Orthodontic Questions

What is Orthodontics?

Orthodontics comes from two Greek words: “orthos” meaning correct or straight and “dons” meaning tooth. To have orthodontic treatment is to have your ‘teeth corrected’.

Orthodontics is the branch of dentistry which specialises in the diagnosis, prevention and treatment of problems in the alignment of teeth and jaws.

Nearly one million people in the UK started having orthodontics last year and more adults than ever before are having treatment.

Orthodontic treatment involves the use of corrective appliances (such as fixed braces, removable appliances and functional appliances) to bring the teeth and jaws into proper alignment.

Why should I have Orthodontic treatment?

Orthodontic treatment is about getting a great smile, making the best of your teeth and improving the harmony of your mouth and jaws. Once you can bite together correctly, you can eat more comfortably and care for your teeth and gums more easily.

In society today people are very aware of how teeth look and an attractive smile can play an important role in enhancing self-confidence.

These are some of the most common reasons for a referral:

1. Protruding upper front teeth – one of the most common dental problems
2. Crowding – a narrow jaw may mean there is not enough room for your teeth, resulting in crowding
3. Spacing – some patients have significant gaps between their teeth
4. Asymmetry – particularly when the centre lines of the upper and lower front teeth do not match, perhaps because the teeth have drifted or the position of the jaw has shifted
5. A deep bite – when your upper teeth cover the lower teeth too much
6. A reverse bite – when your upper teeth bite inside the lower teeth
7. An open bite – when your front teeth remain apart when your back teeth meet; the tongue is often still visible between the upper and lower front teeth
8. Impacted teeth – in some patients, secondary teeth come through in the wrong position or do not erupt at all. Orthodontic treatment can help bring these teeth into the correct position.

What are the benefits of orthodontic treatment and straight teeth?

Straight teeth help an individual to effectively bite, chew and speak. It’s more difficult to clean your teeth when they are crowded and overlapping. Inadequate cleaning is a major factor in tooth decay, gum disease and eventual tooth loss. Straight teeth are much easier to keep clean and contribute towards healthy teeth and gums.

An attractive smile is a wonderful asset. It contributes to self-esteem, self-confidence and self-image-important qualities at every age. A pleasing appearance is a vital component of self-confidence.

A person’s self-esteem often improves as orthodontic treatment brings teeth, lips and face into proportion. In this way, orthodontic treatment can often benefit social and career success, as well as improve a person’s general attitude toward life.

Can anyone have orthodontics or am I too old?

Age is not a limiting factor – patients of all ages can be treated successfully providing they have healthy teeth and gums. Many things that are possible in adolescents are equally possible in adults; crooked teeth can be straightened out in much the same way.

With major advances in orthodontic technology it means that there are now many exciting choices in the appearance and feel of your braces with the added benefit that treatment times are shorter than ever.

At Fairoak Orthodontics we can create great smiles offering you a wide choice of modern braces – ask us about our range of aesthetic (Clarity/Invisalign/Lingual) and fast-acting braces (Damon/Smartclip) or have a look at our at our treatments page on the website.

I don’t want to wear the metal braces – What are my options?

Have a look at our “Treatment” pages to see the choice of modern aesthetic braces we offer at Fairoak Orthodontics.

At what age should children have their first orthodontic appointment?

Most children begin treatment around the age of 12 or 13, once all their permanent teeth have erupted. In a few instances treatment is better started early and your dentist may want to make an earlier referral. But age is not a barrier to treatment and the number of adults seeking treatment is on the increase.

How long will orthodontic treatment take?

It is impossible to give a definite answer. Simple cases may be completed in a few months, the average case may take 12-18 months, while complex cases may take longer. Patients vary a lot as to how fast their teeth will move and this is something which cannot be predicted in advance of treatment.

On average cases needing extractions take longer than non-extraction cases. Your orthodontist will be able to give you an estimate of the likely timescale.

What happens at my first visit?

The orthodontist will examine your mouth to assess the problem. You may have X-rays and/or photographs taken. Impressions or “moulds” of your teeth will also be needed before treatment starts.

The orthodontist will then want to discuss the possibilities for treatment with you and agree how to proceed. It is very unlikely that you would have braces fitted at the first appointment.

Extractions – Are they necessary?

