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How do braces feel? |
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Why does orthodontic treatment time sometimes last longer than anticipated? |
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Why are retainers needed after orthodontic treatment? |
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Do teeth with braces need special care? |
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Are there less noticeable braces? |
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How is treatment accomplished? |
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What are orthodontic study records? |
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What does orthodontic treatment cost? |
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How long will orthodontic treatment take? |
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How can a child's growth affect orthodontic treatment? |
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How does adult treatment differ from that of children and adolescents? |
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I have painful jaw muscles and jaw joints - can an orthodontist help? |
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What kinds of orthodontic appliances are typically used to correct jaw-growth problems?
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Can my child play sports while wearing braces? |
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Will my braces interfere with playing musical instruments? |
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Why is orthodontic treatment important? |
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What are the most commonly treated orthodontic problems? |
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At what age can people have orthodontic treatment? |
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What are the benefits of early treatment? |
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What causes orthodontic problems (malocclusions) |
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How do braces feel?
Most people have some discomfort after their braces are first put on or when adjusted during treatment. After the braces are on, teeth may become sore and may be tender to biting pressures for three to five days. Patients can usually manage this discomfort well with whatever pain medication they might commonly take for a headache. The orthodontist will advise patients and/or their parents what, if any, pain relievers to take. The lips, cheeks and tongue may also become irritated for one to two weeks as they toughen and become accustomed to the surface of the braces. Overall, orthodontic discomfort is short-lived and easily managed. |
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Why does orthodontic treatment time sometimes last longer than anticipated?
Estimates of treatment time can only be that - estimates. Patients grow at different rates and will respond in their own ways to orthodontic treatment. The orthodontist has specific treatment goals in mind, and will usually continue treatment until these goals are achieved. Patient cooperation, however, is the single best predictor of staying on time with treatment. Patients who cooperate by wearing rubber bands, headgear or other needed appliances as directed, while taking care not to damage appliances, will most often lead to on-time and excellent treatment results. |
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Why are retainers needed after orthodontic treatment?
After braces are removed, the teeth can shift out of position if they are not stabilized. Retainers provide that stabilization. They are designed to hold teeth in their corrected, ideal positions until the bones and gums adapt to the treatment changes. Wearing retainers exactly as instructed is the best insurance that the treatment improvements last for a lifetime. |
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Do teeth with braces need special care?
Patients with braces must be careful to avoid hard and sticky foods. They must not chew on pens, pencils or fingernails because chewing on hard things can damage the braces. Damaged braces will almost always cause treatment to take longer, and will require extra trips to the orthodontist’s office.
Keeping the teeth and braces clean requires more precision and time, and must be done every day if the teeth and gums are to be healthy during and after orthodontic treatment. Patients who do not keep their teeth clean may require more frequent visits to the dentist for a professional cleaning. .
The orthodontist and staff will teach patients how to best care for their teeth, gums and braces during treatment. The orthodontist will tell patients (and/or their parents) how often to brush, how often to floss, and, if necessary, suggest other cleaning aids that might help the patient maintain good dental health.
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Are there less noticeable braces?
Today’s braces are generally less noticeable than those of the past when a metal band with a bracket (the part of the braces that hold the wire) was placed around each tooth. Now the front teeth typically have only the bracket bonded directly to the tooth, minimizing the "tin grin." Brackets can be metal, clear or colored, depending on the patient’s preference. Modern wires are also less noticeable than earlier ones. |
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How is treatment accomplished?
Custom-made appliances, or braces, are prescribed and designed by the orthodontist according to the problem being treated. They may be removable or fixed (cemented and/or bonded to the teeth). They may be made of metal, ceramic or plastic. By placing a constant, gentle force in a carefully controlled direction, braces can slowly move teeth through their supporting bone to a new desirable position. .
Orthopedic appliances, such as headgear, Herbst and maxillary expansion appliances, use carefully directed forces to guide the growth and development of jaws in children and/or teenagers. For example, an upper jaw expansion appliance can dramatically widen a narrow upper jaw in a matter of months. Over the course of orthodontic treatment, a headgear or Herbst appliance can dramatically reduce the protrusion of upper incisor teeth (the top four front teeth) or retrusion of the lower jaw (a lower jaw that is too far behind the upper jaw), while making upper and lower jaw lengths more compatible.
