Below are some of the most frequently asked questions patients have about orthodontics. If you have any other questions, or would like to schedule an appointment, we would love to hear from you.
Click on a question below to see the answer.
At what age should my child be checked by an orthodontist?
The American Association of Orthodontics recommends that children get an orthodontic evaluation no later than age 7. Though orthodontic treatment can be done at any age, timely treatment ensures maximum dental health.
Can adults have braces?
Absolutely! Crooked or misaligned teeth look unsightly, which in many cases leads to poor self esteem and a lack of self confidence. Aside from poor aesthetics, improperly aligned teeth can also cause difficulties biting, chewing and articulating clearly. Generally speaking, orthodontists agree that straight teeth tend to be healthier teeth.
What is a Malocclusion?
A malocclusion is an incorrect relationship between the maxilla (upper arch) and the mandible (lower arch), or a general misalignment of the teeth. Malocclusions are so common that most individuals experience one, to some degree. The poor alignment of the teeth is thought to be a result of genetic factors combined with poor oral habits, or other factors in the early years. Moderate malocclusion commonly requires treatment by an orthodontist.
What are the main types of orthodontic braces?
The following are some of the most popular orthodontic braces:
Traditional braces – These braces are strong and tend not to stain the teeth. They are comprised of individual brackets which are cemented to each tooth and accompanied by an archwire which constantly asserts gentle pressure on the teeth. Traditional braces are generally metal but are also available in a clear synthetic material and “tooth colored” ceramic. The ceramic brackets are generally more comfortable than the metal alternative, but can become discolored by coffee, wine, smoking and certain foods.
Invisalign® – Invisalign aligners are favored by many adults because they are both removable and invisible to onlookers. Invisalign® aligners are clear trays, and should be worn for the recommended amount of time each day for the quickest results. Invisalign® aligners are more comfortable and less obtrusive than traditional braces, but also tend to be more costly. Not all patients are candidates for Invisalign®.
Lingual braces – These appliances are usually metal and fixed on the tongue side of the teeth, therefore not seen when a patient smiles. Lingual braces tend to be moderately expensive and in some cases, can interfere with normal speech.
How often should I brush and floss?
Brushing and flossing help control the plaque and bacteria that cause dental disease.
Plaque is a film of food debris, bacteria, and saliva that sticks to the teeth and gums. The bacteria in plaque convert certain food particles into acids that cause tooth decay. Also, if plaque is not removed, it turns into calculus (tartar). If plaque and calculus are not removed, they begin to destroy the gums and bone, causing periodontal (gum) disease.
Plaque formation and growth is continuous and can only be controlled by regular brushing, flossing, and the use of other dental aids.
Toothbrushing – Brush your teeth at least twice a day (especially before going to bed at night) with an ADA approved soft bristle brush and toothpaste.
Brush at a 45 degree angle to the gums, gently using a small, circular motion, ensuring that you always feel the bristles on the gums.
Brush the outer, inner, and biting surfaces of each tooth.
Use the tip of the brush head to clean the inside front teeth.
Brush your tongue to remove bacteria and freshen your breath.
Electric toothbrushes are also recommended. They are easy to use and can remove plaque efficiently. Simply place the bristles of the electric brush on your gums and teeth and allow the brush to do its job, several teeth at a time.
Flossing – Daily flossing is the best way to clean between the teeth and under the gumline. Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone.
Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands.
Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.
Curve the floss into a “C” shape around each tooth and under the gumline. Gently move the floss up and down, cleaning the side of each tooth.
Floss holders are recommended if you have difficulty using conventional floss.
Rinsing – It is important to rinse your mouth with water after brushing, and also after meals if you are unable to brush. If you are using an over-the-counter product for rinsing, it’s a good idea to consult with your dentist or dental hygienist on its appropriateness for you.
How often should I have a dental exam and cleaning?
You should have your teeth checked and cleaned at least twice a year, though your dentist or dental hygienist may recommend more frequent visits.
Regular dental exams and cleaning visits are essential in preventing dental problems and maintaining the health of your teeth and gums. At these visits, your teeth are cleaned and checked for cavities. Additionally, there are many other things that are checked and monitored to help detect, prevent, and maintain your dental health. These include:
Medical history review: Knowing the status of any current medical conditions, new medications, and illnesses, gives us insight to your overall health and also your dental health.