Straightening the teeth often needs additional space. Extractions may well be needed if sufficient space cannot satisfactorily be created in other ways. This decision is taken as part of the orthodontic assessment. The extractions are normally carried out by your own dentist rather than the orthodontist

Extractions as part of orthodontic treatment are required somewhat less frequently than in the past on account of advances in orthodontic techniques. There has been widespread adoption of braces in children which take advantage of the growth of the patient’s jaw to correct the bite, possibly also creating small amounts of additional space in the dental arch. These braces, known as functional appliances, are routinely used now by most orthodontists and can often avoid the need for extractions. Other advances have likewise reduced the proportion of cases where extractions are recommended.

There is little doubt that well-planned orthodontic treatment can both improve the bite and enhance a patient’s overall appearance. Every course of treatment needs to be tailored to the needs of the individual patient. For many patients, in order to get the best appearance and long-term result, extractions will still be part of the process.

In reaching a decision on extractions, a full assessment of the patient’s face, teeth and state of development is essential. A meaningful opinion cannot be given on whether extractions will be required in the absence of such an assessment. Any offer to treat without extractions made before such an assessment should be regarded with considerable caution.

Will treatment be painful?

Fitting a brace is not painful; However for a few days afterwards the teeth and gums will almost certainly ache as the teeth start to move. This is to be expected and is not a cause for concern and the aching will stop in a few days. Your cheeks can also get sore until they are used to the brace; wax will be provided that can help this. You may find small gaps appearing where they weren’t before or the teeth slightly mobile, this is all very normal when you start orthodontic treatment.

It may be helpful to take your normal painkillers for a day or two until things settle down. The amount of discomfort varies enormously from person to person.

Some further discomfort may be experienced when the brace is adjusted subsequently, but this depends very much on what adjustments have been made.

Today’s braces are smaller, more comfortable and use technology that reduces the discomfort. We use the latest in miniature braces and the highest quality of orthodontic materials in order to reduce discomfort and treatment time.

How often will I need an appointment?

You will usually need to have appointments every 8 to 10 weeks. It is not advisable to start treatment if you know you will not be able to keep regular appointments.

Should I have check-ups with my own dentist during orthodontic treatment?

Yes definitely; the orthodontist only looks after the braces. Your teeth are actually at greater risk during orthodontic treatment and it is particularly important that you keep up regular contact with your own dentist.

Do I have to get referred to you from my dentist?

No – we are happy to see you without a referral from your dentist.

Can I have “colours”?

Teenagers are often treated with metal braces and the “colours” are the tiny elastic rings which hold the wires into the brackets on your teeth. They are readily available in many different colours so you can personalise your brace if you wish.

With modern fast-acting metal/aesthetic brackets the “colours” are no longer needed to hold the wires in place as the brackets can do it themselves with special clips. We know how many children love the “colours” so we can still get around this even using the modern braces, ask your orthodontist.

Will the brace affect what I can eat?

In order to prevent damage to both your teeth and brace, you will need to avoid the following:

• Toffees, boiled sweets, chewing gum, hard chewy food stuffs, etc.
• Fizzy drinks including diet drinks, excessive amounts of fruit juice.
• Hard foods which might damage the brace such as crunchy apples, crusty bread, etc.

The slightly harder foods can be eaten with care if you cut them up into smaller pieces first and eat them on your back teeth.

Have a look at our Fixed Appliance Instruction Sheet in the “Treatment” section.

Will orthodontic treatment damage my teeth? What are the risks involved with orthodontics?

All forms of medical and dental treatment, including orthodontics, have potential risks and limitations. Fortunately, in orthodontics, complications are infrequent and, when they do occur, they are usually of minor consequence. Nevertheless, all potential risks and limitations should be considered when making the decision to undergo orthodontic treatment.

Oral Hygiene

It is important that you brush your teeth well, at least three times per day, and it is essential that you use a fluoride toothpaste. It is a good idea to keep a travel toothbrush on you so you can brush your brace after meals.

A fluoride mouthrinse should also be used last thing at night (FluoriGard), after tooth brushing, to further protect the teeth. If the teeth are not cleaned properly, problems such as gum disease, tooth decay, and decalcification (white or coloured marks on the teeth) can result.

Failure to keep your teeth and brace clean will lead to permanent scarring of your teeth.

Root Shortening

In some patients the length of the roots of the teeth may be shortened during orthodontic treatment. Some patients are prone to this happening some are not. It is nearly impossible to predict susceptibility.

Usually this shortening does not have significant consequences, but on very rare occasions it may become a threat to the longevity of the teeth involved.

