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Early Orthodontics
Orthodontic Frequently
Asked Questions
Orthodontic Terms
Orthodontic Care
Orthodontic
Emergencies/Problems
Orthodontics, or braces as they are more commonly known, consists of
placing brackets and banding the teeth. They are mainly for
straightening the teeth for cosmetic and functional purposes. They do
not change the shape of the teeth or jaws. The shape of the jaws and
face can only be enhanced during the growth period of your child.
We
offer traditional and tooth colored braces. After your child has been
examined, one of the doctors will inform you of which of these options
are available.
Early Orthodontics
Early Treatment can create
Beautiful Smiles
Often times bad habits like mouth
breathing, thumb sucking and tongue thrusting, for instance, can
cause the appearance of an ugly face that has a severe overbite,
horse-like teeth, underbite or crossbites. Early treatment and
elimination of these bad habits can help stop this Ugly Face
syndrome. Remember the earlier you treat, the more the face adapts
to your treatment as your childs face is still growing. The later
you treat, the more the treatment has to adapt to fit your face
because your teenager has stopped growing dentally. Don't focus only
on the teeth, "Look at the Face!"
Age 7, A Year to Remember
In the past orthodontic treatment was
often postponed until after eruption of all the permanent teeth. We
now know that many orthodontic problems are better treated earlier
in childhood by utilizing the growth that takes place in younger
children.
The American Association of Orthodontists recommends that every
child have an orthodontic evaluation by age 7 or earlier if a
problem is detected. Although treatment may not begin at this young
age, the doctors may elect to monitor your child's dental
development. Early detection greatly reduces the need for removal of
permanent teeth.
Treatment is sometimes recommended for
younger children and because children are usually enthusiastic and
cooperative, total treatment time is often reduced. Orthodontic
results are often achieved which would not otherwise be possible
once the face and jaws have stopped growing.
Benefits of Early Treatment
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The benefits of early treatment are:
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Influence jaw growth in a positive
manner.
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Harmonize width of the dental
arches.
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Improve eruption patterns.
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Lower risking trauma to protruded
upper incisors.
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Correct harmful oral habits.
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Improve esthetics and self-esteem.
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Simplify and shorten treatment time
for later orthodontic procedures.
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Reduce likelihood of impacted
permanent teeth.
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Preserve or gain space for erupting
teeth.
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Orthodontic
Frequently Asked Questions
What
age should my child have an orthodontic evaluation?
Why is it important to have orthodontic treatment at a young age?
What Causes Crooked Teeth?
/ How Do
Teeth Move? /
Will It Hurt?
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.
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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.
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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.
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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.
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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
Arch
Wire / Brackets
/
Band & Loop (B&L)
/
Elastics (Rubber Bands)
Functional Appliances
/
Headgear / Herbst
/ Lower Lingual Arch (LLA)
Malocclusion /
Occlusion /
Openbite
/ Overbite /
Overjet
O
rings /
Palatal Widening Appliance
/ Retainers
/
Separator
Arch Wire
The part of your braces which actually moves
the teeth. The arch wire is attached to the brackets by small elastic
donuts or ligature wires. Arch Wires are changed throughout the
treatment. Each change brings you closer to the ideal tooth position.
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Brackets
Brackets are the “Braces” or small
attachments that are bonded directly to the tooth surface. The brackets
are the part of your braces to which the dentist or assistant attaches
the arch wire.
Occasionally, a bracket may come loose and
become an irritation to your mouth. You can remove the loose bracket and
save it in an envelope to bring to the office. Call the office as soon
as possible and make an appointment to re-glue the bracket.
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 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.
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Elastics (Rubber Bands)
At some time during treatment, it will be
necessary to wear elastics to coordinate the upper and lower teeth and
perfect the bite. Once teeth begin to move in response to elastics, they
move rapidly and comfortably. If elastics (rubber bands) are worn
intermittently, they will continually "shock" the teeth and cause more
soreness. When elastics are worn one day and left off the next,
treatment slows to a standstill or stops. Sore teeth between
appointments usually indicate improper wear of headgear or elastics or
inadequate hygiene. Wear your elastics correctly, attaching them as you
were told. Wear elastics all the time, unless otherwise directed. Take
your elastics off while brushing. Change elastics as directed, usually
once or twice a day.
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Functional
Appliances
These are used to help modify the growth of
the jaws in children. The theory behind their action is that if you hold
a jaw in a specific position long enough, that it will grow into that
position. What you usually get is a combination of a little jaw growth
with a lot of tooth movement. These are not universally accepted, as
they do not always work.
The first of these appliances were removable and are still very popular.
They are made of plastic and wire. Some of their names are Frankel,
Bionator, and Twin-block. A different style is actually fixed to the
teeth and uses a spring action to hold the jaw into position. These have
names like Herbst and Jasper Jumper.
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Headgear
Often called a “night brace”. The headgear
is used to correct a protrusion of the upper or lower jaw. It works by
inhibiting the upper jaw from growing forward, or the downward growth of
the upper jaw or even by encouraging teeth to move forward, if that is
the case.
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 Herbst
Another appliance designed to encourage the
lower jaw to grow forward and “catch up” to upper jaw growth.
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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.
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Malocclusion
Poor
positioning of the teeth.
Types
of Malocclusion:
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Class I
A Malocclusion where the bite
is OK (the top teeth line up with the bottom teeth) but the
teeth are crooked, crowded or turned. |
Class II
A Malocclusion where the upper
teeth stick out past the lower teeth. |
Class III
A Malocclusion where the lower
teeth stick out past the upper teeth. This is also called an
"underbite". |
Occlusion
The
alignment and spacing of your upper and lower teeth when you bite down.