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What are orthodontic study records?
Diagnostic records are made to document the patient’s orthodontic problem and to help determine the best course of treatment. As orthodontic treatment will create many changes, these records are also helpful in determining progress of treatment. Complete diagnostic records typically include a medical/dental history, clinical examination, plaster study models of the teeth, photos of the patient’s face and teeth, a panoramic or other X-rays of all the teeth, a facial profile X-ray, and other appropriate X-rays. This information is used to plan the best course of treatment, help explain the problem, and propose treatment to the patient and/or parents. .
The profile X-ray, or cephalometric film, shows the facial form, growth pattern, and inclination of the front teeth (if teeth are tipped or tilted), which are essential in planning comprehensive treatment. Panoramic or other dental X-rays are used to locate impacted teeth, missing teeth, and shortened or damaged tooth roots, to determine the amount of bone supporting teeth, and to evaluate position and development of permanent teeth that have not yet come in, among other things. From the necessary records, a custom treatment plan is created for each patient.
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What does orthodontic treatment cost?
The actual cost of treatment depends on several factors, including the severity of the patient’s problem and the treatment approach selected. You will be able to thoroughly discuss fees and payment options before any treatment begins. We offer convenient payment plans to patients. Generally, treatment fees may be paid over the course of active treatment. Arrangements include an initial down payment with monthly installments to make treatment affordable. Our office can also help you by filling out your insurance claims so that you may be reimbursed for the treatment received. |
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How long will orthodontic treatment take?
In general, active treatment time with orthodontic appliances (braces) ranges from one to three years. Interceptive, or early treatment procedures, may take only a few months. The actual time depends on the growth of the patient’s mouth and face, the cooperation of the patient and the severity of the problem. Mild problems usually require less time, and some individuals respond faster to treatment than others. Use of rubber bands and/or headgear, if prescribed by the orthodontist, contributes to completing treatment as scheduled. .
While orthodontic treatment requires a time commitment, patients are rewarded with healthy teeth, proper jaw alignment and a beautiful smile that lasts a lifetime. Teeth and jaws in proper alignment look better, work better, contribute to general physical health and can improve self-confidence.
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How can a child's growth affect orthodontic treatment?
Orthodontic treatment and a child's growth can complement each other. A common orthodontic problem to treat is protrusion of the upper front teeth ahead of the lower front teeth. Quite often this problem is due to the lower jaw being shorter than the upper jaw. While the upper and lower jaws are still growing, orthodontic appliances can be used to help the growth of the lower jaw catch up to the growth of the upper jaw. Abnormal swallowing may be eliminated. A severe jaw length discrepancy, which can be treated quite well in a growing child, might very well require corrective surgery if left untreated until a period of slow or no jaw growth. Children who may have problems with the width or length of their jaws should be evaluated for treatment no later than age 10 for girls and age 12 for boys. The AAO recommends that all children have an orthodontic screening no later than age 7 as growth-related problems may be identified at this time. |
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How does adult treatment differ from that of children and adolescents?
Adults are not growing and may have experienced some breakdown or loss of their teeth and bone that supports the teeth. Orthodontic treatment may then be only a part of the patient's overall treatment plan. Close coordination may be required between the orthodontist, oral surgeon, periodontist, endodontist and family dentist to assure that a complicated adult orthodontic problem is managed well and complements all other areas of the patient's treatment needs. Below are the most common characteristics that can cause adult treatment to differ from treatment for children.
No jaw growth: Jaw problems can usually be managed well in a growing child with an orthopedic, growth-modifying appliance. However, the same problem for an adult may require jaw surgery. For example, if an adult's lower jaw is too short to match properly with the upper jaw, a severe bite problem may result. The limited amount that the teeth can be moved with braces alone may not correct this bite problem. Bringing the lower teeth forward into a proper bite relationship could require jaw surgery, which would lengthen the lower jaw and bring the lower teeth forward into the proper bite. Other jaw-width or jaw-length discrepancies between the upper and lower jaws might also require surgery for bite correction if tooth movement alone cannot correct the bite. .
