Braces
are one of the things you can do for your kids to
insure their health throughout their lifetime. Surveys
have indicated that people who have had braces look
better and feel better about themselves. They live
longer and have a statistically lower risk of cardiovascular
disease.
Braces are not only for kids. Presently, 20% of the orthodontic patients
are over 18; people as old as 60 have had successful orthodontic treatment.
Read on to find out more about braces. The risks and rewards, and what
you can do to improve your health and your children's health.
Q. Why get braces?
A.
Orthodontic treatment improves your smile. Your
smile is the most striking part of your face. Look
in the mirror. Do you like your smile now? Can your
smile be improved?
Think about how you react to someone with a pretty smile. Do you find
them more attractive? Will you be more attractive with an appealing
smile?
Orthodontic treatment will make your smile look fabulous. The fabulous
smile will last for the rest of your life. Think about how a fabulous
smile will improve your life. Orthodontic treatment will also make
your face look delightful. Wouldn't a delightful face be wonderful?
The American Association Of Orthodontics (AAO) has a new program called
a smile bank, which uses computer imaging to show you how much better
your face will look after orthodontic treatment. Contact the AAO at
1-800-787-2444
Q.
How many people need orthodontic treatment?
A.
About 70% of people in the US need orthodontic treatment.
Q.
How does orthodontic treatment work?
A. You
usually think about your jaw as being solid like
a rock, but when you are growing your jaw is really
more like clay. If you apply pressure to your jaw,
you can get your jaw to stretch. If you pull your
jaw apart, your jaw will get wider. If you push your
jaw back, your jaw will slowly move back. Your jaw
does not actually stretch. Instead, when you pull
on your jaw, your jaw grows in the direction you
are pulling. Still, the important thing is that when
your braces pull on your jaw, the braces change the
shape of your jaw.
In the same way, if you push on your teeth, your teeth will move around
in your mouth.
The orthodontist pushes your jaw to stretch your mouth so all your
teeth fit. He then pushes on your teeth so they are all in the proper
places. If your top jaw is too small, your orthodontist can install
a special gadget called a "palatal expander" to get your
jaw to grow wider. If your teeth stick out, your orthodontist can install
another gadget called a "facebow" to push your back teeth
back. In that way, your orthodontist is able to move around individual
teeth and expand your jaw so that all of your teeth fit correctly in
your mouth.
Q.
When Should I Get Treatment? What Is The Best Time
To Get Braces, What happens if I wait?
A. You
can get orthodontic treatment at any age. Kids as young
as 4 are sometimes advised to start orthodontics early
to avoid a problem later on. People as old as 90 sometimes
get orthodontic treatment to fix crooked teeth. Still,
orthodontic treatment works best and is the least painful
when you are 8 to 14 so we advise that you start orthodontic
treatment then.
Your jaw is growing the quickest when your are 8 or 9 so it is usually
best to expand your jaw and reshape your mouth when you are 8 or 9.
This is called "interceptive orthodontic treatment". Then
you should wait for most of your permanent teeth to come in. Usually,
your permanent teeth come in when you are 12 or 13 and so that is the
best time to start full orthodontic treatment when you are 12, 13 or
14.
You can get braces at any age so if you are too afraid, you can wait
a couple of years. However, as you get older the treatment takes longer
and hurts more. Your jaw is growing fast when you are 8, so your jaw
is easy to stretch. If you wait until you are 12, the orthodontist
needs to push a lot harder to expand your jaw so it hurts. By time
you are 20, you may need surgery to expand your jaw.
Still, you can get orthodontic treatment at any age. It just gets more
uncomfortable as you get older.
Q.
What Is Having Braces Like? Does It Hurt?
A. Generally,
teenagers do not find braces to be any big deal. Your
mouth is usually sore for the first week after you
get braces. Also, your mouth will be sore when the
braces are tightened. However, with modern braces,
you should get so used to the braces, that you should
not notice the braces, except when the braces are being
tightened or if you get hit in the mouth.
If
you start orthodontic treatment when you are 18 or
older, it generally is more uncomfortable; your teeth
feel like they are loose in your mouth. Still, the
pain is worth the gain.
