What is the purpose of orthodontic treatment?
- Orthodontics is not merely for improving the aesthetics of the smile; orthodontic treatment improves malocclusions (incorrect bites).
- Malocclusions occur as a result of tooth or jaw misalignment, which affect the way you smile, chew, clean your teeth or feel about your smile.
Why should malocclusions be treated?
- According to studies by the American Association of Orthodontists, untreated malocclusions can result in a variety of problems.
- Crowded teeth are more difficult to properly brush and floss, which may contribute to tooth decay and/or gum disease.
- Protruding teeth are more susceptible to accidental chipping.
- Crossbites can result in unfavorable growth and uneven tooth wear.
- Openbites can result in tongue-thrusting habits and speech impediments.
- Ultimately, orthodontics does more than make a pretty smile - it creates a healthier one, too.
At what age should a screening be scheduled for my child?
- The American Association of Orthodontists recommends an initial orthodontic evaluation at 7 years old.
- Most children do not require orthodontic treatment at this age. However, early intervention can prevent the development of more serious problems for some children.
- We take a conservative approach to treatment. We recommend early intervention only if conditions are present which will adversely affect normal growth and development.
- Because permanent teeth erupt at different ages, an early consultation provides the opportunity to establish a recall schedule that best suits your child’s individual needs.
Can adults benefit from orthodontics?
- Orthodontics can be beneficial to adults as well as to children, as the mechanical process used to move teeth is the same at any age.
- Because adults are no longer growing, certain corrections may require more than braces alone, and the treatment may take a little longer.
What can I expect on my first visit?
- On your first visit, we will perform a health history review, ask you to describe your orthodontic and dental concerns and take a panoramic and cephalometric radiograph, if necessary.
- We will discuss your concerns and your dentist’s recommendations.
- We will perform an oral exam, looking for evidence of malocclusion (bite, crowding or spacing problems), as well as TMJ pathology (jaw joint problems), periodontal (gum) condition, oral hygiene and habits (thumb or finger sucking, tongue thrusting, etc.).
- We will provide for you a treatment plan, including treatment options, if possible, at this initial consultation.
- On occasion, the severity of the problems will necessitate further study prior to making treatment recommendations. If that is the case, we will schedule a case presentation after further records are gathered.
- In most cases, we will proceed with full records, which include radiographs, molds of the teeth and photographs, as well as the application of the braces, all on the second visit.
Do you have payment plans?
- We offer extended payment plans payable over many months for your convenience.
- We offer a no-initial down payment plan through Springstone Patient Financing, www.springstoneplan.com.
- We participate with CareCredit.
What are the different types of appliances you offer?
- If braces are prescribed for your specific needs, there are four different choices for brackets:
- Stainless steel brackets – These are silver-colored braces made of high-grade stainless steel. We use only micro-silver brackets, which are very small, more comfortable and more attractive than traditional metal braces. They are fun when colored ties (which hold the wire into the bracket) are added.
- Ceramic (clear) brackets – These are transparent braces, which are sometimes chosen for cosmetic reasons. The ceramic brackets will not discolor.
- Gold brackets – These are gold-plated stainless steel brackets, which are an option for those desiring a 24-karat gold smile while in treatment.
- Lingual brackets – These brackets attach to the back of the teeth, so they are hidden from view.
- If braces are not desired and your treatment plan does not necessitate them, we offer INVISALIGN, which utilizes a series of computer generated, clear, removable aligners, which progressively guide the teeth into alignment. Because they are nearly invisible, they are very esthetic. Ask us if you are a candidate for this method of treatment.
What are the parts of the braces?
- A band is a “wrap-around” ring on a back tooth, usually a molar, cemented into position with dental bonding cement.
- A bracket is a small rectangular or square shaped piece bonded onto the surface of any tooth
- A wire extends from tooth to tooth, held into position by small elastics (or “colors”) or metal ligatures. These guide the movement of the teeth.
- Spacers, or separators, are rubber pieces that are sometimes placed between teeth to create room to place an orthodontic band.
- Springs, or coils, are sometimes placed on an archwire between brackets to open or close space between teeth.
- Hooks on some brackets and bands allow attachment of rubber bands.
- Elastics, or rubber bands, are worn in various ways between the upper and lower teeth, and sometimes within the same arch, to apply pressure to achieve a perfect fit of the upper to lower teeth.
What should I do if my teeth are uncomfortable when the braces are applied?
- Please be assured that we use special high technology "memory" wires to gently guide the teeth into the correct alignment. These wires minimize discomfort because they exert gentle forces over a long period of time.
- If discomfort does occur, over-the-counter medications, such as ibuprofen (Advil, Nuprin, Motrin or a generic brand), taken prior to the appointment and just before bed are recommended, as long as there is no allergy to the medication.
- Warm salt water rinses (one teaspoon of salt in a glass of warm water) may help.
- Chewing soft, sugarless gum may help, but please note that this is helpful only if you experience no jaw joint discomfort.
- A soft diet is recommended during the first few days.
- Please let us know if you experience significant discomfort, because we are able to make adjustments more slowly, gently or work on one arch at a time, if necessary.
What foods should I avoid while in braces?
- Any food or candy that is sticky, hard or chewy should be avoided, because these will break brackets and bend wires.
- Hard foods such as apples and bagels, pizza crust, hard fruit, raw carrots and celery and nuts should be cut up into small pieces and eaten using the back teeth only.
- Hard foods to avoid include hard pretzels and popcorn kernels, although you may eat the fully popped popcorn.
- Tough-to-bite foods such as corn on the cob and meat on the rib should be removed from the cob or rib to avoid incising with the front teeth.
- Aside from foods, any hard object placed in the mouth and chewed can cause damage to the braces. These include pencils, pen tops and ice cubes.
