Braces and Other Appliances

How do braces straighten crooked teeth?

Braces use constant, gentle pressure, which over time, move teeth into their proper positions. Your braces are at work every moment of your orthodontic treatment. The two main components of your braces are: the brackets that are placed on your teeth and the main archwire that connects them. The bracket is a piece of shaped metal or ceramic that we affix to each tooth. The archwire is bent to reflect your “ideal” bite. In other words, it reflects the way we want you to look after treatment.

The wire threads through the brackets and, as the wire tries to return to its original shape, it applies pressure to move your teeth. Picture your tooth resting in your jaw bone. With pressure on one side from the archwire, the bone on the other side gives way. The tooth moves. New bone grows in behind.

Attached to your braces, elastics (rubber bands) exert the proper force that creates the right amount of pressure to move teeth. In order for this force to remain constant, elastics must be worn all the time and changed every day.

Different Types of Braces

Metal braces are the most popular with kids and teenagers. They love using different colors of ligature ties. These braces are much smaller than ever before.

Gold braces are the newest addition to our line of brackets. They are stainless steel braces coated with 24 karat gold. They have the strength of metal, but blend in with the color of the teeth much better. That is because most teeth have a natural yellow tint. Quite often, we will put ceramic braces on the top teeth and gold braces on the bottom.

Translucent clear ceramic braces are the most popular with adults. You have to be very close to someone to be able to see them. Yet, because they are a ceramic material, they are more fragile.

Invisalign® is a new type of teeth alignment that can straighten crooked teeth as well as spaced-out, crowded teeth. It has also been found to be effective at treating more complex dental conditions, such as overbites and deep bites. Of course the most obvious advantage of Invisalign® is in the name, its invisible appearance.

The aligners are formed specifically to fit each patient’s unique dental profile, gradually shifting each tooth into a correct and comfortable position. To adapt to the changing arrangement of your teeth, the aligner is switched out bi-weekly. Unlike traditional dental braces, Invisalign® can be removed before you eat, reducing the risk of broken braces and any unsightly food remnants.

Headgear

Orthodontic headgear is a very important part of the treatment for some patients. Headgear creates forces that guide the growth of the face and jaws. It also is used to move teeth into better positions or to prevent teeth from moving.

Maintaining constant use of your headgear will achieve the best results. If instructions on usage are not followed, treatment will take longer and our treatment plan may have to change.

Always be careful when removing your headgear. If the headgear is removed carelessly, the part that fits in your mouth and attaches to your teeth could injure your lips, cheeks, face and possibly your eyes.
Never remove the headgear until the straps have been disconnected.
Never lift the headgear over your face.
Never wear the headgear when running or playing sports.

Take your headgear with you to every appointment. If it becomes soiled, Your doctor will tell you how it should be cleaned.

Your teeth may be tender for the first few days of wearing your headgear. This tenderness will disappear as you adjust to the new pressures.

Let Your doctor know if you continue to be uncomfortable for more than a few days. Wearing headgear is necessary for your treatment. Follow the instructions exactly, and you will complete your treatment without any changes in your treatment plan.

Removable Appliances

Removable appliances, unlike conventional braces, are used to retain teeth in their corrected positions and in some cases, to influence growth of the jaws in order to effect changes in facial structure. In addition, they are often used before and in conjunction with fixed appliances.

Removable appliances are not utilized to treat all orthodontic problems. It takes skill, and experience to recognize conditions that will respond favorably to removable appliances. Timing of such therapy also is very important.

Although removable appliances can easily be taken out by the patient, there may be a tendency not to wear them as we have prescribed. This means your teeth, jaws and muscles may move back toward their original positions.

Removable appliances require care. Although you may notice an effect on eating and speaking along with an increase in the flow of saliva, you will eventually adjust to the appliance.

Retainers

Once the active period is completed, your braces are removed. The next step is called retention. Retainers are utilized to hold your teeth in their new positions until your bone, gums, and muscles adapt to the new teeth positions. You must wear your retainer as instructed, otherwise your teeth may move toward their original positions and the benefit of wearing your braces will be lost.

Your doctor will determine how long you need to wear your retainer. Time varies with each patient. Some people may need retainers for an extended period of time in order to eliminate shifting of the teeth. In some cases, permanent retention may be necessary.
The retention period is an important part of your overall treatment and should not be neglected!

Remember, wear them in your mouth, not in your pocket. Retainers work when you follow our instructions.

