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 What is an Orthodontist?
An orthodontist is a specialist who has completed an advanced education program for two to three years following dental school, to learn the special skills required to manage tooth movement and guide facial development.
How Orthodontic Treatment Works
Orthodontic appliances can be made of metal, ceramic or plastic. They may be removable or they may be brackets bonded to the teeth. By placing a constant, gentle force in a carefully controlled direction, braces slowly move teeth to a corrected position. This is a great time to wear braces! Gone are the days when a metal band with a bracket was placed around each tooth. Most bonded brackets can be placed with no discomfort. You can choose brackets that are clear or metallic color. You can choose the color of the ties that hold the wire in brackets. Wires are also less noticeable than they used to be and the latest materials move teeth faster with less discomfort to patients.
Duration of Treatment
Treatment time typically ranges from 12-24 months. Interceptive, or early treatment procedures, may take as few as six months. This varies from patient to patient, depending on such factors as difficulty of the existing problem, age of the patient, certain physiological characteristics of the patient, and probably most important patient cooperation during treatment. The success of orthodontic treatment is keynoted by cooperation. It is very important that all instructions be carefully and completely followed.
The main areas of concern include:
- Wearing certain auxiliaries such as elastics and headgears as instructed (Note: headgears not necessary for all patients)
- Being present and on time for all appointments
- Maintaining good oral hygiene
- Minimizing appliance breakages
- Immediate reporting of broken appliances
Poor cooperation in any of these areas can markedly lengthen treatment time and may detract from the end result.
Appliances:
Herbst
- It will take a week or so to become accustomed to eating and biting with the appliance. Teeth and jaw muscle soreness is normal during this time. Be patient. Anytime something new is put in the mouth it takes time to get used to it.
- Sores may develop where the lower front hubs are pushing out into the lip. Wax may help. If the soreness does not improve within a week, please contact our office. Soreness may develop in the cheeks; if it does not improve within a week, again, please call to have the arms shortened on your appliance.
- Occasionally the rods may come out of the sleeves when you open very wide. Simply put the rod back in the sleeve if you can. If you are unable, call our office and we will do it for you. If this is happening excessively, please call and we will put longer rods in.
- Due to the complexity of this appliance it is very important to try and minimize breakages. Repairs are many times difficult, time consuming and expensive. Please try to minimize breakages as much as possible by being careful with the appliance.
- Daily check to see if the lower archwire has broken where it goes into the tube on the hub just behind the lower cuspid. It this occurs, call immediately to have it repaired.
- Please call immediately if anything breaks, if bands or crowns come loose, or wires break.
- The Herbst appliance is normally left in eight months. Occasionally it will be left in longer if needed in order to get the desired correction.
Rapid Palatal Expander
- Activate appliance one turn only, two times each day (each morning and night) for 8 to 10 days.
- A feeling of pressure is normal for several minutes following activation. There should be little or no pain involved. In the event of continuous pain, discontinue activation and call for an appointment immediately.
- A space may develop between the two upper front teeth after several days of activation. This is normal and will usually close spontaneously over a period of several weeks after activation is complete.
- It is very important to keep the appliance and the roof of the mouth meticulously clean at all times in order to avoid infections. Visually inspect tissues around the edges of the appliance daily and immediately report any signs of infection (redness and swelling)
- Care must be taken with the types of foods eaten as anything hard or chewy can loosen the attachments of the appliance to the teeth. In the event the appliance does come loose, it is very important that you contact our office immediately to set up an appointment to rebond/recement the appliance.
- It will take several days to adjust to having the appliance in the mouth. Speech will be affected during these first few days and the teeth may be sore. These are temporary conditions - be patient.
Bite Plate
- The bite-plate must be worn at all times, except when cleaning it after each meal, and while swimming. Your cooperation will determine how long it will have to be worn.
- Eating and speaking will most likely be discouraging the first few days. You are advised to eat soft foods such as eggs, cereals, and soups in preference to chewy meats or hard-crusted breads. However, in a few days, all foods can be eaten and, with a little practice and patience, all words pronounced.