It
matters what kind of braces you use. Old fashioned
braces will hurt a lot of the time. However, if you
get modern braces, they will not hurt except when
they are first put in or when your braces are tightened.
Orthodontic firms tests their braces to try to find ways to make them
hurt less. We have a number of designs for braces which minimize
the pain you will feel. We have not yet found a way to avoid
the pain when the braces are first put on, or when the braces
are being tightened. Also your mouth will hurt if your friends
punch you. However, we are working on reducing the pain.
Some
orthodontists will only use old fashioned braces
so orthodontic companies still sell them. Still,
companies try to sell comfortable braces whenever
we can.
Initially, when you first get braces, there may be some sores on your
lips. If you rinse the sores in warm salt wateror Amosan , the sores
will heal within a week or two. Thereafter, there will be an occasional
sore when, for example if you get into a fight. However, the sores
should heal rather quickly.
If
your lips get too sore during the first week, you
can put wax on the braces to prevent the braces from
rubbing and irritating the sore.
Several over-the-counter medicines have been found to reduce the pain.
Anbesol Orabase Amosan
Q. How long
does orthodontic treatment take?
A.
It varies a lot according
how much your jaw needs to stretch and how much your
teeth have to move.
If
you start interceptive orthodontic treatment when
you are 8, it usually takes anywhere from 3 to 6
months to stretch your jaw. It takes longer if the
orthodontist needs to reshape your jaw.
If
you get braces when you are 12 years old, it usually
takes two to two and a half years to move around
your teeth. It will take longer if you do not do
what the orthodontist tells you to do or if there
is something unusual about your bite.
Q.
Will my friends laugh at me when I get braces?
A.
Only you know your friends. Some
of my friends laugh at anything especially if you
get old fashioned, clunky braces. However, companies
make stylish braces(tm), and most teenagers feel
good about them. Most of your friends will be getting
braces too. Wouldn't it be excellent if you were
a cool dude and your braces were funkier than all
of your friends' braces?
Q.
Can I still talk when I have braces?
A. Yes.
Standard braces should not affect how you talk or the
sound of your voice. You can talk, sing, yell, make fun
of people, and act just as you do now. Braces will not
stop you from having fun. Just do not get punched in
the mouth. It hurts!
Occasionally the orthodontist needs to put in a gadget which gets in
the way of your tongue. If so, you may have trouble talking clearly
for a day or two, but then you will be able to talk fine.
Q.
Can I still play football, baseball, basketball, soccer,
etc if I have braces?
A.
Of course. Would a fun guy get braces if he could not
play? You
can still play football, baseball, basketball, soccer.
You can still go bowling. You can still do everything.
Just wear a mouthguard, and try to not get hit in the
mouth.
We recommend that you avoid sports where you will get hit in the face.
Fighting, boxing, wrestling, karate, can be very painful when you have
braces.
Guy Funi points out that it hurts when a snowball hits your face. If
you get into a snowball fight, be sure to duck!
Q.
I play the trumpet. Will my ability to play be affected
by my braces?
A. Be
sure to mention your musical abilities to the orthodontist.
The orthodontist will give you Kissable(tm) Kovers or
lip protectors for your braces. The Kissable(tm) Kovers
protect your lips and will make it possible for you to
still play musical instruments. We have had reports of
entire brass bands having braces with no problems.
Guy Funi points out that you can play almost any musical instrument
if you have braces. He can play the drums, and his sister plays the
piano and violin. If you do not have an instrument Guy Funi even plays
songs on his orthodontic rubber bands.
Q.
Are there any other activities that I should avoid
when I have braces?
A. We
advise against you participating in activities where
there will be many blows to a your mouth. Sports like
boxing, karate, and wrestling should be avoided. Fighting
should also be avoided.
You
should wear an orthodontic mouthguard whenever you participate
in any sporting activity.
Q.
Can I eat when I get braces?
A.
Yes! You
can eat most of the good things that you can eat
now.
The one big limitation is that your mouth will get sore after you first
get braces, so we recommend that you only eat softer foods for the
first week. However, after that you should be able to eat normally.