Relapse

Teeth may have a tendency to change their positions after treatment. The long term wear of retainers should reduce this tendency.

Will I still be able to play contact sports?

Yes, but it is recommended you wear a gumshield when doing so. Your orthodontist will be able to advise you on this.

What if I play a musical instrument?

If you play a wind instrument, particularly the flute or a brass instrument, then a fixed brace may make it more difficult; however; with practice most patients adapt and are able to continue playing. You will need to discuss this with your music teacher.

What if my brace breaks during treatment and I have an emergency?

Thankfully true orthodontic emergencies are rare. You will need to contact the practice for an emergency appointment for the brace to be repaired.

Repeated breakages will slow down the treatment and increase the overall treatment time. As a rule, every time the brace is broken 1-2 months is added on to the normal treatment time of 6 – 18 months.

If you repeatedly break the brace, treatment may be stopped, leaving your teeth in a worse position than when you started.

Emergency tips:

1. Occasionally brackets (the small metal or ceramic squares) become ‘detached’ from the teeth. If this occurs, use the wax in the starter kit to stop any rubbing and contact the practice. If you haven’t got wax on you, chewing gum can be a useful substitute.
2. If there is a wire poking out of the back of the brace this can also be dressed with wax.

How do fixed braces work?

Teeth respond to the gentle forces that are applied to them. “Braces” are a combination of “brackets” and “wires”.

Brackets are the part of the braces that attach to the teeth. Brackets are the “handles” that help control movement of the teeth.

Braces require a wire called an “archwire” that connects the brackets and provides the forces to steer the teeth in the proper direction. It’s actually the wires that move teeth.

The interaction of brackets and archwires enables the orthodontist to have three-dimensional control over the movement of the teeth.

In many cases, additional forces are needed to help balance the underlying jaw structure and to help the upper and lower teeth fit properly together to make the bite right. An example of these extra forces include: elastics (rubber bands) hooked to teeth;

Will I need retainers?

YES – The tissues around the roots take time to adjust to the new tooth positions and there is a particular risk of relapse in the early months after the brace is removed. Even in the longer term some risk remains and the best advice is to continue retention indefinitely.

Retainers may be removable or fixed:

• Removable retainers are clear plastic mouth guards, usually worn at night time initially and the wear reduced with time. They are effective but obviously depend on the patient remembering to wear them. They will need occasional repair or replacement.
• Fixed retainers are usually bonded to the back of the teeth. They are therefore in place all the time and are highly effective. A high standard of tooth cleaning in the vicinity of the retainer is essential to avoid gum problems.They do need regular inspection because if any of the bonds fails, the tooth in question may start to drift out of position. For this reason it is essential for the patient to contact the orthodontist at once if there is a breakage. They will need occasional repair or replacement.

What can be done without wearing braces?

Orthodontics can be a lengthy process. Some patients prefer to have crowns or veneers fitted to their teeth instead in order to mask the irregularity. Whether this is feasible in any particular case needs good professional advice.

These restorative approaches offer the attraction of rapid results and may be the treatment of choice in some cases. Drawbacks that you need to be aware of are:

• The preparation of the teeth is, to a greater or lesser extent, a destructive and irreversible process
• The crowns or veneers cannot be expected to last indefinitely and the need for replacements over the years should be borne in mind
• There are definite limits to the amount of irregularity which can be tackled successfully in this way. Veneers can be become excessively thick, crowns can only be reshaped by a limited extent
• There may be adverse effects on the underlying gum tissues over the years from having the edges of the crowns or veneers close by.

How much will orthodontic treatment cost?

There is no “going rate” for private orthodontic treatment. Costs are typically in the range £2000 to £4000.

The cost of treatment depends on several factors. Orthodontics for adults tends to cost more than for children. The overall cost will be affected by the complexity of the case and the type of brace to be used.

To obtain a definite figure you will need to arrange a consultation with the orthodontist – this should not involve you in any commitment to proceed with treatment. The orthodontist will then be able to assess the problem, discuss the options with you and set out the costs.

We offer several flexible payment methods in order to accommodate your specific needs.

How successful is orthodontic treatment?

This very much depends on your commitment to the treatment. As a general rule, patients who co-operate well with treatment get good results, whilst those who do not co-operate well, get poor results. Unless retainers are worn in the longer term some settling and growth changes may occur after treatment.