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Below we've listed answers to some of our patients' most frequently asked questions. If you have any further questions, please feel free to call us during regular office hours! |
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Q: What is orthodontics?
A: Orthodontics is a specialty branch of dentistry that deals with the diagnosis, prevention and treatment of dental and facial irregularities. The technical term for these problems is "malocclusion," which means "bad bite." The practice of orthodontics requires professional skill in the design, application and control of corrective appliances, such as braces, to bring teeth, lips and jaws into proper alignment and to achieve facial balance.
Q: What is an orthodontist?
A: All orthodontists are dentists, but only about 6 percent of dentists are orthodontists. An orthodontist is a specialist in the diagnosis, prevention and treatment of dental and facial irregularities. Orthodontists must first attend college, and then complete a four-year dental graduate program at a university dental school or other institution accredited by the Commission on Dental Accreditation of the American Dental Association (ADA). They must then successfully complete an additional two- to three-year residency program of advanced education in orthodontics. This residency program must also be accredited by the ADA. Through this training, the orthodontist learns the skills required to manage tooth movement (orthodontics) and guide facial development (dentofacial orthopedics). Only dentists who have successfully completed this advanced specialty education may call themselves orthodontists.
Q: Why is orthodontics important?
A: An attractive smile and improved self-image is just one of the benefits of orthodontic treatment. Without treatment, orthodontic problems can lead to tooth decay, gum disease, bone destruction, chewing and digestive difficulties, speech impairments, tooth loss and other dental injuries. 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.
Q: At what age should orthodontic treatment occur?
A: 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, the American Association of Orthodontists recommends that all children have an orthodontic screening no later than age 7 (or earlier if a problem is detected by parents, the family dentist or the child's physician). Some orthodontic problems may be easier to correct if treated early. Additionally, early treatment may mean that a patient can avoid extractions, surgery or more serious complications.
Q: What causes orthodontic problems?
A: 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 extended 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.
Q: What are the most commonly treated orthodontic problems?
A: CROWDING: Teeth may be aligned poorly because the dental arch is small and/or the teeth are large; impacted teeth (teeth that should have come in, but have not), poor biting relationships and undesirable appearance may all result from crowding. 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; 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; may cause significant bone damage, excessive wearing of the incisors, and discomfort. 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 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); this is often caused by an upper jaw that has failed to grow forward enough or in width; 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; if indicated, the need for early orthodontic correction of this problem may prevent needing jaw surgery later.
Q: What are the benefits of braces?
A: Having straight teeth that fit together properly improves function and your teeth and jaw joints can work more effectively. Straight teeth makes it easier for you and your dental team to keep them clean. If you ever need a filling, crown or bridge, your dentist can usually do a better restoration if the teeth are aligned properly. The appearance of teeth and face is improved. Having a pleasing smile improves self-esteem, confidence and a feeling of acceptance in daily activities.
Q: Will braces hurt?
A: Although the actual process of putting the braces on is virtually painless, most patients experience some discomfort the first week after their braces are put on and immediately after their braces are tightened. Aspirin, non-aspirin pain reliever or ibuprofen can be used to ease the discomfort.
Q: Should I avoid eating certain foods while wearing braces?
A: Although you can enjoy most of the same foods you did before getting your braces, you should avoid hard, crunchy and sticky foods that can damage braces.
Q: How long does orthodontic treatment take?
A: 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.
Q: Why does orthodontic treatment sometimes take longer than anticipated?
A: 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 practicing good oral hygiene and by wearing rubber bands, headgear or other needed appliances as directed, while taking care not to damage appliances, will most often be rewarded by on-time and excellent treatment results.
Q: How often will I need office visits?
A: Once appliances are in place, routine office visits are at four-to-eight week intervals. Periodically, we may need to see you sooner or in case of any emergency we will probably need to see you that day.
Q: Why are retainers needed after orthodontic treatment?
A: After braces are removed, teeth can shift out of position if they are not stabilized. Retainers provide that stabilization and 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.
Q: Is orthodontic care expensive?
A: When orthodontic treatment is implemented at the proper time, treatment is often less costly than the dental care required to treat the more serious problems that can develop years later. 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 commonly offered by our office may include an initial down payment with monthly installments, credit card payment, and other innovative ways to make treatment affordable. Insurance plans or other employer-sponsored payment programs, such as direct reimbursement plans, may be helpful.
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Q: Why should children start orthodontic screening no later than at age 7?
A: By age 7, enough permanent teeth have come in and enough jaw growth has occurred that the dentist or orthodontist can identify many current problems, anticipate future problems and alleviate parents' concerns if all seems normal. The first permanent molars and incisors have usually come in by age 7, and crossbites, crowding and developing injury-prone dental protrusions can be evaluated. Any ongoing finger sucking or other oral habits can be assessed at this time also.