Q.
Can I still chew gum with braces?
A.
Gum is usually not recommended. The
gum can get caught on the braces and pull the braces
off. Also the sugar in the gum can get trapped behind
the braces and cause cavities.
It may be possible for you to chew a sugar free, non stick gum such
as Freedent ® or Wrigley's Extra®. A study in the American
Journal Of Orthodontics 107(1995)497 (a big fancy magazine for orthodontists)
indicates that the xylitol in the Freedent® or Wrigley's Extra® prevents
cavities, and the gum does not stick to some styles of braces.
Freedent® and Wrigley's Extra® will still damage some kinds
of braces so you need to TALK TO YOUR ORTHODONTIST BEFORE CHEWING GUM.
Q.
Is there anything else that I cannot eat?
A. You
probably should not eat hard sticky, gooey or crunchy
foods. Caramel, taffy, peanut brittle can stick on your
braces and pull the braces off your teeth. You also need
to be careful with crunchy foods like carrots and apples
and hard rolls so that you do not knock your braces off
your teeth.
Q.
What happens if the braces come off?
A.
The orthodontist will attach them again. Usually,
this is no big deal, although if it happens lots
of times, your orthodontic treatment will take longer.
Q.
Why cannot the orthodontist attach the braces strongly
enough that the braces cannot come off during eating?
A. The
orthodontist needs to take off your braces at the end
of the orthodontic treatment. If the orthodontist attaches
your braces too firmly, the braces will not come off
again at the end of your orthodontic treatment.
Wouldn't it be strange if your braces never came off, so you would
be stuck with them for the rest of your life?
Q.
What Happens If A Piece Of My Braces Comes Off And
I Swallow It?
A.
I know you are concerned, but it is usually NOT a
serious problem if
you swallow parts of your braces. All braces are
tested so they are completely safe. The parts just
pass through your digestive system. Inhaling a part
from your braces is a problem however. If you inhale
a part of your braces, and the part gets into your
lungs, it could cause a problem. Therefore, the orthodontist
will normally ask an MD to remove the part of your
braces from your lungs.
Q.
What is it like going to a school dance in braces?
A
cool dude is still a dude with or without braces. Years
ago, when glasses (eyeglasses) were old and clunky,
people used to worry about going to the dance in
glasses. Now it is no big deal. In the same way,
years ago when braces were all big and clunky, people
worried about going to a dance in braces. Now you
can get stylish braces (tm) so there is nothing to
worry about.
Q.
Is there any chance that I will be able to hear the
radio on my braces?
A.
Well, we do not think so, but you should listen carefully
to be sure. Years
ago there were reports of people hearing the radio
on their fillings. At the time, radio was different.
There were only a few stations and they were all
AM. People also used crystals to listen to the radio.
The crystal set consisted of a "ceramic insulator" much
like a tooth covered by a metal piece which was like
a bracket. Crystal radios could pick up AM signals
when they were close to the AM station. People claimed
to have heard the radio on their fillings when they
were standing by the radio transmitter and their
mouth was completely dry. I have never heard of a
report of someone hearing the radio on their braces,
though. Still, it is theoretically possible so listen
carefully! If you hear the radio on your braces be
sure to tell us.
Q.
What Kinds Of Braces Are There?
A.
Braces come in lots of different sizes and colors.
First
there are old fashioned braces. Old fashioned braces are
big and clunky. They can cut your lips, and are generally
uncomfortable.
Then there are modern braces. Modern braces are smaller and more comfortable
than old fashioned braces. They have what is called a low profile design,
which is less irritating to your lips. They also have special contours
to make your orthodontic treatment go faster and be less painful.
Q. What Steps Occur During Orthodontic Treatment?
A. There are two parts
to orthodontic treatment, interceptive orthodontic treatment and Class
I (i.e regular) orthodontic treatment. Do not worry about the big words.
Just read on and see what each of the parts of orthodontic treatment
does.
Interceptive
orthodontic treatment
The objective of interceptive orthodontic treatment is to make your
jaw wider and reshape your mouth so there is room for your permanent
teeth.
