Common Questions

h-braces3Common Orthodontic Questions for Children

We have compiled some helpful information below that will help parents understand the management of their child’s orthodontic problems.

Common Orthodontic Questions for Adults

Approximately 20 percent of our patients are adults. While mostly similar to adolescent orthodontic treatment, adult orthodontics has some extra considerations.

General Orthodontic Information

A general overview of what qualifies a person as an orthodontist and what their job entails.

Common Orthodontic Questions for Children

  1. At what age should I schedule an appointment for an orthodontic screening?
  2. What benefits come along with early orthodontic treatment?
  3. What is a spacer?
  4. Will I need to have teeth extracted for braces?
  5. How is orthodontic treatment affected by a child’s growth?
  6. What appliances are normally used to correct jaw-growth problems?
  7. Can I still play sports?
  8. Will having braces interfere with playing musical instruments?
  9. Why does it sometimes take longer than the estimated time for orthodontic treatment?
  10. What is the purpose of retainers?
  11. Will my child’s teeth shift back later?
  12. Will my child’s wisdom teeth have to be removed?

1. At what age should I schedule an appointment for an orthodontic screening?
The American Association of Orthodontists recommends an orthodontic screening at age 7. By this age, several permanent teeth in most children have erupted, allowing us to effectively evaluate your orthodontic condition. Some common signs that may be indicating factors that your child will need orthodontic treatment include:

  • Difficulty biting or chewing
  • Early or late loss of primary teeth
  • Thumb sucking
  • Finger sucking
  • Clicking or popping jaws
  • Biting the cheek
  • Apparent abnormal bite
  • Apparent facial imbalance
  • Crowded or misplaced teeth

An early orthodontic evaluation allows your orthodontist to recognize potential problems early and correct them before they become more serious.

2. What benefits come along with early orthodontic treatment?
Early evaluation provides both timely detection of problems and greater opportunity for more effective treatment. Prudent intervention guides growth and development, preventing serious problems later. When orthodontic intervention is not necessary, an orthodontist can carefully monitor growth and development and begin treatment when it is ideal.

Some of the most direct results of interceptive treatment are:

  • Creating room for crowded, erupting teeth
  • Creating facial symmetry through influencing jaw growth
  • Reducing the risk of trauma to protruding front teeth
  • Preserving space for unerupted teeth
  • Reducing the need for tooth removal
  • Reducing treatment time with braces

3. What is a spacer?
Spacers are small elastics that fit snugly between certain teeth to move them slightly so bands can be placed around them later. Spacers can fall out on their own if enough space has already been created. To determine if it needs to be replaced, slip some dental floss between the teeth; if it gets stuck, that means the spacer hasn’t created enough room and needs to be replaced prior to your banding appointment.

4. Will I need to have teeth extracted for braces?
Removing teeth is sometimes required to achieve the best orthodontic result. Straight teeth and a balanced facial profile are the goal of orthodontics. However, because new technology has provided advanced orthodontic procedures, removing teeth is not always necessary for orthodontic treatment.

5. How is orthodontic treatment affected by a child’s growth?
Your child’s growth and orthodontic treatment can work well with each other. Often times either the upper front teeth are protruding ahead of the lower teeth because the lower jaw is shorter than the upper jaw. As your child’s jaw continues to grow, we can use orthodontic appliances to help guide their growth allowing the lower jaw to catch up with the upper jaw. Occasionally, if there is a severe discrepancy in the length of the jaws, corrective surgery may be necessary. It is important if your child has problems with the width or length of their jaws to be evaluated by age 10 for girls and 12 for boys.

6. What appliances are normally used to correct jaw-growth problems?
There are a number of orthodontic appliances available to help correct jaw-growth problems. We will work with each patient individually to determine which appliance will be most effective for your individual case. It is critical that patients follow the wearing instructions provided by your orthodontist in order to achieve the desired results. Some of the growth appliances we provide include:

  • MARA (Mandibular Anterior Repositioning Appliance) and Herbst Appliance

The Herbst appliance and the MARA appliance are excellent choices for treating "overbite" which is characterized by protrusion of the upper front teeth and/or a lower jaw that is lagging back in growth compared to the upper jaw. Using MARA or Herbst for "overbite" correction is more efficient and also eliminates the need for the old headgear appliance, extraction of teeth to compensate and possibly avoid jaw surgery in more severe cases.

Generally, these appliances are secured to the patient's first molars and glued in place so there is nothing that the patient or parent has to insert or wear nightly like the headgear. Therefore, patient compliance is not an issue. It is active 24/7 making it hyper-efficient and easier for the patient to adapt to. Also, the orthodontist can more accurately predict the length of treatment.

  • Trans-Palatal Arch

The Trans-Palatal Arch is an orthodontic appliance used to maintain the upper jaw’s arch width and move molars into positions that wires alone can't. The appliance is banded around the first molars on each side of the mouth, and a thin wire spans across the roof of the mouth.

Patients should be sure to brush their teeth and their appliance daily. Also, avoid sticky, chewy or hard foods as these can get caught between the appliance and the roof of your mouth. These foods may also break the Trans-Palatal Arch.

