WHAT YOU MAY WANT TO KNOW WITH BRACES
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?
ORTHODONTIC SPECIALS
• Reward points
• Discounts
ORTHODONTIC TERMS
• Arch wire
• Brackets
• Crossbite
• Elastics (rubber bands)
• Malocclusion (types of bite)
• Occlusion
• Open-bite
• Over-bite
• Over-jet
FIXED AND REMOVABLE APPLIANCES
• Herbst
• Lower Lingual Arch (LLA)
• Palatal Expander
• Hawley
• Retainers
• Headgear
ORTHODONTIC CARE
• Braces Care
• Retainer Care
• Elastics Care
• Proper Diet
ORTHODONTIC EMERGENCIES OR PROBLEMS
• Loose bracket
• Poking wire
• Wire out of back brace
• Poking elastic (rubber band) hook
• Sore teeth
Orthodontic Frequently Asked Questions
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.
Why is it important to have orthodontic treatment at a young age?
Studies have shown that serious orthodontic problems can be more easily corrected when
the patient 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 have erupted is called Phase-2.
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.
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 4-6 weeks apart to give the teeth time to move.
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.
ORTHODONTIC SPECIALS
Reward points
Taking care of your braces comes with great rewards. Patients that come on time, have
great oral hygiene, and take proper care of their braces will be rewarded. The rewards are
as follows:
Earning points: Prizes:
On time 1 point Movie pass ($10) 20 points
Great Oral Hygiene 1 point I-Tunes ($15) 30 points
No loose brackets or Best Buys ($25) 50 points
broken wires 1 point
Wearing appliances
or elastics properly 1 point
Family Discounts:
We appreciate your loyalty and trust by bringing all your family members to our practice.
If an additional member of the family becomes an orthodontic patient, they will receive
$100 discount to be used towards their orthodontic charges.
ORTHODONTIC TERMS
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.
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.
Elastics (Rubber Bands)
At some time during treatment, it will be necessary to wear elastics to coordinate the
upper and lower teeth and prefect 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.
Malocclusion
Poor positioning of the teeth.
Types of Malocclusion
Class I Class II Class III
A Malocclusion where the A Malocclusion where the A Malocclusion where
bite is OK (the top teeth upper teeth stick out past the lower teeth stick out
line up with the bottom the lower teeth. past the upper teeth.
teeth) but the teeth are This is also called an
crooked, crowded or “underbite”.
turned.
OCCLUSION
The alignment and spacing of your upper jaw and lower teeth when you bite down.
Types of Occlusion
Openbite Overbite
Anterior opening between upper Vertical overlapping of the upper
and lower teeth. teeth over the lower.
Overjet Crossbite
Horizontal projection of the upper When top teeth bite inside the lower
teeth beyond the lower. teeth. It can occur with the front
teeth or back teeth.
FIXED AND REMOVABLE APPLIANCES
Headgear
Often called and “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.
Herbst
An appliance designed to encouraged the lower jaw to grow forward and “catch up” to
upper jaw growth.
Lower 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 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.
Palatal Expander
An appliance which is placed in the roof of the mouth to widen the upper dental arch.
This helps create more space and help provides a beautiful smile when done.
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!
Hawley
A universally use retainer with many applications; to move teeth, close spaces, maintain
alignment during or after treatment.
ORTHODONTIC CARE
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.
1. Brush back and forth across between the wires and gums on the upper
and lower to loosen any food particles.
2. Next, brush correctly as if you had no brackets or appliances on.
3. 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.
4. Next, do the same on the inner surface of the upper teeth.
5. Then, go to the lower teeth and repeat steps 1 & 2.
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.
RETAINER 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.
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 twice a
day.
PROPER DIET
AVOID STICKY FOODS AVOID HARD OR TOUGH FOODS CUT THE FOLLOWING
SUCH AS: SUCH AS: FOODS INTO SMALL PIECES
Caramels Pizza Crust AND CHEW WITH THE BACK
Candy bars with caramel Nuts TEETH:
Fruit Roll-Ups Hard Candy Apples
Gum Corn Chips Carrots
Candy or caramel apples Ice Cubes Corn on the Cob
Skittles Bagels Pizza
Starbursts Popcorn Kernels Pears
Toffee Celery
Gummy Bears Chicken Wings
Spare Ribs
ORTHODONTIC EMERGENCIES OR PROBLEMS
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”.
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
irritation. Call the office as soon as possible in order for us to allow time to re-glue the
bracket.
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.
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.
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.
Sore Teeth
You many 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:
1. Rinse with warm water, eat a soft diet, take acetaminophen (Tylenol) or ibuprofen (Advil) as directed on the bottle.
2. Chewing on the sore teeth may be sorer in the short term but feel better faster.
3. If pain persists more than a few days, call our office.