Gum or bone loss (periodontal breakdown): Adults are more likely to have experienced damage or loss of the gum and bone supporting their teeth (periodontal disease). Special treatment by the patient's dentist or a periodontist may be necessary before, during and/or after orthodontic treatment. Bone loss can also limit the amount and direction of tooth movement that is advisable. .
Worn, damaged or missing teeth: Worn, damaged or missing teeth can make orthodontic treatment more difficult, but more important for the patient to have. Teeth may gradually wear and move into positions where they can be restored only after precise orthodontic movement. Damaged or broken teeth may not look good or function well even after orthodontic treatment unless they are carefully restored by the patient's dentist. Missing teeth that are not replaced often cause progressive tipping and drifting of other teeth, which worsens the bite, increases the potential for periodontal problems and makes any treatment more difficult.
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I have painful jaw muscles and jaw joints - can an orthodontist help?
Jaw muscle and jaw joint discomfort is commonly associated with bruxing, that is, habitual grinding or clenching of the teeth, particularly at night. Bruxism is a muscle habit pattern that can cause severe wearing of the teeth, and overloading and trauma to the jaw joint structures. Chronically or acutely sore and painful jaw muscles may accompany this bruxing habit. An orthodontist can help diagnose this problem. Your family dentist or orthodontist may also place a bite splint or nightguard appliance that can protect the teeth and help jaw muscles relax, substantially reducing the original pain symptoms. |
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What kinds of orthodontic appliances are typically used to correct jaw-growth problems?
Correcting jaw-growth problems is done by the process of dentofacial orthopedics. Some of the more common orthopedic appliances used by orthodontists today that help the length of the upper and lower jaws become more compatible include: :
Headgear: This appliance applies pressure to the upper teeth and upper jaw to guide the rate and direction of upper jaw growth and upper tooth eruption. The headgear may be removed by the patient and is usually worn 10 to 12 hours per day. .
Herbst: The Herbst appliance is usually fixed to the upper and lower molar teeth and may not be removed by the patient. By holding the lower jaw forward and influencing jaw growth and tooth positions, the Herbst appliance can help correct severe protrusion of the upper teeth. .
Palatal Expansion Appliance: A child's upper jaw may also be too narrow for the upper teeth to fit properly with the lower teeth (a crossbite). When this occurs, a palatal expansion appliance can be fixed to the upper back teeth. This appliance can markedly expand the width of the upper jaw .
The decision about when and which of these or other appliances to use for orthopedic correction is based on each individual patient's problem. Usually one of several appliances can be used effectively to treat a given problem. Patient cooperation and the experience of the treating orthodontist are critical elements in success of dentofacial orthopedic treatment.
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Can my child play sports while wearing braces?
Yes. Wearing a protective mouthguard is advised while playing any contact sports. Your orthodontist can recommend a specific mouthguard. |
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Will my braces interfere with playing musical instruments?
Playing wind or brass instruments, such as the trumpet, will clearly require some adaptation to braces. With practice and a period of adjustment, braces typically do not interfere with the playing of musical instruments. |
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Why is orthodontic treatment important?
Crooked and crowded teeth are hard to clean and maintain. This may contribute to conditions that cause not only tooth decay but also eventual gum disease and tooth loss. Other orthodontic problems can contribute to abnormal wear of tooth surfaces, inefficient chewing function, excessive stress on gum tissue and the bone that supports the teeth, or misalignment of the jaw joints, which can result in chronic headaches or pain in the face or neck.
When left untreated, many orthodontic problems become worse. Treatment by a specialist to correct the original problem is often less costly than the additional dental care required to treat more serious problems that can develop in later years. .
The value of an attractive smile should not be underestimated. A pleasing appearance is a vital asset to one’s self-confidence. A person's self-esteem often improves as treatment brings teeth, lips and face into proportion. In this way, orthodontic treatment can benefit social and career success, as well as improve one’s general attitude toward life.
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What are the most commonly treated orthodontic problems?