  • Headgear

    Headgear is often used to correct an excessive overbite. This is done by placing pressure against the upper teeth and jaw, which would hold the teeth in position or help move them into better positions. The severity of the problem determines the length of time headgear needs to be worn. The key to success with your headgear appliance is consistency.

    Headgear must be worn a certain number of hours per day, and if not, it must be made up the following day.

    Headgear should never be worn while playing sports and should also be removed while eating or brushing your teeth.

  • Activators

    This appliance works to keep the lower jaw forward as it guides the eruption of the permanent teeth into the intended position, while simultaneously guiding the upper and lower jaw to grow proportionately with one another. The success of this appliance relies on patient compliance.

7. Can I still play sports?
Yes. We recommend a mouth guard for all sports.

8. Will having braces interfere with playing musical instruments?
While it may take some time getting used to playing instruments, such as wind or bass instruments, typically braces do not interfere with playing instruments.

9. Why does it sometimes take longer than the estimated time for orthodontic treatment?
We can only provide you with an estimated time frame of how long you will be in braces. Each patient grows differently and responds to treatment differently so variables are endless when trying to determine an exact time frame. With that in mind, the purpose of orthodontic treatment is to achieve the desired result from treatment for you. Until that result has been achieved, we will continue with treatment as long as necessary. Generally, patients who cooperate by wearing their appliances and rubber bands as instructed by their orthodontist tend to complete treatment on time and have achieved amazing results.

10. What is the purpose of retainers?
If not stabilized, the teeth can begin to shift out of position once the braces have been removed. Retainers are designed to hold teeth in the corrected position until the gums and bones are fully adapted to these changes. To ensure that your results last a lifetime, it is important to wear your retainers as instructed.

11. Will my child’s teeth shift back later?
As we age, our teeth tend to shift. Wearing retainers as instructed can help stabilize the correction and maintain your beautiful, straight smile for a lifetime. Once your orthodontist has instructed you that full time wear is no longer necessary, wearing your retainer nightly will help maintain the position of your teeth and prevent future shifting.

12. Will my child’s wisdom teeth have to be removed?
About 75% of patients who have not had other teeth extracted for orthodontic treatment will likely have to have their wisdom teeth removed. Your orthodontist will work with you and your family dentist to determine if having your wisdom teeth extracted is right for you.

Common Orthodontic Questions for Adults

  1. Is orthodontic treatment for adults as effective as it is for children?
  2. How does orthodontic treatment for adults differ from children?
  3. My dentist said I need to have some missing teeth replaced, but should have orthodontic treatment first. Why?
  4. Why would orthodontic treatment benefit me now if I’ve had crooked teeth for years?

1. Is orthodontic treatment for adults as effective as it is for children?
A surprising percentage of our patients are adults. In fact, 25 percent of all orthodontic patients are adults. For many, orthodontic problems can be corrected just as easy in adults as they are in children. Health, happiness and self-esteem are vitally important to adults. No patient is "too old" to wear braces!

2. How does orthodontic treatment for adults differ from children?
Adults have stopped growing and some may have experienced extreme tooth decay, loss of teeth or bone loss. In this instance, orthodontics is only one step in helping an adult patient achieve and maintain a beautiful, healthy smile. Working alongside your dentist, periodontist, endodontist and/or oral surgeon, we will ensure your orthodontic problem is managed well and works to complement all the other oral needs this patient has. Below are some common reasons adult treatment may differ from treatment for children:

  • Damaged or missing teeth
  • Lack of jaw growth
  • Gum or bone loss

You can rest assured that our orthodontists are skilled and trained in the latest advancements for all levels of adult orthodontic treatment. We will work in conjunction with your other oral health professionals to ensure you receive beautiful, lasting results.

3. My dentist said I need to have some missing teeth replaced, but should have orthodontic treatment first. Why?
Many times, having orthodontic treatment prior to having missing teeth replaced helps to set a healthy foundation for achieving optimum results. Properly aligned teeth and correct bites allow more complex restorations like crowns, bridges and dental implants to be completed more easily and effectively.

4. Why would orthodontic treatment benefit me now if I’ve had crooked teeth for years?
Orthodontic treatment not only restores the natural beauty of your smile and good function to your teeth and jaws, it helps to boost your self-confidence and self-esteem no matter how old you are.

General Orthodontic Information

1. What is orthodontics?
Orthodontics is the specialty branch of dentistry that focuses on the diagnosis, prevention and treatment of malocclusions or bad bites. Combining professional skill for design and application with maintain accurate control with corrective appliances like braces, the teeth, lips and jaws are moved into proper alignment.

2. What is an orthodontist?
Orthodontic specialists have extensive and specialized training that enables them to provide their patients with professional, personalized treatments. While all orthodontists are trained dentists, only six percent of dentists are certified orthodontists. In addition to completing undergraduate studies and a four year dental graduate program at a dental school or other ADA accredited institution, a two to three-year residency program focused on orthodontics must also be completed.