Types
of Occlusion:
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Openbite
- Anterior opening between upper
and lower teeth.
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Overbite
- Vertical overlapping
of the upper teeth over the lower.
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Overjet
- Horizontal projection
of the upper teeth beyond the lower.
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Crossbite
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When top teeth bite inside the lower teeth. It can occur with
the front teeth or back teeth.
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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.
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 Palatal
Widening Appliance
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.
Care of appliance: Brush as usual. Brush the
appliance and roof of the mouth thoroughly. Rinse often to clean any
food lodged between the arch and appliance.
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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!
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Separator
A plastic or rubber donut piece which the
dentist uses to create space between your teeth for bands.
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Orthodontic Care
Braces Care
/ Appliance
Care /
Elastics Care
/ Proper
Diet
Braces Care
You will be shown the proper care of your
braces when your orthodontic treatment begins. Proper cleansing of your
mouth is necessary every time you eat. Teeth with braces are harder to
clean, and trap food very easily. If food is left lodged on the brackets
and wires, it can cause unsightly etching of the enamel on your teeth.
Your most important job is to keep your mouth clean. If food is allowed
to collect, the symptoms of gum disease will show in your mouth. The
gums will swell and bleed and the pressure from the disease will slow
down tooth movement.
BRUSHING: You should brush your teeth
4-5 times per day.
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Brush
back and forth across……between the wires and gums on the upper and
lower to loosen any food particles.
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Next,
brush correctly as if you had no brackets or appliances on.
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Start
on the outside of the uppers with the bristles at a 45 degree angle
toward the gum and scrub with a circular motion two or three teeth at
a time using ten strokes, then move on.
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Next,
do the same on the inner surface of the upper teeth.
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Then,
go to the lower teeth and repeat steps A & B.
Look in a mirror to see if you have missed
any places. Your teeth, brackets and wires should be free of any food
particles and plaque.
Note: If your gums bleed when
brushing, do not avoid brushing, but rather continue stimulating the
area with the bristles. Be sure to angle your toothbrush so that the
area under your gum line is cleaned. After 3 or 4 days of proper
brushing, the bleeding should stop and your gums should be healthy
again.
FLOSSING: Use a special floss
threader to floss with your braces on. Be sure to floss at least once
per day.
FLUORIDE RINSE OR GEL: May be
recommended for preventive measures.
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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.
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Elastics
Care
If elastics (rubber bands) are worn
intermittently, they will continually "shock" the teeth and cause more
soreness. Sore teeth between appointments usually indicate improper wear
of headgear or elastics or inadequate hygiene. Wear your elastics
correctly, attaching them as you were told. Wear elastics all the time,
unless otherwise directed. Take your elastics off while brushing. Change
elastics as directed, usually once or twice a day.
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Proper Diet
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Avoid Sticky Foods
such as: |
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Caramels |
Skittles |
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Candy bars with
caramel |
Starbursts |
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Fruit Roll-Ups |
Toffee |
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Gum |
Gummy Bears |
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Candy or caramel
apples |
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Avoid
Hard or Tough Foods such as: |
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Pizza Crust |
Ice cubes |
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Nuts |
Bagels |
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Hard Candy |
Popcorn Kernels |
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Corn Chips |
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Cut
the following foods into small pieces and chew with the back
teeth: |
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Apples |
Pears |
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Carrots |
Celery |
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Corn on the Cob |
Chicken wings |
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Pizza |
Spare Ribs |
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Orthodontic
Emergencies or Problems
Loose Bracket
/ Poking Wire
/ Wire
out of Back Brace
Poking Elastic (Rubber
Band) Hook /
Sore Teeth
Please feel free to contact the office if
you are experiencing any discomfort or if you have any questions. Below
are a few simple steps that might help if you are unable to contact us
or if you need a “quick fix”.
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Loose Bracket
Occasionally, a glued bracket may come
loose. You can remove the loose bracket and save it in an envelope to
bring to the office or leave it where it is, if it is not causing any
irritation. Call the office as soon as possible in order for us to allow
time to re-glue the bracket.
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Poking
Wire
If a wire is poking your gums or cheek there
are several things you can try until you can get to the office for an
appointment. First try a ball of wax on the wire that is causing the
irritation. You may also try using a nail clipper or cuticle cutter to
cut the extra piece of wire that is sticking out. Sometimes, a poking
wire can be safely turned down so that it no longer causes discomfort.
To do this you may use a pencil eraser, or some other smooth object, and
tuck the offending wire back out of the way.
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Wire
out of Back Brace
Please be careful to avoid hard or sticky
foods that may bend the wire or cause it to come out of the back brace.
If this does happen, you may use needle nose pliers or tweezers to put
the wire back into the hole in the back brace. If you are unable to do
this, you may clip the wire to ease the discomfort. Please call the
office as soon as possible to schedule an appointment to replace the
wire.
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Poking Elastic (Rubber Band) Hook
Some brackets have small hooks on them for
elastic wear. These hooks can occasionally become irritating to the lips
or cheeks. If this happens, you may either use a pencil eraser to
carefully push the hook in, or you can place a ball of wax on the
hook to make the area feel smooth.
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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:
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Rinse
with warm water, eat a soft diet, take acetaminophen (Tylenol) or
ibuprofen (Advil) as directed on the bottle.
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Chewing on the sore teeth may be sorer in the short term but feel
better faster.
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If
pain persists more than a few days, call our office.
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