Crowding: Teeth may be aligned poorly because the dental arch is small and/or the teeth are large. The bone and gums over the roots of extremely crowded teeth may become thin and recede as a result of severe crowding. Impacted teeth (teeth that should have come in, but have not), poor biting relationships and undesirable appearance may all result from crowding. .
Overjet or protruding upper teeth: Upper front teeth that protrude beyond normal contact with the lower front teeth are prone to injury, often indicate a poor bite of the back teeth (molars), and may indicate an unevenness in jaw growth. Commonly, protruded upper teeth are associated with a lower jaw that is short in proportion to the upper jaw. Thumb and finger sucking habits can also cause a protrusion of the upper incisor teeth.
Deep overbite: A deep overbite or deep bite occurs when the lower incisor (front) teeth bite too close or into the gum tissue behind the upper teeth. When the lower front teeth bite into the palate or gum tissue behind the upper front teeth, significant bone damage and discomfort can occur. A deep bite can also contribute to excessive wear of the incisor teeth. .
Open bite: An open bite results when the upper and lower incisor teeth do not touch when biting down. This open space between the upper and lower front teeth causes all the chewing pressure to be placed on the back teeth. This excessive biting pressure and rubbing together of the back teeth makes chewing less efficient and may contribute to significant tooth wear. .
Spacing: If teeth are missing or small, or the dental arch is very wide, space between the teeth can occur. The most common complaint from those with excessive space is poor appearance. .
Crossbite: The most common type of a crossbite is when the upper teeth bite inside the lower teeth (toward the tongue). Crossbites of both back teeth and front teeth are commonly corrected early due to biting and chewing difficulties.
Underbite or lower jaw protrusion: About 3 to 5 percent of the population has a lower jaw that is to some degree longer than the upper jaw. This can cause the lower front teeth to protrude ahead of the upper front teeth creating a crossbite. Careful monitoring of jaw growth and tooth development is indicated for these patients.
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At what age can people have orthodontic treatment?
Children and adults can both benefit from orthodontics, because healthy teeth can be moved at almost any age. Because monitoring growth and development is crucial to managing some orthodontic problems well, the American Association of Orthodontists recommends that all children have an orthodontic screening no later than age 7.
Some orthodontic problems may be easier to correct if treated early. Waiting until all the permanent teeth have come in, or until facial growth is nearly complete, may make correction of some problems more difficult.
Some signs or habits that may indicate the need for an early orthodontic examination are:
a. early or late loss of baby teeth,
b. difficulty in chewing or biting,
c. mouth breathing,
d. thumb sucking,
e. finger sucking,
f. crowding, misplaced or blocked out teeth,
g. jaws that shift or make sounds,
h. biting the cheek or roof of the mouth,
i. teeth that meet abnormally or not at all,
j. jaws and teeth that are out of proportion to the rest of the face.
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What are the benefits of early treatment?
For those patients who have clear indications for early orthodontic intervention, early treatment presents an opportunity to:
a. guide the growth of the jaw,
b. regulate the width of the upper and lower dental arches (the arch-shaped jaw bone that supports the teeth),
c. guide incoming permanent teeth into desirable positions,
d. lower risk of trauma (accidents) to protruded upper incisors (front teeth),
e. correct harmful oral habits such as thumb- or finger-sucking,
f. reduce or eliminate abnormal swallowing or speech problems,
g. improve personal appearance and self-esteem,
h. potentially simplify and/or shorten treatment time for later corrective orthodontics,
i. reduce likelihood of impacted permanent teeth (teeth that should have come in, but have not), and
j. preserve or gain space for permanent teeth that are coming in.
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What causes orthodontic problems (malocclusions)
Most malocclusions are inherited, but some are acquired. Inherited problems include crowding of teeth, too much space between teeth, extra or missing teeth, and a wide variety of other irregularities of the jaws, teeth and face.
Acquired malocclusions can be caused by trauma (accidents), thumb, finger or dummy (pacifier) sucking, airway obstruction by tonsils and adenoids, dental disease or premature loss of primary (baby) or permanent teeth. Whether inherited or acquired, many of these problems affect not only alignment of the teeth but also facial development and appearance as well.
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