Examination of diagnostic x-rays (radiographs): Essential for detection of decay, tumors, cysts, and bone loss. X-rays also help determine tooth and root positions.
Oral cancer screening: Check the face, neck, lips, tongue, throat, tissues, and gums for any signs of oral cancer.
Gum disease evaluation: Check the gums and bone around the teeth for any signs of periodontal disease.
Examination of tooth decay: All tooth surfaces will be checked for decay with special dental instruments.
Examination of existing restorations: Check current fillings, crowns, etc.
Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth for sometime and is now firmly attached to the tooth surface. Calculus forms above and below the gum line, and can only be removed with special dental instruments.
Removal of plaque: Plaque is a sticky, almost invisible film that forms on the teeth. It is a growing colony of living bacteria, food debris, and saliva. The bacteria produce toxins (poisons) that inflame the gums. This inflammation is the start of periodontal disease!
Teeth polishing: Removes stain and plaque that is not otherwise removed during toothbrushing and scaling.
Oral hygiene recommendations: Review and recommend oral hygiene aids as needed (electric dental toothbrushes, special cleaning aids, fluorides, rinses, etc.).
Review dietary habits: Your eating habits play a very important role in your dental health.
As you can see, a good dental exam and cleaning involves quite a lot more than just checking for cavities and polishing your teeth. We are committed to providing you with the best possible care, and to do so will require regular check-ups and cleanings.
Do braces hurt?
One of the most commonly asked questions about dental braces is whether placing them causes any pain or discomfort. The honest answer is that braces do not hurt at all when they are applied to the teeth, so there is no reason to be anxious. In most cases, there may be mild soreness or discomfort after the orthodontic wire is engaged into the brackets, which may last for a few days.
Are there things I can't eat?
A normal, healthy diet is still enjoyable while in braces. You can still eat many of your favorite foods, but there will be some foods that you will need to stay away from. We provide each patient with a list of foods to avoid. This tells the patient which foods to stay away from and why.
How long will I be in braces?
Some cases can be completed in less than a year. More difficult cases take longer. The average case will take from 2-3 years. Our appointment system and the Doctors' mechanics are designed to reduce the number of times you will need to be seen and the overall length of treatment. Treatment time varies with the severity of the case, patient cooperation,and growth and development. The Doctors will attempt to estimate treatment time at the initial appointment.
What do I need to consider when using a retainer?
There are a few basic things to consider for proper use and maintenance of your retainer.
Don’t lose the appliance – Removable retainers are very easy to lose. It is advisable to place your retainer in the case it came in while eating, drinking and brushing. Leaving a retainer folded in a napkin at a restaurant or in a public restroom can be very costly if lost because a replacement must be created. A brightly colored case serves as a great reminder.
Don’t drink while wearing a retainer – It is tempting to drink while wearing a retainer because of the unobtrusive nature of the device. However, excess liquid trapped under the trays can vastly intensify acid exposure to teeth, increasing the probability of tooth decay.
Don’t eat while wearing a retainer – It can be difficult and awkward to eat while wearing a removable retainer and it can also damage the device. Food can get trapped around a Hawley retainer wire or underneath the palate, causing bad breath. When worn on the upper and lower arches simultaneously, VFR retainers do not allow the teeth to meet. This means that chewing is almost impossible.
Clean the retainer properly – Removable retainers can become breeding grounds for calculus and bacteria. It is essential to clean the inside and outside thoroughly as often as possible. Hawley retainers can be cleaned with a toothbrush. Because harsh bristles can damage the PVC surface of a VFR, denture cleaner or a specialized retainer cleaner is recommended for this type of device.
Wear the retainer as directed – This phase of treatment is critical. The hard work has been done, the braces are off and now it is tempting not to wear the retainer as often as the orthodontist recommends. Retainers are needed to give the muscles, tissues and bones time to stabilize the teeth in their new alignment. Failure to wear the retainer as directed can have regrettable consequences, such as teeth returning to their original position, added expense and lost time.
What are my options if I have missing teeth?