- Cleanliness of both the bite-plate and all of the teeth against which the bite-plate fits is a must. Always remove the bite plate after each meal and rinse it. Clean the bite plate with a toothbrush and toothpaste each morning and night when you brush your teeth.
- Soreness of certain teeth is quite common during the first few days. Actual irritation of the gums, cheeks, or lips should also disappear within two to three days. If soreness is persistent or if any wire should be accidentally bent, phone the office for an emergency appointment.
- A bite-plate is constructed to keep the back teeth apart. Removing it and closing your teeth together will slow your treatment significantly.
- You may have to wear the bite-plate for several months. Try not to become discouraged these first few days as eating and speaking will gradually improve. Just be patient.
- There is a fee to replace lost bite plates.
Removable Retainer
- The retainer(s) are to be worn 24 hours a day until instructed otherwise. This is needed to stabilize the teeth in their new positions. If retainers are not worn consistently during this period the teeth can begin to move back to where they were before treatment.
- If a retainer does not fit (due to inconsistent wear, damage etc.) you must call our office immediately and set up an appointment. It is very important that this appointment be made as soon as possible.
- If a retainer becomes loose, do not attempt to adjust or discontinue wearing the retainer. Call for an appointment immediately.
- Never boil the retainer to sterilize it. The acrylic will distort.
- Retainers are to be kept in the provided retainer case whenever not in the mouth. No exceptions. If you don't have the retainer case with you, don't take the retainers out.
- Retainers are to be cleaned with a toothbrush and toothpaste twice each day (when you brush your teeth).
- There is a charge to replace broken or lost retainers. Please try to avoid this extra charge by following instructions closely.
- Note: All patients, following removal of braces, should see their dentist as soon as possible for a checkup and cleaning.
Bonded Retainer
(a wire permanently bonded to the back of the teeth)
- Care must be taken to try and avoid breaking the bonded retainer by watching what you bite into with your front teeth. Please do not bite into anything hard or chewy.
- Each tooth is attached to the wire with a small pad of white bonding material. Please inspect these bonds several times a week and call us immediately if one is missing or has come unattached from a tooth. Once a tooth comes unbonded it is free to move and often will do so. If this occurs the bonded retainer will have to be removed and remade.
- If the bonded wire comes completely unbonded it will have to be remade and there will be a charge. Please avoid this by calling us immediately when you can see a bond loose or missing. There is no charge to repair a loose bond.
- Please make sure and brush around the bonded retainer thoroughly twice a day removing all visible plaque. Instructions will be given at our clinic.
- Please understand: It is the patient's responsibility to care for the bonded retainer by being careful what you eat, to inspect it regularly for loose bonds, to call immediately if there are problems and to keep it clean.
Removable Appliance
- The appliance is to be worn 24 hours a day until instructed otherwise. Once the problem has been corrected the appliance will be worn at night only for several months to stabilize the correction.
- If the appliance does not fit (due to inconsistent wear, damage etc.) you must call our office immediately and set up an appointment. It is very important that this appointment be made as soon as possible.
- If a appliance becomes loose, do not attempt to adjust or discontinue wearing the appliance. Call for an appointment immediately.
- Never boil the appliance to sterilize it. The acrylic will distort.
- Removable appliances are to be kept in the provided retainer case whenever not in the mouth. No exceptions. If you don't have the retainer case with you, don't take the appliance out.
- The appliance is to be cleaned with a toothbrush and toothpaste twice each day (when you brush your teeth).
- If the appliance is broken, please bring it with you to our office. Many times the appliance can be repaired. Do not attempt to repair the appliance yourself.
- There is a charge to replace broken or lost appliances. Please try to avoid this extra charge by following instructions closely.
Headgears
- Need to be worn 14 hours per day in order to see any progress. Anything less will not work.
- Always bring both your headgear and the time sheet with you to every appointment. Total hours at end of each week.
- Be gentle. Never wear headgear while playing sports or roughhousing. Don't test breakaway system.
- Always call immediately if headgear is not fitting or bands have come loose.
- Teeth will be sore for three to four days. Soreness will stop if you are consistent.
- Keep tension on straps by moving to the second hole if needed.
- Make sure your inserting headgear correctly. Don't insert upside down.
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