What should I expect on the first orthodontic appointment?

The orthodontist first will evaluate the patient bite and oral habits by visually examining patient’s occlusion. The patient’s should be free of cavity and have healthy gums before starting braces treatment. The orthodontist requires a cavity clearance form to be signed by the patient’s dentist, as long as, the last dental check up has been within 6 months. The patient is ready for getting braces on the same day treatment.

Panoramic X-ray, photos and study models will be taken from the patient to guide the orthodontist to evaluate the jaw joints, and overall health of the teeth that can not be diagnosed by visual exam. Orthodontist will place the braces (brackets) on the patient’s teeth by applying special bonding material, composite, and curing light. This procedure is pain free and the patients is not going to feel any discomfort. There is no need to anesthetize the patient. After the braces are placed, a Niti (Nickel Titanium) wire will be placed on the braces. At this point, the patient can select any color of ties that goes around the braces.

The orthodontist will show the patient how to brush and floss and discuss all the foods that must be avoided during orthodontic treatment. The patient must feel some discomfort 24 hours after the wire is placed and it should last for 2-3 days.

What is the best age to see an orthodontist?

As early as 7 year old. Patients do not have to wait until all their adult teeth have erupted. Interceptive (early) orthodontic treatment which starts as early as age 7, can prevent severe malocclusion by correcting the root cause and making sure there is enough space for all the permanent teeth to erupt.

I am getting braces, should I pull my wisdom teeth before or after getting my braces?

Wisdom teeth or 3rd molars can be extracted before, after or during orthodontic treatment. In some situation, it’s recommend wisdom teeth to be extracted before treatment, however, in majority of cases, wisdom teeth can be extracted later and will depend on the diagnosis and recommendation by your dentist, orthodontist, and oral surgeon. Your orthodontist will take a digital panoramic X-ray of your jaw to diagnose at what point the wisdom teeth should be extracted.

Can my wisdom teeth cause my teeth to shift?

According to research and the current literature, wisdom teeth do not cause shifting of the anterior(front) teeth, however, there are many other factors that can cause shifting of teeth. Those causes include such as aging, night time grinding, bone remodeling, unstable occlusion (bite), location and pattern of eruption of wisdom teeth, and not wearing retainers. Your orthodontist or dentist will take a digital panoramic X-ray of your jaw in order to see the pattern of eruption of the wisdom teeth and whether the eruption pattern could affect shifting of the remaining teeth.

Am I a candidate for braces or Invisalign?

You should visit your orthodontist in order to properly examine the severity of your occlusion and assess what treatment modality would help you obtain that dream smile.

I have lost a tooth, should I get an implant or braces? Before getting an implant, its best to also consult with an orthodontist to diagnose if the space can be closed using braces or Invisalign treatment. Your dentist and orthodontist will take comprehensive measures to discuss all options and to diagnose and recommend the best treatment plan for your situation based on your occlusion.

Am I too old to get braces?

There is no age limit for orthodontic treatment. Everyone deserves to have their dream smile. However, in cases of severe periodontal disease or decay, orthodontic treatment may not be the best option and treating the periodontal disease and decay would take priority over receiving orthodontic treatment. Your orthodontist and dentist will work hand in hand to make sure your mouth is cavity free and in great periodontal health.

Why do I have to wear elastics?

Braces and wires can only level and align teeth, movement such as right/left and up/down to bring the teeth together can only be achieved by external forces such as elastics. Your orthodontist will assess every patient’s elastics needs based on the complexity of malocclusion. Elastic compliance is a mandatory requirement of a successful orthodontic treatment.

How long should I wear my retainers?

Retention is one of the most important parts of a successful orthodontic treatment. Basically, as long as straight teeth are desired, retention is required. Orthodontists usually recommend retainers to be worn 24 hours a day in the first few months after removing the braces and will assess how many hours a day is required after that.

What are spacers (separators) for?

In some situations we have to fit a band between molar teeth, the spacers will open the space between the tight molar contacts.

When is a good time to whiten my teeth?

It is usually recommended to receive whitening after the completion of your orthodontic treatment.

Do I still need to see my general dentist while I am in braces?

Yes, it is necessary to keep your regular exam, x-ray and check up appointments with your general dentist and hygienist during orthodontic treatment to ensure the teeth are in good health and have not been decayed or affected since the start of orthodontic treatment.

How long do I have to be in braces for?

Depending on your condition and the difficulty of the case, your orthodontist will diagnose how many months is required to complete the proposed treatment plan. Orthodontic treatment can range anywhere between 6 to 24 months depending on the complexity of the occlusion and the alignment of the teeth. However, on patients that have had phase I or early orthodontic treatment will usually need less time to achieve optimal results.

Do I need to pull my teeth to get braces?

With new technology and advancement in braces, orthodontic treatment can be achieved without the necessity of pulling teeth in order to create space. When patients have early treatment, the orthodontist can create more space by expanding the Maxilla before the bones fuse to create more space for all adult teeth to erupt.

What should I do if my lose or break my retainer?

Make an appointment with your orthodontist as soon as possible to get a new set of retainers.

Does it hurt to have braces?

There is some discomfort after the wire has been placed for the first time or if the wire has been tightened (changing ties). The discomfort usually starts 24 hours after activation and it lasts for 2-3 days. In severe cases, it is recommended to take over the counter pain medication.

What is a phase I treatment?

Phase I or preventive treatment is a short term orthodontic treatment that is performed between the ages of 6 until 11 to take advantage of patient growth while they are in mixed dentition (have some adult teeth and some baby teeth) or Deciduous (all baby teeth) to correct dental and skeletal malocclusion. In this phase, if a patient has lost a baby tooth early then special orthodontic appliances are used to hold the space, and prevent other teeth to move into that space. Unwanted teeth movement can create major problems as the patient gets older. Also, if the patient’s upper jaw is narrow due to thumb sucking or tongue sucking, this is the best age to expand the Maxilla (upper jaw) before the maxillary bones fuse together. Expansion of maxilla at an early age will allow all adult teeth to erupt and minimize pulling teeth to create space.

In addition, the orthodontist can diagnose unwanted excessive or lack of growth of either jaws and intercept the growth of either one of them by using appliances before the patient’s growth has been completed. The goal of phase I treatment is to correct the major dental and skeletal problems in the early age, so either the patient does not need orthodontic treatment when all adult teeth erupted, or the patient needs minimal orthodontic treatment.

Why do my teeth hurt after orthodontic adjustment?

Teeth are attached to the periodontal ligament (PDL). When the orthodontist applies pressure on your teeth by changing your ties or placing a new wire, that causes the pulling or pushing of the PDL. This movement is very similar to when we exercise our muscle and we feel sore. The soreness should last for a few days and the pick of discomfort is after 24 hours.

Why do orthodontist take panoramic X-ray?

Panoramic X-rays will allow the orthodontist to evaluate the temporomandibular joints (TMJ) and also to evaluate if any of the teeth have short roots, or if they are impacted (stuck into the bone), or if they are missing.

Why do orthodontist take cephalometric X-ray?

Cephalometric X-rays will allow orthodontist to evaluate the upper and lower jaws ratio and relation and the position of teeth relative to both jaws. Orthodontists use these ratios as a diagnostic tool for creating a better treatment plan.

Best age to visit an orthodontist? 7