With many state-of-the-art dental treatments and prevention options available in dentistry today, there are fewer reasons for having to extract (remove) teeth. When something does go wrong with a tooth, we try to do everything possible to restore the tooth to its original function. Removing a tooth is the last option because we know that removal may lead to severe and costly dental and cosmetic problems if the tooth is not replaced.
Losing a tooth can be a very traumatic experience and it’s very unfortunate when it does happen. Injury, accident, fracture, severe dental decay, and gum disease are the major reasons for having to remove a tooth. If teeth are lost due to injury or have to be removed, it is imperative that they be replaced to avoid cosmetic and dental problems in the future.
When a tooth is lost, the jaw bone that helped to support that tooth begins to atrophy, causing the teeth on either side to shift or tip into the open space of the lost tooth. Also, the tooth above or below the open space will start to move towards the open space because there is no opposing tooth to bite on. These movements may create problems such as decay, gum disease, excessive wear on certain teeth, and TMJ (jaw joint) problems. These problems and movements do not result immediately, but will eventually appear, compromising your chewing abilities, the health of your bite, and the beauty of your smile.
Options for replacement of missing teeth:
Removable bridges - This type of bridge is a good solution for replacing one or more missing teeth, especially in complex dental situations where other replacement options are not possible. They are usually made of tooth-colored, artificial teeth combined with metal clasps that hook onto adjacent natural teeth. Removable bridges are the most economical option for replacing missing teeth, but may be the least aesthetically pleasing. This is because the metal clasps on the appliances are often impossible to completely conceal.
Fixed bridges - This type of bridge is generally made of porcelain or composite material and is anchored (cemented) permanently to a natural teeth adjacent to the missing tooth site. The benefit of this type of bridge is that it is fixed (not removable) and it is very sturdy. The disadvantage is that in order to create a fixed appliance, two healthy, natural teeth will have to be crowned (capped) to hold the bridge in place.
Dentures - This type of tooth replacement is used when most or all of the natural teeth are missing in one dental arch. Dentures are removable artificial teeth that are made to closely resemble the patients’ original teeth.
Implants - Are a great way to replace one or more missing teeth. They may also be great to support ill fitting dentures. A dental implant is an artificial root that is surgically placed into the jaw bone to replace a missing tooth. An artificial tooth is placed on the implant, giving the appearance and feel of a natural tooth. Implants are very stable, durable, and are the most aesthetically pleasing tooth replacement option.
If you are missing teeth, ask us if they need replacement and what options are available to you. Together we will select the best replacement option for your particular case. Prevention and early treatment is always less involved and less costly than delaying treatment and allowing a serious problem to develop.
What should I do if a tooth is knocked out?
We’re all at risk for having a tooth knocked out. More than 5 million teeth are knocked out every year! If we know how to handle this emergency situation, we may be able to actually save the tooth. Teeth that are knocked out may be possibly reimplanted if we act quickly, yet calmly, and follow these simple steps:
Locate the tooth and handle it only by the crown (chewing part of the tooth), NOT by the roots.
DO NOT scrub or use soap or chemicals to clean the tooth. If it has dirt or debris on it, rinse it gently with your own saliva or whole milk. If that is not possible, rinse it very gently with water.
Get to a dentist within 30 minutes. The longer you wait, the less chance there is for successful reimplantation.
Ways to transport the tooth
Try to replace the tooth back in its socket immediately. Gently bite down on gauze, a wet tea bag or on your own teeth to keep the tooth in place. Apply a cold compress to the mouth for pain and swelling as needed.
If the tooth cannot be placed back into the socket, place the tooth in a container and cover with a small amount of your saliva or whole milk. You can also place the tooth under your tongue or between your lower lip and gums. Keep the tooth moist at all times. Do not transport the tooth in a tissue or cloth.
Consider buying a “Save-A-Tooth” storage container and keeping it as part of your home first aid kit. The kit is available in many pharmacies and contains a travel case and fluid solution for easy tooth transport.
The sooner the tooth is replaced back into the socket, the greater the likelihood it has to survive and possibly last for many years. So be prepared, and remember these simple steps for saving a knocked-out tooth.
You can prevent broken or knocked-out teeth by:
Wearing a mouthguard when playing sports
Always wearing your seatbelt
Avoid chewing hard items such as ice, popcorn kernels, hard breads, etc.