive smile
  • Less worry over appearance during critical development years
  • Better function of the teeth
  • Possible increase in self-confidence
  • Increased ability to clean the teeth
  • Improved force distribution and wear patterns of the teeth
  • Better long-term health of teeth and gums
  • Guide adult/permanent teeth into more favourable positions
  • Reduce the risk of injury to protruded front teeth
  • Aids in optimising other dental treatments

What are some signs that braces may be needed?

  • Upper front teeth protrude excessively over the lower teeth, or are “bucked”
  • Upper front teeth cover the majority of the lower teeth when biting together (deep bite)
  • Upper front teeth are behind or inside the lower front teeth (underbite)
  • The upper and lower front teeth do not touch when biting together (open bite)
  • Crowded or overlapped teeth
  • The centre of the upper and lower teeth do not line up
  • Finger or thumb sucking habits which continue after six or seven years old
  • Difficulty chewing
  • Teeth wearing unevenly or excessively
  • The lower jaw shifts to one side or the other when biting together
  • Spaces between the teeth

At what age should orthodontic treatment occur?
Orthodontic treatment can be started at any age. Many orthodontic problems are easier to correct if detected at an early age before jaw growth has slowed. Early treatment may mean that a patient can avoid surgery and more serious complications. The American Association of Orthodontists recommends that every child first visit an orthodontist by age 7 or earlier if a problem is detected by parents, the family dentist, or the child’s physician.

What is Phase I and Phase II (two-phase) treatment?
Phase I (first phase or early interceptive treatment), is limited orthodontic treatment (i.e. expander or partial braces) before all of the permanent teeth have erupted. Such treatment can occur between the ages of six and ten. This treatment is sometimes recommended to make more space for developing teeth, correction of crossbites, overbites, underbites, or harmful oral habits. Phase II treatment is also called comprehensive treatment because it involves full braces when all of the permanent teeth have erupted, usually between the ages of eleven and thirteen.

What is the advantage of a two-phase treatment?
Two-phase orthodontic treatment is a very specialised process that encompasses tooth straightening and physical, facial changes. The major advantage of two-phase treatment is that it maximises the opportunity to accomplish an ideal healthy, functional, aesthetic result that will remain stable throughout a patient’s life.

Would an adult patient benefit from orthodontics?
Orthodontic treatment can be successful at any age. Everyone wants a beautiful and healthy smile. Adults make up 20-25 percent of orthodontic patients today, and this percentage is growing each year.

What is surgical orthodontics?
Just as orthodontics repositions teeth, surgical orthodontics (also known as orthognathic surgery) corrects jaw irregularities to improve a patient’s ability to chew, speak, breathe, and for improved facial appearances also. In other words, surgical orthodontics straightens the jaw. Moving the jaws also moves the teeth, so braces are always performed in conjunction with jaw correction. This helps ensure that teeth are in their proper positions after surgery.

Who needs surgical orthodontics?
An orthodontist will consider surgical orthodontic treatment for non-growing adult patients with improper bites and those with facial aesthetic concerns. Jaw growth is usually completed by age 16 for girls and 18 for boys. All growth must be completed before jaw surgery can be performed. However, the pre-surgical tooth movements can begin 1-2 years prior to these ages.

How does surgical orthodontics work?
During orthodontic treatment (which usually lasts 6-18 months), a patient will wear braces and visit the orthodontist for scheduled adjustments to his or her braces. Surgery is performed in the hospital with an oral surgeon. After completing surgery, most patients should be able to return to school or work within 1-2 weeks. After the necessary healing time (about 4-8 weeks), the orthodontist “fine-tunes” the patient’s bite. In most cases, braces are removed within 6 months following surgery.

How does orthodontic treatment work?
Braces apply steady gentle pressure to gradually move teeth into their proper positions. The brackets that are placed on teeth and the arch wire that connects them are the main components. When the arch wire is placed into the brackets, it tries to return to its original shape. As it does so, the arch wire applies pressure that moves teeth to their new, more ideal positions.