Clean your retainers! After meals, clean all parts of the retainer with a brush.

Handle your retainers with care. Retainers are easy to lose. If you take your retainers out, always place them in your retainer case for safety. Click here for more information on caring for your retainers.

Frequently Asked Questions

Questions from the patient

How do I know if my child is in need of orthodontic treatment?

It is usually difficult for you to determine if treatment is necessary because there are many problems that can occur even though the front teeth look straight. Also, there are some problems that look intimidating and complex which will resolve on their own. Asking your general dentist is good reference. Our initial exam is complimentary and we would be more than happy to see your child and make any recommendations necessary.

What are the early symptoms of orthodontic problems?

Although determining if treatment is necessary is difficult for you to assess, the following symptoms may help in prompting you to seek our orthodontic advice.

Ask your child to open their mouth, and let you look at their teeth. If you see any signs of crooked teeth, gaps between your child’s teeth or overlapping teeth, your child may need orthodontic treatment.

Ask your child to bite all the way down, but keeping their lips open so you can see their teeth. Do the front top teeth line up with the bottom? Do the top teeth protrude out away from the bottom teeth? Do the top front teeth cover more than 50% of the bottom teeth? Are the top teeth behind the bottom teeth? All these are indicators for potential orthodontic treatment.

Look at the alignment of your child’s jaw. Does the jaw shift off center when your child bites down? If you see any misalignment or shifting of the jaw, your child may have a skeletal problem, which requires early orthodontic intervention.

These are only some of the obvious symptoms of orthodontic problems.

What age should my child be seen by an orthodontist?

The American Association of Orthodontists recommends that your child be evaluated by age 7. Early detection of some orthodontic problems is important in order to take early corrective action and avoid more difficult treatment later.

Can you be too old for braces?

No, age is not a factor, only the health of your gums and bone which support your teeth. About 25% of our orthodontic patients are adults and that number is still growing!

Will it hurt?

Orthodontic treatment has improved dramatically. As a rule, braces make your teeth sore for a few days, but it is not painful. This annoyance can be relieved with an over-the-counter pain reliever. 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.

Can I still have braces if I have missing teeth ?

Yes. When teeth are missing, adjacent teeth will drift into the empty space. This will cause a functional, esthetic or periodontal problem. Orthodontic treatment will correct and prevent these problems and will also provide proper alignment for your dentist to replace the missing teeth.

Questions about the treatment

What is Phase I (Interceptive Treatment) and Phase II treatment?

Phase I or Interceptive Treatment usually starts while the child has most of their baby teeth and a few of their permanent front incisors. This stage in development is usually about the age of 7. The goal of Phase I treatment is to intercept a moderate or severe orthodontic problem early in order to reduce or eliminate it. These problems include skeletal dysplasia, crossbites and crowding. Phase I treatment takes advantage of the early growth spurt and turns a difficult orthodontic problem into a more manageable one. This helps reduce the need for extractions or surgery and delivers better long term results and treatment options. Most Phase I patients require a Phase II treatment in order to achieve an ideal bite.

Phase II treatment usually occurs a number of years later. Usually we are waiting for 12-16 more permanent teeth to erupt before Phase II begins. This most commonly occurs at the age of 12 or 13. The goal of Phase II treatment is to achieve an ideal occlusion with all of the permanent teeth.

What is Full or Comprehensive Orthodontic Treatment?

This is another name for orthodontic treatment in the permanent dentition at any age. It is more commonly used when a Phase I treatment was not performed.

Does everyone need a Phase I treatment?

Absolutely not! Only certain bites require early intervention. All others can wait until most if not all their permanent teeth erupt.

Can I wait on Phase I/Interceptive Orthodontic Treatment until my child is older?

This is not recommended. If your child needs Phase I treatment this usually means that there is a difficult problem that requires attention now. If no orthodontic action is taken, treatment options become limited, more difficult, and the long-term stability may be compromised. In addition, it may lead to extractions, oral surgery and increased costs and treatment times later.

What is the length or duration of orthodontic treatment?

Braces may be on between 6 months to 30 months, or longer depending on the age of the patient, the severity of the problem, the patient’s cooperation, and the degree of movement possible.

What are extraction and non-extraction therapy?

Extraction therapy is a technique where some teeth are removed to make room for the other teeth. This is in contrast to non-extraction therapy where one expands a patients’ jaw and shave down some teeth to make everything fit.