Care During Orthodontic Treatment

Taking care of braces properly and being committed ideal results is an important part of orthodontic treatment. Orthodontic braces contain many parts and should be protected from damage to ensure ideal results. It is essential to strictly adhere to the instructions provided by your orthodontist to ensure excellent at-home care.

Foods to Avoid

Stick to softer foods for the first few days following the placement of braces to optimize comfort. Throughout the course of treatment, there are types of foods that should be avoided entirely. These foods can snap archwires, displace orthodontic bands and loosen brackets. Your orthodontist will offer a complete list of foods to steer clear of, but here are some general examples:

• Hard Foods – Ice cubes, popcorn kernels, and potato chips
• Sticky Foods – Taffy, gum, bagels, jerky and caramel
• Sugary Foods – Candy, jam, jelly, chocolate, breath mints and soda
• On The Bone Foods – Chicken wings, barbecue ribs and corn on the cob

Cleaning Around Braces

Orthodontic braces create spots where oral bacteria can stick and promote tooth decay. It is crucial to brush your teeth after every meal or snack to rid the teeth of debris and plaque. Flossing is also an essential part of everyday braces care. All sides of each tooth should be carefully cleaned twice a day. Your orthodontist will be able to provide advice on home hygiene techniques with braces.

Preventing Damage During Athletics

Sports are one of the major causes of dislodged and broken orthodontic appliances. Special mouth guards that protect braces should be worn every time a sport is played. Though contact sports, such as football, put orthodontic patients at higher risk for to injury, players of non-contact sports like soccer are also at susceptible to lip lacerations and snapped archwires.

Braces can be rendered ineffective from loose bands, brackets and broken archwires. An appointment should be made with your orthodontist as promptly as possible so appliances can be fixed for maximum function. A broken orthodontic appliance prolongs total treatment time when not corrected.

Commitment to Best Results

Braces require a significant commitment from the wearer to work effectively. It is essential to attend scheduled orthodontic adjustment appointments and follow instructions diligently. Remember: the result of effective treatment is a perfect smile!

If you have any questions or concerns about orthodontic care, please contact your orthodontist.

When Should My Child Get An Orthodontic Evaluation?

Orthodontists aim to prevent and treat irregularities in the jaw and misalignment of the teeth that are the result of genetics, or develop in accordance with a child’s habits. The best way to achieve these goals is to have your child evaluated by an orthodontist as early as age seven; however, children with noticeable facial irregularities may benefit from preventive orthodontic treatment several years earlier.

Orthodontists are highly trained to notice minute problems with emerging teeth and jaw growth – even if a mixture of baby teeth and permanent teeth are present. While the untrained eye might fail to spot these irregularities, an orthodontic check-up allows for early detection of problems and development of efficient treatment plans.

Some of the key signs that an orthodontic problem is present are as follows:

• Difficulty chewing and biting
• Jaws that click, shift or make noise as they move
• Asymmetry in the face due to disproportionate jaws
• Finger and thumb sucking
• Bite misalignment (arches of teeth that do not meet properly)

Common Orthodontic Problems for Children

Children often experience overcrowding, jaw growth irregularities, protruding teeth and teeth that are too widely spaced. While some problems are inherited, main causes of acquired orthodontic irregularities are:

• Inadequate nutrition or dental hygiene problems
• Medical problems, such as birth defects
• Habits such as thumb or finger sucking
• Breathing through the mouth
• Earlier or later loss of baby teeth than is considered normal

How Can an Orthodontist Help my Child?      

The orthodontist may take one of several approaches when dealing with children. In some cases, malocclusions or irregularities are carefully monitored and are addressed at a later date. The ideal time to initiate treatment varies with each individual child and is based on their unique diagnosis.

Early orthodontic treatment is beneficial to reduce the amount and duration of later treatment, preventing more complex conditions from occurring. Through early intervention, the orthodontist is able to correct habits that lead to acquired irregularities, increase the confidence of the child, guide the growth of the jawbone, and decrease the risk of injury to protruding teeth.