How long does orthodontic treatment take?
Treatment times vary on a case-by-case basis, but the average time is from one to two years. Actual treatment time can be affected by rate of growth and severity of the correction necessary. Treatment length is also dependent upon patient compliance. Maintaining good oral hygiene and keeping regular appointments are important in keeping treatment time on schedule.

Do braces hurt?
Overall, most orthodontic discomfort is brief and easily managed. The placement of bands and brackets on your teeth does not hurt. Once braces are placed and connected with the arch wires there may be some general soreness of the teeth for one to four days. A patient’s lips and cheeks (soft tissue) may need one to two weeks before adapting to the braces. Orthodontic wax helps reduce soft tissue irritation during this period. Most patients manage their discomfort with whatever pain medication they may commonly take for a headache.

Will braces interfere with playing sports?
No. It is recommended, however, that patients protect their smiles by wearing a mouth guard when participating in any sporting activity. Mouth guards are inexpensive, comfortable, and come in a variety of colours and patterns.

Will braces interfere with playing musical instruments?
No. However, there may be an initial period of adjustment. In addition, brace covers can be provided to prevent discomfort.

What if I delay treatment?
The disadvantage of waiting for complete eruption of permanent teeth and having only one phase of treatment for someone with a jaw discrepancy is facing the possibility of a compromised result that may not be stable.

Should I see my general dentist while I have braces?
Yes, you should continue to see your general dentist every six months for cleanings and dental checkups.

First Phase Treatment:

The foundation for a lifetime of beautiful teeth
The goal of first phase treatment is to develop the jaw size in order to accommodate all the permanent teeth and to relate the upper and lower jaws to each other. Children occasionally exhibit early signs of jaw problems as they grow and develop. An upper and lower jaw that is growing too much or not enough can be recognized at an early age. If children after age 6 are found to have this jaw discrepancy, they are candidates for early orthodontic treatment.

Planning now can save smiles later
Because they are growing rapidly, children can benefit enormously from an early phase of orthodontic treatment utilizing appliances that direct the growth relationship of the upper and lower jaws. Thus, a good foundation can be established that provides adequate room for eruption of all permanent teeth. This early correction may prevent later removal of permanent teeth to correct overcrowding and/or surgical procedures to align the upper and lower jaws. Leaving such a condition untreated until all permanent teeth erupt could result in a jaw discrepancy that is too severe to achieve an ideal result with braces alone.

Making records to determine each unique treatment
Orthodontic records (diagnostics) will be necessary to determine the type of appliances to be used, the duration of treatment time, and the frequency of visits. Records consist of models of the teeth, x-rays, and photographs.

Resting Period
In this phase, the remaining permanent teeth are allowed to erupt. Retaining devices are not usually recommended since they may interfere with eruption. It is best to allow the existing permanent teeth some freedom of movement while final eruption of teeth occurs. A successful first phase will have created room for teeth to find an eruption path. Otherwise, the teeth may become impacted or severely displaced.

Monitoring a patient’s progress
At the end of the first phase of treatment, teeth are not in their final positions (which will be determined and accomplished in the second phase of treatment). Selective removal of certain primary (baby) teeth may be in the best interest of enhancing the eruption of permanent teeth during this resting phase. Therefore, periodic recall appointments for observation are necessary, usually on a six-month interval.

Second Phase Treatment:

Stay healthy and look attractive
The goal of the second phase is to make sure each tooth has an exact location in the mouth where it is in harmony with the lips, cheeks, tongue, and other teeth. When this equilibrium is established, the teeth will function together properly.

Movement & Retention
At the beginning of the first phase, orthodontic records are made and a diagnosis and treatment plan is established. Certain types of appliances are used in the first phase, as dictated by the problem. The second phase is initiated when all permanent teeth have erupted, and usually requires braces on all the teeth for an average of 24 months. Retainers are worn after this phase to ensure retention of a beautiful smile. This is normally the final phase of treatment.

Fixed braces
Removable braces