Your orthodontist will install a gadget called a "palatal expander" to
make your mouth bigger. He may also use a facebow to try to start to
correct overbites and underbites. If you start interceptive orthodontic
treatment when you are 8, it usually only takes 3-6 months, and avoids
painful treatment later on.
Note: interceptive orthodontic treatment can take as long as 14 months
if your bones grow slowly, or if you do not follow the orthodontists
directions.
Q. Does
the palatal expander hurt?
A. A little. The
palatial expander is stretching your mouth, and you know the old saying, "No
Pain, No Gain".
Most kids finish interceptive orthodontic treatment by time they are
9. Then they usually wait until they are 12 and ready for braces.
Full
orthodontic treatment
The objective of full orthodontic treatment is to continue to stretch
your mouth, and move around your teeth so that your teeth are in the
right places.
First there are a series of appointments where the orthodontist examines
your mouth and figures out what is needed.
Next the orthodontist installs your braces.
You usually keep your braces in for two to two and a half years. During
that time, your orthodontist's assistant will "tighten" your
braces every three or four weeks.
The orthodontist may tell you to wear a facebow during that time.
Then your orthodontist will remove your braces and give you a retainer.
You will need to wear the retainer 24 hours a day for a year, then
a few nights a week until you stop growing (when you are 24).
Generally, full orthodontic treatment takes about two or two and a
half years for a typical case. It will take longer with a complicated
case or if your do not follow the orthodontist's instructions.
Generally,
it takes several visits to the orthodontist for you
to start your treatment. On your first visit the orthodontist's
assistant will take a medical history. The orthodontist
will then examine your mouth to see if you need orthodontic
treatment.
Generally, the orthodontist will look at your mouth to see if everything
is ok. Is your mouth big enough to hold all of your teeth? When you
close your mouth, are the top teeth lined up with your bottom teeth?
Are any of your teeth crooked or not in the right place? Are there
any missing teeth? Are there any other problems like a breathing problem,
or a problem with the joint in your jaw?
NOTHING THAT THE ORTHODONTIST DOES ON THE FIRST EXAM HURTS
Q.
How often should I brush my teeth when I have braces?
A.
Brushing and flossing is really important when you
have braces because food can get caught in the braces
and cause cavities. Also you will have terribly bad
breath so no one will want to talk to you.
You should brush and floss your teeth after every meal and before you
go to bed. You may want to brush with a special fluoride jell to make
sure that you do not get any cavities.
Brushing might hurt the first week after you get braces but then everything
might hurt your first week in braces. Fortunately, you can get through
it.
After the first week, brushing should be fine. Flossing is a little
harder. However, a waterpic works great. There are also special brushes
and floss designed to clean around your braces. Be sure to ask your
orthodonists for some. Also, please ask your orthodontist's assistant
for help flossing every time you get your braces tightened. The orthodontist's
assistant can do a great job cleaning your teeth.
Q. What happens
if I get a cavity with braces?
A. It
is hard to say. If it is a normal cavity, your regular
dentist will just fill it. If the cavity is underneath
your braces, your orthodontist will have to remove your
braces first.
Q.
I have noticed that some of my friends have rubber
bands in their braces. What do the rubber bands do?
A.
The rubber bands are used to move teeth forward or
back in your mouth. For
example, they could be used to move your lower teeth
forward or back, to move a tooth that is in the wrong
place, or to close a gap between your teeth.
Most people get rubber bands.
Q.
How often should I change rubber bands?
A. Orthodontic
rubber bands break after they have been chewed a few
times. Usually, the rubber bands will snap suddenly when
you open your mouth wide. The rubber bands will hurt
your jaw. The only way to avoid the pain is to change
your rubber bands frequently. Take off your rubber bands
before each meal and put in new ones when you are done
eating. Change your rubber bands before you go to bed
to make sure that the rubber bands do not snap when you
are snoring in the middle of the night.
Q. What happens
if I leave off my rubber bands?
A.
Your braces will need to stay on for up to a year
longer and
your teeth will hurt more.