If you have any further questions about when your child should visit the orthodontist, please contact our office.

What Does Orthodontic Treatment Involve?

Orthodontics is a highly-specialized branch of dentistry that deals with facial and jaw irregularities. As proper alignment of the teeth and jaw arches affects coherent speech, chewing and biting abilities, orthodontic treatment is vital for health and comfort.

What Problems Do Orthodontic Treatments Solve?

There is a wide range of orthodontic treatments available to successfully and expediently alter the alignment of teeth. The type of treatment provided depends on the exact nature of the malocclusion or teeth misalignment. Here is a brief overview of the main classifications of bite and teeth positioning problems:

Overcrowding – The non-eruption of adult teeth and the overcrowding of arch space can lead to misalignment. Additionally, overcrowding may cause twisting and complete displacement of teeth.

Negative Underjet – An underbite is characterized by a pronounced lower jaw, which protrudes further than the upper jaw. This malocclusion causes the chin to look large or pointed.

Overbite – Overbite is a result of a protruding maxilla (upper jaw) in relation to the mandible (lower jaw). This type of malocclusion makes the chin look like it has receded.

What Does Orthodontic Treatment Involve?

The first step in developing a treatment plan is completion of a thorough visual examination of a patient’s smile. After completing this, your care provider creates diagnostic records which include panoramic x-rays, bite impressions and additional imaging of the jaw joints in some cases. If treatment is needed to realign the teeth, this is discussed extensively.

Examining diagnostic records allows for the development of a predictable treatment plan. Your dental professional can also work with an oral surgeon if the symmetry of the face needs to be altered. In the case of an overcrowded mouth, one or several teeth may need to be extracted to prepare for the realignment process. Once the diagnosis and preparation phases are complete, a fixed or removable orthodontic appliance is used to move the teeth and jaw arches into ideal alignment.

Fixed Appliances

There are several types of fixed orthodontic appliances, of which traditional metal braces are the most common. Ceramic, clear or metal brackets are fixed onto each individual tooth for the duration of the treatment, and an archwire is threaded through each one to connect them.

The wire is tightened slightly every few weeks until the desired results are achieved. Typically the fixed brackets are removed after 18-30 months.

Removable Devices

Removable devices come in many shapes and sizes and are popular because of their convenience and versatility. Removable devices include headgear, which corrects malocclusions due to developmental problems; retainers, which maintain the correct alignment of the teeth after orthodontic treatment; and Invisalign® trays, which are used for several weeks at a time to correct common teeth alignment problems.

It is important to note that a dental professional creates a custom treatment plan or each individual case. The time-span for corrections with removable devices can greatly vary in accordance with the severity of the original malocclusion.

If you have questions about orthodontic care and procedures, please be sure to ask your dental office.

Orthodontic Appliances

Orthodontic appliances are not just limited to fixed and removable braces. There are many devices available to correct jaw alignment irregularities and reposition the teeth. In some cases, traditional fixed or removable braces are used in conjunction with another type of orthodontic appliance, which serves to fulfill one of the following functions:

• Expanding the palate to create space
• Closing large gaps between the teeth
• Correcting irregularities, such as an elongated mandible (lower jaw) bone or a short maxilla (upper jaw) bone
• Alleviating crowding in the upper or lower jaw

Types of Orthodontic Appliances

Most types of orthodontic appliances treat a specific irregularity. The nature of your diagnosis points your dental professional towards the most effective treatment.

Here is a brief overview of some of the most commonly used orthodontic appliances:

Palatal Expanders

Palatal expanders come in two styles: the bonded appliance and the banded appliance. These devices widen the upper arch to create room for the eruption of permanent teeth and are used to correct a narrow bite or crossbite. Palate expanders are fairly discreet and work effectively as long as the device is adjusted at the designated intervals. Some individuals experience slight difficulty speaking and eating until they have fully acclimated to the device.

