Orthodontics - Questions & Answers
A child's first visit to an orthodontist should occur around age 4. This does not mean that the child will be treated right away, but we are able to assess how the eruption of permanent teeth and the growth of the jawbone may proceed and whether it will affect the development of malocclusion. This will allow us to plan the optimal time to start treatment. It is important to eliminate bad habits and assess the patency of the respiratory tract (allergies, enlarged tonsils, snoring), as this has an impact on the development of malocclusion.
Orthodontic therapy is possible for all people regardless of age - starting with a few years old children and ending with the elderly. The prerequisite is that there is no unstable periodontal disease and that all teeth are conservatively cured.
The duration of wearing braces on teeth depends on the type of defect and usually lasts from one to three years.
Yes, permanent braces do not eliminate the possibility of ongoing dental treatments for tooth cavity repair or hygiene. During orthodontic treatment, the patient should attend regular dental check-ups.
The application of the braces itself is not painful. The brackets are glued to the teeth, and patients typically hardly feel it. However, in the first few days after they are applied, discomfort may arise due to the brackets rubbing against the inside of the mouth. We can alleviate these symptoms by using special orthodontic wax on the brackets. The forces acting on the teeth may cause discomfort and pain in the first days after the braces are put on and after follow-up appointments. Patients may also feel the mobility of their teeth, which is associated with their shifting.
When wearing braces, it is important to avoid products that can promote cavities (such as fruit juices and sweets) as well as hard foods (like carrots, crackers, and apples) — these should be cut into pieces, as biting into hard items can cause brackets to become detached. Staining foods (such as curry and red wine) can change the color of the ligatures. Foods with small particles (like poppy seeds and sesame) as well as chewy and sticky foods (like toffee and gum) can also pose challenges. If you choose aesthetic braces (with cosmetic brackets), it’s advisable to limit the intake of strong coffee, tea, and smoking, as these can stain the ligatures.
Maintaining oral hygiene with fixed braces can be challenging due to limited access to the entire surface of the teeth, making them more susceptible to cavities. Food particles left in the spaces between the brackets should be thoroughly removed with a toothbrush after every meal, supplemented with flossing and rinsing with a special mouthwash. There are specific tools for caring for braces and teeth, such as interproximal brushes, specialized toothpaste, and rinses. The orthodontist will inform the patient about the options and recommendations for proper oral hygiene.
Orthodontic treatment is a medical procedure, and like other medical interventions, it is not entirely predictable and may be associated with complications. In medical terminology, a complication is an undesirable event resulting from the treatment. Possible complications of orthodontic treatment with fixed braces may include:
- Cavities and enamel demineralization: This is often the result of inadequate oral hygiene.
- Temporomandibular joint pain: Often caused by excessive clenching and grinding of teeth.
- Allergic reactions: In rare cases, there can be allergies due to increased levels of nickel, chromium, or copper ions from the orthodontic appliance.
- Gum overgrowth: Usually caused by poor oral hygiene.
- Periodontal diseases: Particularly in patients who had pre-existing gum disease prior to treatment; in such cases, orthodontic treatment should be monitored by a periodontist.
- Root resorption: The shortening or destruction of tooth roots.
- Necrosis of the dental pulp: This refers to the death of the tooth's nerve tissue.
Orthodontic treatment is always an individual process tailored to each specific case. Decisions regarding tooth extraction are based on a personalized treatment plan. After treatment, the teeth should be positioned within the alveolar bone. It is not always possible to safely expand the dental arches to accommodate all the teeth, as this could sometimes lead to gum recession—exposing the necks of the teeth, which can cause sensitivity and worsen periodontal health. The orthodontist considers the patient's facial features and ensures that the bite functions correctly after treatment.
Removing fixed braces does not signify the end of orthodontic therapy, although having straight teeth may suggest that no further steps are necessary. However, it is essential to monitor the results of orthodontic treatment, as teeth are held in their sockets by periodontal fibers that tend to shift them back to their previous positions.
To ensure the stability of orthodontic results, it is crucial to complete any planned prosthetic work, replace fillings, and restore worn tooth surfaces. Teeth with proper anatomical shapes (with the right cusps, grooves, and lengths) and a good bite maintain treatment results better.
To solidify the effects of orthodontic therapy, retention treatment is employed, which can be either fixed or removable. Fixed retainers consist of thin metal wires bonded to the lingual surfaces of the front teeth, making them virtually invisible. Removable retainers typically come in the form of a plate that the patient must wear every night or a clear, thin aligner perfectly fitted to the shape of the teeth. The retention period is individually determined by the orthodontist.
The emergence of new gaps between teeth or the shifting of teeth in different directions during orthodontic treatment is normal and a temporary phase of the therapy. These changes are part of the process and ultimately lead to the intended goal of achieving evenly aligned and symmetrical teeth.
The duration of orthodontic treatment always depends on the specific type of malocclusion. The self-ligating braces in the Damon system can accelerate certain tooth movements; for example, they make it easier to address tooth rotations or close extraction gaps. However, the overall treatment time will still vary based on individual cases.
Like other orthodontic treatment methods, the total cost of Invisalign treatment depends on the individual case and treatment progression. The price of the aligners varies based on factors such as whether the treatment is for one or both arches and how many aligners will be needed (typically ranging from 7 to 14).
The total cost of orthodontic treatment depends on various factors, such as the chosen method of treatment, the number of follow-up visits (which depends on the specifics of the malocclusion and the course of treatment), and any additional procedures that may be necessary. When deciding on orthodontic treatment, patients always receive a treatment plan and cost estimate for approval.
In every case, cost components to consider include: initial consultation, preparation of the teeth (cleaning and any necessary restorative treatment), diagnostics (impressions, X-rays), the braces themselves, follow-up visits, and retention appliances. After treatment and during the process, regular dental cleanings may be needed in case of tartar or plaque buildup, along with check-ups with the dentist. It's important to remember that the total cost of orthodontic treatment is typically spread out over time, so payment is not required all at once.
The choice of orthodontic appliance primarily depends on the type of malocclusion and which aspect of the issue is the most difficult to address. This assessment is made by the orthodontist. Procedures that can shorten treatment time include orthodontic microimplants, which allow for the movement of one or a group of teeth in the desired direction with little to no reaction forces affecting the remaining teeth. Another method that accelerates orthodontic treatment is the use of appliances with skeletal anchorage, either palatal or zygomatic (based on the palatine bone or zygomatic arch).
Skeletal Anchorage in Orthodontic Treatment, Benefit System, Orto Trading
Every appliance that doesn't use rubber bands is a self-ligating appliance, but not every self-ligating appliance is a Damon appliance.