3. When can people begin orthodontic treatment?
Orthodontic treatment is available to patients of all ages. In accordance with the American Association of Orthodontists, we recommend that children have their first orthodontic evaluation by the age of 7. With early evaluation and diagnosis, children can achieve optimal orthodontic results. Early treatment provides a range of benefits and often means that a patient can avoid surgery or other serious complications. There is, of course, no age limit for orthodontic treatment as both children and adults benefit from orthodontics. As such, our office accommodates orthodontic patients of all ages.

4. What causes malocclusions?
While most bad bites are inherited, some are acquired as a result of accidents, dental disease or premature loss of teeth, or bad habits like thumb/finger sucking. No matter the cause of the malocclusion, the problem has affected both the alignment of the teeth and the development and appearance of the facial features.

5. What are the most common problems treated?
  • Upper Front Teeth Protrusion
    The appearance and function of your teeth are impacted by this type of bite. It is characterized by the upper teeth extending too far forward or the lower teeth not extending far enough forward.
  • Overbite
    The upper front teeth extend out over the lower front teeth, sometimes causing the lower front teeth to bite into the roof of the mouth.
  • Crossbite
    The upper teeth sit inside the lower teeth, which may cause tooth stratification and misaligned jaw growth.
  • Openbite
    Proper chewing is impacted by this type of bite, in which the upper and lower front teeth do not overlap. Openbite may cause a number of unwanted habits, such as tongue thrusting.
  • Crowding
    Crowding occurs when teeth have insufficient room to erupt from the gum. Crowding can often be corrected by expansion, and many times, tooth removal can be avoided.
  • Spacing
    Spacing problems may be caused by missing teeth, or they may only be a cosmetic or aesthetic issue.
  • Dental midlines not matched
    This type of problem is caused when the back bite does not fit and match appropriately, which may negatively impact jaw and proper dental function.

6. What is so important about orthodontic treatment?
It is very difficult to keep crooked and crowded teeth clean, making tooth decay and gum disease more possible. When left untreated, the orthodontic problems only grow worse. Often times, orthodontic treatment can prove less costly than restorative dental procedures to care for tooth decay and gum disease. We believe you should never underestimate the value of a beautiful smile. Not only will a beautiful, healthy smile boost your self-confidence and your self-esteem, but it can prove beneficial for your social and career success.

7. How much do braces cost?
There are several contributing factors that have to be considered when determining the cost of braces. Every patient is different and requires different treatment and treatment times. We will thoroughly discuss your treatment options and the estimated cost of treatment during your initial consultation. We offer flexible payment options to help make your orthodontic treatment more affordable. Please review our Financial and Insurance page for more information about our payment options.

8. How long does orthodontic treatment take?
Orthodontic treatment time obviously depends on each patient's specific orthodontic problem. In general, treatment times range from 12 to 30 months. The "average" time frame a person is in braces is approximately 22 months.

9. How is treatment achieved?
We will work with each patient individually to develop a personalized treatment plan to meet their individual needs and desires. Custom-made appliances and braces will be fabricated according to the orthodontist’s prescription for the orthodontic problem being treated. We offer a full range of braces including metal, ceramic and plastic. Growth-guidance appliances such as Herbst, MARA and maxillary expansion appliances may be necessary to help guide the growth and development of the jaws in children and teenagers. Early orthodontic treatment allows your orthodontist to recognize potential problems early and correct them before they become more serious – thus saving you time and money!

10. I am concerned about the appearance of metal braces. Are there any clear alternatives?
We have clear, ceramic, tooth colored braces available for patients concerned about the appearance of traditional metal braces. This revolutionary technology makes the braces virtually undetectable. Also, for metal braces, the modern wires we use are less noticeable, but just as effective as the past arch wires used.

11. How has orthodontic treatment improved with the new “high tech” wires?
Over the past few years, the materials used in orthodontics have advanced dramatically. Today, braces are smaller, less noticeable and more efficient than past braces. We now use wires made of nickel, titanium, copper and cobalt to help teeth move into the desired position. These new wires help to reduce the number of appointments needed for adjustments while creating beautiful smiles.

12. How do braces feel?
Generally, braces do not "hurt." After certain visits, teeth may be sore for a few days. In these situations, pain medications such as Advil or Tylenol will ease the discomfort. However, after most visits, patients do not feel any soreness at all! We often remind our patients, “It does not have to hurt to work!”

13. Do I need to treat my braces with special care?
Regular checkups with your family dentist are important while in braces. Your family dentist will determine the intervals between cleaning appointments while you are in braces.

Patients should brush their teeth at least four times each day - after each meal and before going to bed. We will show each patient how to floss their teeth with braces and may also provide a prescription for a special fluoride, if necessary.

Once treatment begins, we will explain the complete instructions and provide a comprehensive list of foods to avoid. Some of those foods include: ice, hard candy, raw vegetables and all sticky foods (i.e. caramel and taffy). You can avoid most emergency appointments to repair broken or damaged braces by carefully following our instructions.

14. Is patient cooperation very important for the success of orthodontic treatment?
Yes. We need patients to work just as hard at keeping their braces and teeth clean and cared for as the braces work hard to straighten your teeth. Damaged braces and/or appliances will only lengthen your treatment time and may possibly deliver an undesirable treatment result.