Common Orthodontic Questions

Orthodontic Treatment

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 reduced 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

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

How long does orthodontic treatment take?

The length of Orthodontic treatment is approximately 2 years for comprehensive treatment with fixed appliances i.e. braces in the young adult (eg.14 – 12 years old).

In specific conditions two phases of treatment (one in early childhood and one in early adolescence) might be required that will influence the treatment time.

The best way to get an accurate estimation of treatment time for your specific case would be to visit your orthodontist for a consultation. There is a lot of variation in treatment procedures, all influencing treatment timing, therefore the best idea is to visit your Orthodontist to investigate all the options.

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.

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 a significant percent of orthodontic patients today, and this percentage is growing.

Are there any side effects of Orthodontic treatment?

There are many things to keep in mind before initiating Orthodontic treatment, however, most of these considerations are only serious in approximately %2 of the population. The best would be to discuss all possible negative effects with your Orthodontist prior to treatment.

Some of the possible negative effects are the following, but once again the emphasis is placed on discussion with your Orthodontist.

• Enamel decalcification eg. White spot development
• Related to inadequate oral hygiene during treatment
• Gum disease (Periodontal disease) worsening.
• Related to inadequate oral hygiene during treatment.
• Periodontal disease do not develop due to Orthodontic treatment, but may be aggravated depending on your disease status and oral hygiene measures.
• Root resorption eg. Tooth root shortening
• Related to all tooth movements, but normally minor in nature.
• Injuries due to broken appliances or inaccurate use of appliances.

What are my responsibilities if I am undergoing Orthodontic treatment?

There are a number of responsibilities that the patient has to remember in order to enable your Orthodontist to give you the best treatment result possible.

• Impeccable oral hygiene is non-negotiable during treatment. Inadequate oral hygiene may necessitate the early removal of appliances, in order to prevent any irreversible damage to your teeth.
• Religious use of your anchorage devices and elastics, if provided by your Orthodontist. The use of these devices will enable your Orthodontist to make your treatment time as short as possible.
• Honour all appointments timeously. By lengthening the time between adjustments the rate of tooth movement becomes decreased, this may increase treatment time.
• Retainer wear following treatment maintains your result.

For how long does a patient have to wear the retainers following orthodontic treatment?

Orthodontic treatment moves the teeth into positions that they are not genetically meant to be in, apart from this fact, the tissues stabilizing the teeth connects each tooth to the one beside it. This means that when the teeth are moved, the fibers connecting the teeth to each other are twisted. The natural straightening of these fibers takes very long, and is one of the main reasons for movement of the teeth into their original positions.

Therefore, retainers are given to patients following Orthodontic treatment, to stabilize the teeth in their new positions, and enable the twisted fibers to reorganize in their new positions. Thus retainer wear is essential in order to maintain your treatment result. The Orthodontist is not responsible for any tooth movement after treatment is finished in the absence of adequate retainer wear.

If your retainer is broken or lost, it is in your best interest to replace or repair it as soon as possible in order to avoid movement of your teeth.

When is the best time to do bleaching of my teeth if I am planning to do orthodontic treatment?

The best time to bleach your teeth is after you have had your Orthodontic treatment completed, not before.

Will I be required to replace some of my current fillings, bridges or crowns before or after Orthodontic treatment?

Quite often it is necessary to replace current restorations (fillings) seeing as those fillings have been done in a situation where the occlusion/bite was not optimal. Sometimes it is impossible to move the teeth in the correct positions with current crowns, bridges or restorations, and your Orthodontist may ask you to replace these with new restorations/fillings prior or post treatment to maintain your optimal treatment result.

What if I cannot finish my treatment as I’m relocating to another country?

Sometimes you have to move to a new country during your orthodontic treatment. That means you have to find a new orthodontist who will help continue your course of care. You’ll be happy to know that most of the “transfer” cases we’ve experienced continued on without any issues.

Your Snö Orthodontist will give you all your treatment details and records. The orthodontic appliances we use have international standards so you will be able to continue your treatment in any major city in the world.

Children and Orthodontics

When is the best time to start orthodontic treatment?

The optimal timing for Orthodontic treatment depends on the condition of the baby teeth (deciduous teeth), the adult teeth (permanent teeth), the relationship of the jaws to the face (growth) and how these elements influence each other.