Q: What are some signs indicating the need for an early orthodontic examination?
A: Early or late loss of baby teeth; difficulty in chewing or biting; mouth breathing; thumb sucking; finger sucking; crowding, misplaced or blocked out teeth; jaws that shift or make sounds; biting the cheek or roof of the mouth; teeth that meet abnormally or not at all and; jaws and teeth that are out of proportion to the rest of the face.
Q: What are the benefits of early treatment?
A: For those patients who have clear indications for early orthodontic intervention, early treatment presents an opportunity to: guide the growth of the jaw; regulate the width of the upper and lower dental arches (the arch-shaped jaw bone that supports the teeth); guide incoming permanent teeth into desirable positions; lower risk of trauma (accidents) to protruded upper incisors (front teeth); correct harmful oral habits such as thumb- or finger-sucking; reduce or eliminate abnormal swallowing or speech problems; improve personal appearance and self-esteem; potentially simplify and/or shorten treatment time for later corrective orthodontics; reduce likelihood of impacted permanent teeth (teeth that should have come in, but have not); preserve or gain space for permanent teeth that are coming in.
Q: Why do baby teeth sometimes need to be pulled?
A: Pulling baby teeth may be necessary to allow severely crowded permanent teeth to come in at a normal time in a normal location. If the teeth are severely crowded, some permanent teeth will either remain impacted (teeth that should have come in, but have not), or come in to an undesirable position. To allow severely crowded teeth to move on their own into much more desirable positions, sequential removal of baby teeth and permanent teeth (usually first premolars) can dramatically improve a severe crowding problem. This sequential extraction of teeth, called serial extraction, is typically followed by comprehensive orthodontic treatment after tooth eruption has improved as much as it can on its own. After all the permanent teeth have come in, the pulling of permanent teeth may be necessary to correct crowding or to make space for necessary tooth movement to correct a bite problem. Proper extraction of teeth during orthodontic treatment should leave the patient with both excellent function and a pleasing look.
Q: Can a child's growth affect orthodontic treatment?
A: 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 or 11. The American Association of Orthodontics recommends that all children have an orthodontic screening no later than age 7 as growth-related problems may be identified at this time.
Q: Will I still be able to play sports?
A: Yes. It is recommended, however, that patients protect their smiles by wearing a mouth guard when participating in any sporting activity. Mouth guards are inexpensive, comfortable, and come in a variety of colors and patterns. These are generally provided by our office.
Q: Will braces interfere with playing musical instruments?
A: 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.
Q: Will my child's tooth arrangement change later?
A: Studies have shown that as people age, their teeth may shift. This variable pattern of gradual shifting, called maturational change, probably slows down after the early 20's, but still continues to a degree throughout life for most people. Even children whose teeth developed into ideal alignment and bite without treatment may develop orthodontic problems as adults. The most common maturational change is crowding of the lower incisor (front) teeth. Wearing retainers as instructed after orthodontic treatment will stabilize the correction. Beyond the period of full-time retainer wear, nighttime retainer wear can prevent maturational shifting of the teeth.
Q: When should wisdom teeth (third molars) be removed?
A: For about 80-90% of patients, there are good reasons to have the wisdom teeth removed, usually when a person reaches his or her late-teen years to early twenties. Careful studies have shown, however, that wisdom teeth do not cause or contribute to the progressive crowding of lower incisor teeth that can develop in the late teen years and beyond. Your orthodontist, in consultation with your family dentist, can determine what is right for you.
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Q: Can orthodontic treatment be as effective on me as it is on children?
A: Healthy teeth can be moved at almost any age. Many orthodontic problems can be corrected as easily and as well for adults as children. Orthodontic forces move the teeth in the same way for both an adult and a growing child. Complicating factors, such as lack of jaw growth, may create special treatment planning needs for the adult. In the U.S., one in five orthodontic patients is an adult. The American Association of Orthodontics estimates that nearly 1,000,000 adults in the United States and Canada are receiving treatment from an orthodontist. In our practice, 40-45% of patients in braces are adults.
Q: How does adult treatment differ from that of children and adolescents?
A: 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, prosthodontist, 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. The following 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.
Q: I have painful jaw muscles and jaw joints -- can an orthodontist help?
A: 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. Sometimes structural damage can require joint surgery and/or restoration of damaged teeth.
Q: My teeth have been crooked for years; why start treatment now?
A: Orthodontic treatment, when indicated, is a positive step - especially for adults who have endured a long-standing problem. Orthodontic treatment can restore good function. Teeth that work better usually look better, too. And a healthy, beautiful smile can improve self-esteem, no matter the age.
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