Orthodontics

Orthodontic Frequently Asked Questions

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.

Why is it important to have orthodontic treatment at a young age?

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.

What causes crooked teeth?

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.

How do teeth move?

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.

Will it hurt?

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.

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Orthodontic Terms

Malocclusion

Poor positioning of the teeth.

Types of Malocclusion

Occlusion

The alignment and spacing of your upper jaw and lower teeth when you bite down.

Types of Occlusion:

O Rings

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.

Separator

A plastic or rubber donut piece which the dentist uses to create space between your teeth for bands.

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Fixed and Removable Appliances

Band & Loop (B & L)

A Band & Loop is routinely used to hold space for a missing primary (baby) posterior (back) tooth until the permanent tooth can grown in.

Bi Helix

An appliance used to expand the lower arch without interfering with tongue posture or movement.

Herbst

An appliance designed to encourage the lower jaw to grow forward and “catch up” to upper jaw growth.

Hawley

A universally used retainer with many applications; to move teeth, close spaces, maintain alignment during or after treatment.

Lower Lingual Arch (LLA)

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.

Nance

This appliance maintains the position of the maxillary molars without using any other teeth. The plastic button on the palate provides stability.

Retainers

At the completion of the active phase of orthodontic treatment, braces are removed and removable appliances called retainers are placed. To retain means to hold. Teeth must be retained or held in their new positions while the tissues, meaning the bone, elastic membranes around the roots, the gums, tongue and lips have adapted themselves to the new tooth positions. Teeth can move if they are not retained. It is extremely important to wear your retainers as directed!

Palatal Expander

An appliance which 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 knit back together and new bone fills in the space.

Quad Helix

This appliance provides continual, gradual pressure in as many as four directions, to move molars, expand or contract arches or assist in eliminating finger or thumb habits.

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Appliance Care

Clean the retainer by brushing with toothpaste. If you are wearing a lower fixed retainer be extra careful to brush the wire and the inside of the lower teeth. Always bring your retainer to each appointment. Avoid flipping the retainer with your tongue, this can cause damage to your teeth. Place the retainer in the plastic case when it is re-moved from your mouth. Never wrap the retainer in a paper napkin or tissue, someone may throw it away. Don't put it in your pocket or you may break or lose it. Excessive heat will warp and ruin the retainer.

Proper Diet

 

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Orthodontic Emergencies or Problems

Please feel free to contact the office if you are experiencing any discomfort or if you have any questions. 

Sore Teeth

You may be experiencing some discomfort after beginning treatment or at the change of wires or adjusting of appliances. This is normal and should diminish within 24-72 hours. A few suggestions to help with the discomfort:

1. Rinse with warm water, eat a soft diet, take acetaminophen (Tylenol) or ibuprofen (Advil) as directed on the bottle.
2. Chewing on the sore teeth may be sorer in the short term but feel better faster.
3. If pain persists more than a few days, call our office.