The optimal time to take your child for an orthodontic consultation is at the age of 7-8 years. This is the most efficient time that specific condition can be treated, and that your Orthodontist can advise you on the future problems that may develop, as well as the next time an examination has to be done in order to diagnose any problems early.

Early treatment at a young age can most often eliminate or reduce orthodontic problems in the future.

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 11 and 13.

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.

Braces

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 in chewing.
• Teeth wearing unevenly or excessively
• The lower jaw shifts to one side or the other when biting together
• Spaces between the teeth

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. A customised mouth guard made by your Snö Orthodontist will ensure the most comfort and protection.

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.

What about my smile can be changed with braces?

Teeth can be moved in all directions, up down, backwards or forwards. This enables the Orthodontist to straighten teeth, and move them to the front and back within the face. This helps to increase or decrease lip support, which in turn changes the prominence of the lips and lower part of the face in relation to the nose and chin.

Teeth can also be rearranged in order to replace lost teeth with implants or bridges, or close spaces in between teeth where a tooth has been lost. There are limitations to the movements that can be attained in the presence of lost teeth, and you should discuss this with your Orthodontist in depth before initiating treatment.

What about my face can be changed with braces?

Orthodontics in conjunction with Orthognatic surgery enables the Orthodontist to correct deviations present in the relationships the upper jaw, lower jaw and the middle of the face have with each other. This is most commonly seen as bringing the lower jaw forward if this jaw’s growth has been deficient in comparison with the upper jaw, or bringing the lower jaw backward if that growth has been excessive in comparison to the upper jaw.

Any jaw movement can be performed in order to correct the underlying skeletal deviation and can have a tremendously positive effect on the patient’s function and appearance.

Jaw surgery, or Orthognathic surgery is performed by a Maxillo-facial and Oral surgeon, and is preceded by Orthodontic treatment (braces) in order to increase the success and stability of the surgery. After the surgery, the final movements of the teeth are done with braces in order to get the optimal result.

What is the relationship between braces and habits a patient may have?

There are many habits a person might have that can be the cause of a malocclusion or influence the position of the teeth in a negative manner. This can include, but is not limited to:

• Abnormal tongue posture and movements eg. Protrusive resting tongue posture
• Changes in swallowing patterns eg. Tongue thrust swallowing
• Object biting habits eg. Nailbiting, pen chewing
• Mouth breathing or open mouth sleeping
• Sucking habits eg. Lip sucking, thumb sucking

Most habits are present in childhood, and thus can effect the final position and appearance of the adult/permanent teeth.

Surgical Orthodontics

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 2-1 years prior to these ages.

How does surgical orthodontics work?

During orthodontic treatment (which usually lasts 18 – 16 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 2-1 weeks. After the necessary healing time (about 8-4 weeks), the orthodontist “fine-tunes” the patient’s bite. In most cases, braces are removed within 6 months following surgery.

Miscellaneous

What is the relationship between Orthodontic treatment/braces and Jaw joint pain (Temporomandibular Dysfunction)?

If jaw joint problems exist before Orthodontic treatment, your Orthodontist may advise specific procedures to help in minimizing, or removing discomfort. All jaw joint problems present before treatment should be relieved before initiating Orthodontic treatment.

If jaw joint problems develop during treatment, your Orthodontist may advise a pause in treatment to help the body to normalize the condition of the jaw joints before continuing treatment.

Many studies have been done by Orthodontists and other dental and medical professionals to try and establish the relationship between Orthodontic treatment and Jaw joint symptoms, up to date, no definite relationship has been established.

What is occlusal equilibration, esthetic bonding & enamel reshaping?

In some situations, the genetic size of the teeth make it impossible to get a perfect result and fit of the teeth. This may necessitate occlusal equilibration, enamel reshaping or esthetic bonding may be required to get the optimal result wanted.

This may necessitate the selective grinding (occlusal equilibration) of some tooth surfaces in order to fit (interdigitate) perfectly with each other. If some teeth are smaller than their optimal size, or misshapen, esthetic bonding and enamel reshaping may be suggested in order to improve the appearance of specific teeth, and therefore the whole smile.

These options will be discussed with you if your Orthodontist feels it necessary.