How long does treatment last?
- The active stage of treatment, when the braces are on, will vary significantly depending on the severity of the problem. The amount of room available, the distance teeth must move, the health of the teeth, gum tissue and supporting bone and how closely you follow instructions all affect treatment time.
- Typically, once all permanent teeth have erupted, the treatment will last from 9 to 24 months.
- Certain bite problems will require earlier start times than others and may result in more extended treatment times and the possibility of extra treatment phases.
- We will be more able to give you specific recommendations and treatment times at our initial meeting.
How often will I be seen during treatment?
- We will see you approximately every four weeks.
- Certain oral conditions and different appliances require different appointment sequences.
What are my responsibilities with home care while the braces are on?
- Excellent oral hygiene (brushing and flossing) is a necessity, to avoid extended treatment times, as well as to prevent enamel scarring (white spots), caries (cavities) and gingivitis (gum disease).
- Use of fluoride toothpastes, good manual or electric tooth brushing technique and flossing are essential.
- Brushing is recommended after every meal or snack, paying careful attention to the areas at the gum line and around the brackets and underneath the wires where food and plaque can get stuck.
- We prescribe a fluoride mouthwash prescription as needed to help in the care of the teeth while in braces.
- We recommend regular cleanings and examinations every six months or more often as recommended by your dentist. We will be happy to remove wires for these cleanings if you inform us of an upcoming appointment at your dentist. We will also be happy to coordinate appointments for you if you would like. Please just ask the scheduling coordinators for assistance.
What should I do if I cannot make a scheduled appointment?
- Steady progress depends on keeping your appointments regularly, but if you must cancel an appointment, we would appreciate being notified at least 24 hours in advance. This way, the reserved time we have allotted for you may be given to someone else, and a new appointment time may be scheduled for you.
- Please understand that broken appointments may have to be rescheduled during school or working hours, as the early morning and late day time slots are the first to be taken.
What do I do if I have an emergency when the office is closed?
- Most emergency calls involve the loosening of a band or bracket from a tooth. Should the loosened bracket be on a tooth without an attached wire, it can simply be discarded.
- If the loosened bracket is being held to the wire with an elastic tie or color, the color may be removed to loosen the bracket from the wire and then the bracket may be discarded.
- If the loosened bracket is on the tooth farthest back and is attached to the wire, the wire, if poking, may be cut with pliers or a fingernail clipper. Alternatively, wax may be placed on the wire end, or on any loose bracket, until you are able to come to the office. Be sure to dry the area first before placing a small ball of wax.
- A loose band may be removed from the tooth by slipping it off the end of the wire or by clipping the wire in front of the band with pliers or a nail clipper. Please do not discard the band since it may be recemented later. Instead, bring it with you to your repair appointment.
- If you feel uncomfortable performing any of the above procedures on your own, please call the office for the phone number of the doctor on call.
- Most other problems, including loss of elastic colors, chains, rubber band attachments, etc. can wait until we are back in the office. Please give us a call at your earliest convenience.
- Please see the Emergency Information page for further information.
What should I expect from my rubber bands?
- Rubber bands are small elastics used to provide a gentle continuous force to your teeth.
- Rubber bands may cause your teeth to be sensitive for a few days, for which you may take ibuprofen or another pain medication.
- You may be tempted to remove the rubber bands at the beginning because of the discomfort, but resist the temptation to do so. Please take the pain medication instead, as this will allow your teeth to adjust to the new pressures the rubber bands are exerting. In a few days, you will no longer experience the discomfort.
- The “jiggling” of the teeth, which occurs with inconsistent rubber band wear, actually results in a resistance in the bone, which prevents the desired movement.
- Rubber bands must be worn as directed for optimal treatment results.
- Rubber bands should be worn all the time. They may be removed for eating, but only 3 times a day for 15 minutes at a time.
- Rubber bands should then be immediately replaced with new ones after brushing and flossing.
- Please carry extra rubber bands with you so that if one breaks, you may replace it immediately.
- Please do not run out of rubber bands. When starting to run low on your supply, come by one of the offices to pick up extras or call us and we will be happy to mail them to you. Please be sure to ask for the correct size.
Can I play sports while wearing braces?
- You may participate in any sport you choose.
- Let us know if you play a sport where there is a possibility of getting hit in the mouth, so that we can give you a special mouth guard worn during play to protect your teeth and soft tissues.
- Please do not wear a mouth guard that is made pliable in hot water and shaped to your teeth, as this type of mouth guard will not allow your teeth to move into the desired positions during orthodontic treatment.
Can I play my musical instrument?
- You may play any musical instrument.
- There may be some changes needed in your embouchure when playing a brass or woodwind instrument, but most patients readily adjust.
What is a retainer?
- A retainer is a custom-made appliance that helps to maintain the teeth in the corrected positions after braces are removed.
- A retainer can be either removable, or “permanent” (which means it is not removed by you but can be removed by us or your dentist and is completely reversible).
- A removable retainer may be a clear, Invisalign-type which completely encases the teeth or may have metal clasps and bars with plastic against the roof of the mouth.
What care can I expect after the braces are removed?
- Once the braces are removed, your teeth will be cleaned of bracket bonding material and band cement and you will receive your removable retainer.
- You will be instructed on the use and care of your retainer.
- Proper retainer wear is critical to the long-term success of your treatment.
- Retainers should be worn a minimum of five hours during the day and all night for the first 6 months. This is because your teeth are not completely settled in their new position until the bones, gums and muscles adapt to the change.
- Thereafter, nightly wear should suffice if you do not experience any discomfort when placing the retainer into position.
- Discomfort is an indication that the teeth are trying to relapse (or move back) to their original position. If you experience discomfort, please wear your retainer more, not less.