Facemasks (Reverse Headgear)

Facemasks are designed to combat growth discrepancies between upper and lower jaw arches. In the case of a class III malocclusion, where the upper jaw grows faster than the lower jaw, the upper arch can look more prominent. Facemasks pull the lower arch forward and encourage its growth relative to the upper arch. This appliance consists of a frame, which fits around the headand elastics, which are directly applied to the teeth. Facemasks are removable, but must be worn for 12-20 hours a day to expedite treatment.

Headgear

Headgear works to correct class II malocclusion, more commonly known as an overbite. In this case the maxilla or lower jaw is growing faster than the mandible or upper jaw. Headgear restricts lower jaw growth and allows the mandible to catch up. Headgear consists of a frame which fits around the head and is attached to braces and bands. In some cases, headgear is used to create space to move the front teeth backwards. As with facemasks, it is typically recommended to ear headgear for wear 12-20 hours each day.

Other types of orthodontic appliances include the Andresen appliance to reduce overbite, Biobloc, which works to posture the lower jaw forward, and Bass Dynamax, which also corrects malocclusion.

If you have any questions or concerns about orthodontic appliances, please contact your dental professional.

Is It Ever Too Late To Get Braces?

The field of orthodontics is most commonly associated with treatment for pre-teens and teenagers, but an increasing amount of adults are choosing to correct jaw irregularities (malocclusions) and misaligned teeth with orthodontics. It is now estimated that approximately one third of all orthodontic patients are adults. The major advantage of treating irregularities at a young age is that orthodontic appliances are widely accepted in youth and ideal alignment can be achieved before adulthood. Most orthodontists agree, however, that it is never too late to get braces.Aside from the pleasing aesthetic of a beautifully straight smile, correcting malocclusion and teeth misalignment with braces is beneficial for a number of other reasons:

Reduced Tooth Decay – Misaligned teeth can make maintaining adequate oral hygiene incredibly difficult. Hard-to-reach spaces can become breeding grounds for the oral bacteria that cause tooth decay.

Reduced Wear and Tear – Chewing capability is impacted by malocclusion. Improper alignment means that as food is chewed, force is not evenly distributed. This can lead to flattened teeth and lopsided wear and tear on dental enamel.

Relief of Jaw Pain – Not only does a comfortable bite distribute pressure evenly across teeth, it can also create smooth, pain-free dental function. Patients with malocclusion experience jaw joint disorders (TMJ dysfunction) that create clicking, popping, and discomfort when opening and closing the mouth.

What Types of Misalignment Require Braces?

An oral health professional can successfully treat jaw irregularities and teeth alignment issues with orthodontic braces. Here is a brief overview of the most common types of issues and alignment irregularities that require braces:

Overbite – An overbite occurs when the maxilla (upper jaw) protrudes further than the mandible (lower jaw). This condition can give the chin a sunken appearance and make the smile look toothier than normal.

Underbite – An underbite occurs when the mandible protrudes further than the maxilla. This condition may be the result of growth irregularities and can make the chin look overly large.

Overcrowding – Overcrowding occurs when there is insufficient room for the adult teeth to erupt and align. In some cases, a tooth or several teeth may need to be extracted to provide room on the arch for proper alignment.

What Kind Of Braces Will I Need?

Dental braces tend to fall into two major categories: fixed and removable. Before recommending a specific course of treatment, your dental professional will visually examine your mouth, take x-rays and form bite impressions. Once a firm diagnosis has been made, a discussion regarding treatment options can take place to determine the quickest and best procedure.

Here is a brief overview of some common types of braces:

Fixed Dental Braces – These dental braces have two major components: brackets and an archwire. A metal, clear or ceramic bracket is glued to each tooth and an archwire is used to link them. During adjustment appointments, the orthodontist will gently tighten or replace wires to train the teeth into the desired position.

Lingual Braces – These braces are fixed yet invisible because they are fitted behind the teeth. Lingual braces are effective for straightening teeth, but on occasion cause minor speech problems and tongue discomforts due to their positioning.

Invisalign® – This system of removable aligners is favored by many adults because of its natural appearance. A series of plastic trays are used to gradually move teeth into proper alignment.