Changing rubber bands is not hard, so there is no reason not to change
them. Old fashioned rubber bands used to taste awful, but people now
make flavored rubber bands which taste like candy breathmints. With
flavored rubber bands, changing your rubber bands after every meal
is like eating a piece of candy after every meal, but using a flavored
rubber band does not cause cavities.
Q.
What happens if accidentally I swallow a rubber band?
A.
Nothing; the rubber band is safe unless you are allergic
to it. The
rubber band just passes through yur dijestive system,
and comes our in your feces. Just do not swallow
a whole pack of rubber bands. They will give you
indigestion and you might have a bad allergic reaction.
Q.
What does a retainer do?
A. The retainer keeps your teeth in perfect alignment after braces
are removed so you keep an excellent smile as your mouth grows
Usually, when braces are first removed, your teeth will all be in perfect
alignment, and your smile is excellent. However, your gums, bones,
etc will not have completely shifted into their new positions. The
retainer holds your teeth in position until your gums, bones etc settle
in to their new positions. At the end of your orthodontic treatment,
your smile will be wonderful and your will look excellent. You need
to wear your retainer to keep yourself looking excellent.
Also, you are still growing after your braces are removed. Sometimes,
your mouth will grow unevenly. If so a retainer can be used to make
sure your teeth stay perfect as you grow. Cool dudes all have perfect
teeth.
Q.
What happens if I do not wear the retainer?
A. Your
gums and bones will not settle into their new positions
so your teeth will move part way back to their old positions.
Your fabulous smile will dwindle. You may even need to
get your braces put on again. Don't let that happen!
Wear your retainer.
Q.
Does the retainer hurt?
A.
It should not. If
your retainer hurts after the first week, it means
that the retainer was fitted wrong. Go back to your
orthodontist and ask him to give you a new retainer.
Q.
How long should I use a retainer?
A. You
need to wear your retainer 24 hours a day for at least
a year after your braces are removed. Then continue to
wear the retainer a few nights a week until you are 24
and stop growing.
Q.
What happens if I break the retainer?
A.
Ask your orthodontist for a new one.
Q.
Won't the retainer wear out after a while?
A.
A well made retainer should last for years. If
your retainer breaks ask your orthodontist for a new
one.
Q.
What happens if I swallow a part of the retainer.
A. Nothing.
The part will just pass through your digestive system.
Q.
Tell me about fixed retainers
A. Fixed
retainers are an alternative that is sometimes used when
you keep "forgetting" to wear your retainer.
The orthodontist cements a retainer in your mouth and
you cannot take the retainer off for a year.
If this happens, be sure to clean the retainer every night or else
your breath will smell awful.
Q.
I notice that some braces have little colored rings
around the brackets. What do the colored rings do?
A. The
colored rings are called ligating modules. They hold
the wires into the brackets.
Ligating modules can be fun. You can get them in 24 colors! There are
orange and black ligating modules for Halloween, red and green for
Christmas and red or pink for Valentines day. Red, white and blue for
the fourth of july. You can get ligating modules in your favorite colors,
your school colors, your favorite teams colors or even your mom's least
favorite colors. Ligating modules allow you to make your braces match
your personality. Enjoy!
Q.
What happens if I swallow a ligating module?
A. I
know it is scary, but orthodontic ligating modules are
safe. Orthodontic ligating modules are made of a medical
grade polyurethane which is similar to the grade of polyurethane
used for medical implants. The polyurethane is safe to
eat. If you swallow a ligating module, the ligating using
just passes through your digestive system.
Q.
What are lingual braces, and what are their advantages
and disadvantages?
A.
Lingual braces are an old technique where braces are
mounted behind a patients teeth. They
were used years ago, before the advent of stylish or
orthocosmetic(tm) braces. Now lingual braces are rarely
used.
Occasionally an orthodontist can be convinced to use lingual braces
when the patient insists that the braces absolutely cannot show. Generally,
lingual braces are much more uncomfortable than standard braces. The
orthodontic treatment is much more painful, and the treatment takes
almost twice as long as with standard braces. Also the patient often
has trouble talking with lingual braces.
