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Orthodontic Frequently
Asked Questions
Orthodontic Frequently Asked Questions
What
age should my child have an orthodontic evaluation? What age should my child have an orthodontic evaluation?
The American Association of Orthodontists (AAO)
recommends an orthodontic screening for children by the age of 7 years.
At age 7 the teeth and jaws are developed enough so that the dentist or
orthodontist can see if there will be any serious bite problems in the
future. Most of the time treatment is not necessary at age 7, but it
gives the parents and dentist time to watch the development of the
patient and decide on the best mode of treatment. When you have time on
your side you can plan ahead and prevent the formation of serious
problems.
Research has shown that serious orthodontic problems can be more easily corrected when the patient’s skeleton is still growing and flexible. By correcting the skeletal problems at a younger age we can prepare the mouth for the eventual eruption of the permanent teeth. If the permanent teeth have adequate space to erupt they will come in fairly straight. If the teeth erupt fairly straight their tendency to get crooked again after the braces come off is diminished significantly. After the permanent teeth have erupted, usually from age 12-14, complete braces are placed for final alignment and detailing of the bite. Thus the final stage of treatment is quicker and easier on the patient. This phase of treatment usually lasts from 12 - 18 month and is not started until all of the permanent teeth are erupted.
Doing orthodontic treatments in two steps
provides excellent results often allowing the doctor to avoid removal of
permanent teeth and jaw surgery. The treatment done when some of the
baby teeth are still present is called Phase-1. The last part of
treatment after all the permanent teeth have erupted is called Phase-2.
Crowded teeth, thumb sucking, tongue
thrusting, premature loss of baby teeth, a poor breathing airway caused
by enlarged adenoids or tonsils can all contribute to poor tooth
positioning. And then there are the hereditary factors. Extra teeth,
large teeth, missing teeth, wide spacing, small jaws - all can be causes
of crowded teeth.
Tooth movement is a natural response to
light pressure over a period of time. Pressure is applied by using a
variety of orthodontic hardware (appliances), the most common being a
brace or bracket attached to the teeth and connected by an arch wire.
Periodic changing of these arch wires puts pressure on the teeth. At
different stages of treatment your child may wear a headgear, elastics,
a positioner or a retainer. Most orthodontic appointments are scheduled
4 to 6 weeks apart to give the teeth time to move.
When teeth are first moved, discomfort may
result. This usually lasts about 24 to 72 hours. Patients report a
lessening of pain as the treatment progresses. Pain medicines such as
acetaminophen (Tylenol) or ibuprofen (Advil) usually help relieve the
pain. Arch
Wire / Brackets
/
Band & Loop (B&L)
/
Elastics (Rubber Bands)
The part of your braces which actually moves
the teeth. The arch wire is attached to the brackets by small elastic
donuts or ligature wires. Arch Wires are changed throughout the
treatment. Each change brings you closer to the ideal tooth position. Brackets are the “Braces” or small attachments that are bonded directly to the tooth surface. The brackets are the part of your braces to which the dentist or assistant attaches the arch wire.
Occasionally, a bracket may come loose and
become an irritation to your mouth. You can remove the loose bracket and
save it in an envelope to bring to the office. Call the office as soon
as possible and make an appointment to re-glue the bracket. A Band & Loop is routinely used to hold space for a missing primary (baby) posterior (back) tooth until the permanent tooth can grown in.
At some time during treatment, it will be
necessary to wear elastics to coordinate the upper and lower teeth and
perfect the bite. Once teeth begin to move in response to elastics, they
move rapidly and comfortably. If elastics (rubber bands) are worn
intermittently, they will continually "shock" the teeth and cause more
soreness. When elastics are worn one day and left off the next,
treatment slows to a standstill or stops. Sore teeth between
appointments usually indicate improper wear of headgear or elastics or
inadequate hygiene. Wear your elastics correctly, attaching them as you
were told. Wear elastics all the time, unless otherwise directed. Take
your elastics off while brushing. Change elastics as directed, usually
once or twice a day.
These are used to help modify the growth of
the jaws in children. The theory behind their action is that if you hold
a jaw in a specific position long enough, that it will grow into that
position. What you usually get is a combination of a little jaw growth
with a lot of tooth movement.
The facemask is used in conjunction with braces to
move the upper jaw forward to correct an underbite. Another appliance designed to encourage the lower jaw to grow forward and “catch up” to upper jaw growth.