Retainers – When realignment is complete, measures need to be taken to ensure that the teeth do not shift back into the old alignment. Retainers hold teeth in the desired position, allowing bone to form around teeth’s new position.

If you have questions or concerns about dental braces, please contact your dental health professional.

Brushing and Flossing with Braces

Adjusting to proper oral hygiene with a smile full of brackets, including cleaning around bands and wires, is incredibly important. Effectively cleaning orthodontic appliances ensures that plaque is not allowed to build up around the braces. Typically, if a proper oral hygiene routine is not strictly adhered to, gum inflammation and tooth decay can occur.

The key to brushing and flossing effectively with orthodontic braces is learning the best technique. Though everyone has different preferences, here are some excellent tips on how to get started:

Brushing

Regular, proper brushing is especially important when braces have been applied to the teeth. If possible, brush teeth after every snack to eliminate plaque buildup. If this isn’t practical, aim to brush four times daily, including:

• After breakfast
• After lunch
• After dinner
• Right before bedtime

It is important to choose an appropriate toothbrush and to inspect the bristles routinely for signs of wear. The orthodontic braces will wear and fray the bristles, so replacement brushes will be needed more often than usual.

A soft bristled toothbrush is best because it will not damage the archwire or brackets. Apply a small strip of toothpaste, preferably a brand with fluoride, to the brush. Keep in mind that every tooth has several sides that need to be thoroughly cleaned: the outside, the sides facing each other and the chewing side.

When brushing front-facing sides of the teeth, create a 45 degree angle between the brush and the gum line. Brush in gentle circular motions from the top of the tooth to the bottom and then from bottom to top. Try not to exert too much force on either the wire or the brackets. When brushing the inside angles of teeth, work methodically creating the same 45 degree angle with the brush. The back surfaces of the teeth should pose no additional problems and should be brushed in the regular way.

Next, use a specially-designed proxabrush (Christmas tree brush) to brush between two brackets at a time. Insert the proxabrush and use downward and upward motion. Continue until all the spaces between the braces are plaque-free. As a last step, use mouthwash to flush out remaining bacteria.

Flossing

Flossing is also of paramount importance. Plaque and food particles can quickly provide fuel for the formation of bacteria colonies that cause gum disease and tooth loss. Though flossing between braces can be more time-consuming, it should still be completed several times per day.

Floss threaders can be used or the floss can be wrapped around fingers in the standard method. First, thread a piece of floss underneath the archwire of the braces. Slide the floss in an up-and-down motion against the large surface of the tooth. Exercise great care around the bracket and archwire, as they can easily be damaged by excess pressure.

Next, guide the floss to the interdental area (between the teeth) and use gentle sawing motions to move down from the gum line toward the bottom of the tooth. Repeat this motion several times. Then, using the same sawing motion, work the floss from the bottom of the tooth toward the gum line several times.

In some cases, flossing around orthodontic braces can cause mild bleeding, which should go away. If this bleeding persists for several days, be sure to inform your oral health professional.

If you have any questions or concerns about brushing and flossing with braces, please contact your dental office.

At-Home Care for Orthodontic Soreness

When braces are first applied, it can take several days to get used to the new appliances. During this time, the mouth may feel tender or sore. While soreness is rarely problematic enough to warrant additional dental care, contact your orthodontist if soreness becomes highly uncomfortable.Causes of Orthodontic Soreness

When braces are initially applied or the archwire is changed during an orthodontic adjustment appointment, teeth start to gradually shift toward their new destination. This initial movement causes adjacent tissue to become inflamed. This inflammation causes fibers that join the teeth to the jawbone and gums (periodontal ligaments) to swell. The swelling in turn leads to compressed nerve fibers, which are the true cause of orthodontic soreness.

What Can Be Done to Ease Soreness?

It is important to remember that orthodontic discomfort generally decreases within a few days. After the initial affixation of braces, it can take between one and two weeks for the tissues of the tongue, cheek and lips to adapt to the new orthodontic device. There are several home remedies, however, that will help ease initial discomfort:

Wax Application

Orthodontic relief wax is usually provided at your appointment and can be applied to the braces as required. If the soreness is being caused by braces rubbing on the cheek, lip or tongue, the wax provides a smooth, effective buffer between the two. Roll a pea-sized amount of wax into a ball and place it the protruding and bothersome part of the appliance. Press the wax into place to efficiently cover any irritating wires.