Today, most orthodontists refuse to put on lingual braces. However,
there are a few orthodontist who still use the procedure if the patient
is very insistent.
Q.
What is the purpose of a facebow?
A. A
facebow is designed to push your rear teeth back so that
there is space for the teeth in the front of your mouth.
Q.
What Happens If I "Forget" to wear my facebow?
A. If
you do not wear your facebow, your orthodontist will
not be able to stretch your mouth so all of your teeth
fit. Usually, the orthodontist will try another alternative.
He may wire in the facebow, so you cannot take it out!
He may try a more painful appliance. You need to wear
your facebow! Your braces will not work unless you wear
them.
Q.
How do I use a facebow?
A.Generally,
you should wear the facebow for about 12 hours a day.
The facebow should be inserted into the two holes on
the buccal tubes at the back of your mouth. The facebow
should then be connected to the breakaways, and on to
the neckpad or other headgear. A facebow should never
be worn without a safety strap or breakaway.
Q.
Are there any dangers with a facebow?
A. A
facebow uses headgear to provide the force needed to
move your jaw. There is so called "high pull" headgear,
which has straps over the top of your head, and around
your neck, and "cervical headgear" which only
have straps around your neck.
Many manufacturers do not sell high pull headgear because we consider
high pull headgear risky. High pull headgear has been known to snap
a facebow. In rare cases, the parts from the facebow have been known
to go into a person's eye. Sometimes, high pull headgear is the only
alternative to surgery, and so an orthodontist will prescribe it. Still,
we recommend that parents and children be very cautious around high
pull facebows.
Be sure that the facebow is inserted properly. Be sure you wear a safety
strap. Be very cautious to make sure that the facebow does not come
loose and hurt you.
If you find your facebow coming loose at night be sure to tell your
orthodontist about it immediately. If the facebow comes loose, it could
hurt you or even poke you in the eye. If the facebow comes loose, ask
the orthodontist to adjust your safety strap. The safety strap needs
to be tight enough that the facebow cannot come out of your buccal
tubes. Use the tightest hole possible. Try out the facebow to make
sure that it cannot come loose and hurt you.
Cervical headgear is less risky than high pull headgear but still not
100% safe. Some kids try to bend their facebows to make them more comfortable.
They can weaken the facebow as they bend it which can cause the facebow
to snap. DO NOT BEND YOUR FACEBOW - IT COULD SNAP AND HURT YOU. Insist
that the orthodontist give you a facebow with breakaway modules and/or
a safety strap. Ask the orthodontist's assistant to carefully instruct
you on the use of the facebow. Make sure that you do not bend the facebow,
and uses the break away modules or safety strap whenever you are wearing
the facebow.
Q.
What causes the facebow to snap?
A.
Something called "metal fatigue". When you
bend a wire enough times, the wire will break. You
can see this with a solid copper wire like the wires
in the wall in your house. If you take a piece of solid
(unstranded) copper wire and bend it several times,
the wire will break. Facebows are made of a special
stainless steel wire which is resistant to breakage.
However, all wire will break if the wire is bent enough
times.
Q.
Are there any other dangers in orthodontics?
A. There
are some concerns about sterilization of orthodontic
materials, taking orthodontic materials out of one patients
mouth and "recycling" them to a second patient's
mouth, and allergic reactions to orthodontic materials.
These issues are discussed in the next section.
Q.
I have lots of allergies. Are there any special concerns
when I comes in for orthodontic treatment?
A.
There are always special concerns with an allergic
patient, so your parents will need to discuss your
allergies with your orthodontist. You
can be allergic to something in the orthodontist's
office, or allergic to the orthodontic materials.
There are two kinds of allergies to orthodontic materials: allergies
to nickel chrome and copper and allergies to latex. Allergies to nickel,
chromium, or copper happen a lot, but are not very dangerous. Latex
allergy is very rare but can be life threatening. Further details about
latex allergy, and nickel, chrome and copper allergy are given later
in this document. If you are worried about allergic reactions your
orthodontist can provide you with latex, nickel, chrome and copper
free orthodontic materials.
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