Poor positioning of the teeth. Types of Malocclusion:
The alignment and spacing of your upper and lower teeth when you bite down. Types of Occlusion:
O rings, also called A-lastics, are little
rings used to attach the arch wire to the brackets. These rings come in
standard, gray or clear, but also come in a wide variety of colors to
make braces more fun. A-lastics are changed at every appointment to
maintain good attachment of the arch wire to the bracket, enabling our
patients to enjoy many different color schemes throughout treatment. A Palatal Widening Appliance is placed in the roof of the mouth to widen the upper dental arch. The maxilla, or upper dental arch, is joined in the center by a joint, which allows it to be painlessly separated and spread. Temporarily, you may see a space develop between the upper two front teeth. This will slowly go away in a few days. Once this has occurred, the two halves fuse back together and new bone fills in the space.
Care of appliance: Brush as usual. Brush the
appliance and roof of the mouth thoroughly. Rinse often to clean any
food lodged between the arch and appliance.
A plastic or rubber donut piece which the
dentist uses to create space
Braces Care / Appliance Care / Elastics Care / Proper Diet You will be shown the proper care of your braces when your orthodontic treatment begins. Proper cleansing of your mouth is necessary every time you eat. Teeth with braces are harder to clean, and trap food very easily. If food is left lodged on the brackets and wires, it can cause unsightly etching of the enamel on your teeth. Your most important job is to keep your mouth clean. If food is allowed to collect, the symptoms of gum disease will show in your mouth. The gums will swell and bleed and will slow down tooth movement. BRUSHING: You should brush your teeth 4-5 times per day.
Look in a mirror to see if you have missed any places. Your teeth, brackets and wires should be free of any food particles and plaque. Note: If your gums bleed when brushing, do not avoid brushing, but rather continue stimulating the area with the bristles. Be sure to angle your toothbrush so that the area under your gum line is cleaned. After 3 or 4 days of proper brushing, the bleeding should stop and your gums should be healthy again. FLOSSING: Use a floss threader or special floss to floss while you have braces. Be sure to floss at least once per day.
FLUORIDE RINSE OR GEL: May be
recommended for preventive measures. Now that you have your appliances, you must be sure to
brush your teeth and gums better than ever before.
Extra care must be taken in the area between the gums and
appliances. We call this the
“danger zone”. Food that collects
around your bands and wires can cause stains and cavities as well as
unpleasant odors, so be sure to keep your teeth clean.
Brush after each meal.
Take your time and do it right.
An electric toothbrush can be used.
A “Water Pik” appliance, if used conscientiously, is highly
recommended. However, the
Water Pik does not take the place of brushing.
Some foods can damage your orthodontic appliances.
In general there are two types of foods you should not eat; hard,
brittle foods and soft, sticky foods.
Some examples of each are as follows:
I. Hard, brittle foods
• Ice
• Hard edges of pizza • Pecans, peanuts, etc. • Popcorn (because the hulls get under the gum tissue) • Hard candy such as lifesavers, peppermint sticks, jolly ranchers • Beef Jerky
II. Soft, Sticky Foods
• Gum (includes sugarless, bubble gum)
• Sticky candy such as caramels, taffy, now and later’s, skittles, fruit chews.
III. Excessive use of soft drinks which are
usually high in sugar and acid, will permanently etch the teeth around
the braces, leaving white stains or cavities. Certain foods can be eaten if they are served in a
special way. Whole fruits
and vegetables such as apples and carrots should be sliced and eaten
carefully. Hard, crusty
breads should be broken and eaten in small pieces.
Fritos and potato chips are allowed if eaten carefully.
Fresh corn may be eaten if sliced off the cob.
Please exercise caution in your selection of food.
If you exceed the limit of eight loose bonds/bands, the patient
will be charged $25.00 per loose part. In general, keep pencils, fingernails, etc. out of
your mouth. Do not suck on
lemons or limes. Treat your
appliances as expensive, fine pieces of jewelry- in a real sense this is
what they are. With your
cooperation and efforts we will achieve the best results possible. Retainer Instructions
The retainer is a removable appliance carefully
designed to maintain the teeth in their corrected positions.
The retainers will fit properly when delivered.
If it does not fit in the future, this is because of lack of wear
or mutilation of the retainer.
If elastics (rubber bands) are worn
intermittently, they will continually "shock" the teeth and cause more
soreness. Sore teeth between appointments usually indicate improper wear
of headgear, elastics, or inadequate hygiene. Wear your elastics
correctly, attaching them as you were told. Wear elastics all the time,
unless otherwise directed. Take your elastics off while brushing. Change
elastics as directed, usually once or twice a day.
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A lower lingual arch is a space maintainer
for the lower teeth. It maintains the molars where they are, it does not
move them. This is fabricated by placing bands on the molars and
connecting them to a wire that fits up against the inside of the lower
teeth. It keeps the molars from migrating forward and prevents them from
blocking off the space of teeth that develop later. This is used when
you have the early loss of baby teeth or when you have lower teeth that
are slightly crowded in a growing child and you do not want to remove
any permanent teeth to correct the crowding.
between your teeth for bands.