Salt Water Rinses

Warm salty water is an excellent remedy for sore lips, gums and cheeks. The salt water mixture actually extracts excess fluid in inflamed tissue by way of osmosis, alleviating pressure on the nerves and easing soreness. To utilize this remedy, add a teaspoon of salt to around half a cup of lukewarm water. Swish the water around the mouth without gargling for one minute before spitting it out.

Chewing on Soft Foods

To further ensure comfort, you can also chewing on soft foods that won’t damage your braces. Apple and cheese slices work nicely, as do small celery slices. The chewing action compresses the fibers that fix the teeth and gums together (periodontal ligaments), thus pumping out the fluid accumulation that causes soreness.

Eat Berries

Not only do berries contain high levels of antioxidants, they can also substantially reduce intraoral swelling. Cherries, blackberries, blueberries and raspberries all contain natural anti-inflammatory properties which reduce soreness. Cherries are preferable because they are soft enough not to damage the braces and do not contain small seeds which tend to stick between the braces.

Pain Medication

While it is unlikely that orthodontic soreness will warrant over-the-counter pain medications, some patients choose to alleviate soreness this way.

If you have any questions or concerns about orthodontic soreness, please contact your oral health provider.

Eating While Wearing Braces

Traditional braces consist of bands, brackets and wires, which are easily dislodged or damaged while eating. When orthodontic braces sustain damage, they cease to work in the intended way. For this reason, it is essential to take good care of your braces and follow guidelines for eating as provided by your orthodontist.

Certain types of foods should either be completely avoided or eaten with extreme care. Here are some general guidelines to follow when eating with braces:

Do Not Eat Hard Foods Whole     

Hard foods pose the biggest threat to braces. They can dislodge the brackets and snap the wires. Here are some foods which must never be eaten whole:

• Hard candy
• Popcorn (the kernels can cause breakage or inflammation if they get stuck between teeth)
• Ice cubes
• Unsliced hard fruits and vegetables
• Hard potato chips
• Gumballs

Slice Fruits and Vegetables Before Consumption      

There are many hard, healthy foods such as fruits and vegetables that should still be consumed, but need to be prepared first. The best way to eat fruits and vegetables, such as carrots and apples, without damaging braces is to slice or dice them into small pieces. This will make them easier to eat and reduce the chance of dislodging braces.

Do Not Eat Sticky Foods

Sticky foods can quickly dislodge braces and tend to wrap around brackets, making them look stained and unattractive. Examples of sticky foods to be avoided include:

• Gum
• Taffy
• Jerky
• Caramel
• Chocolate bars containing caramel

Similarly, foods which are generally eaten off the bone or the cob must be must be completely stripped from the bone, and then cut into tiny pieces which will not dislodge or break appliances.

Do Not Chew On Inedible Items

Chewing on pencils, crayons, pens or fingernails can easily damage braces. Always keep in mind that your orthodontic appliances are fragile. Some habits and activities require a change in routine to ensure effective treatment.

Avoid Sugary Foods and Drinks

It is no secret that high sugar levels lead to tooth decay. As orthodontic appliances can exacerbate the decay process, it is even more crucial to think about the sugar content in foods. It is also essential to thoroughly brush teeth (including in-between the brackets) a minimum of four times each day. If brushing is not an option after every meal, try to rinse with water to remove food particles captured on brackets and between teeth.

Always remember to remove retainers before drinking beverages. The sugary liquid can become trapped between the device and teeth, which expedites the decay process.

Here are some sugary foods and beverages to avoid (the sugarless versions are acceptable):

• Milk
• Soda
• Breath mints
• Iced tea
• Jam and jelly
• Cereals
• Fruit juice

If you have any questions or concerns about what foods to eat while wearing braces, please contact your orthodontist.

Why Straighten Teeth?