Frequently Asked Questions When Considering Braces and Orthodontic Treatment In Rochester, NY

What is orthodontics?
Orthodontics is a special field of dentistry which diagnoses the prevention and treatment of malocclusion or “bad bites” and facial irregularities to create a beautiful smile. Orthodontics requires professional skill in the placement and control of braces to bring the teeth, lips, and jaws into proper alignment to achieve facial balance.

What is an orthodontist?
An orthodontist is a dentist, but only 6% of dentists are orthodontists. An orthodontist is a specialist in the diagnosis, prevention and treatment of dental and facial irregularities. An orthodontist must first attend college and then complete a four-year dental graduate program accredited by the American Dental Association. They must then successfully complete an additional three-year orthodontic residency program.

What causes orthodontic problems?
Most orthodontic problems (bad bites) are inherited and cannot be prevented, but some are due to habits or medical and dental problems. Inherited problems involve the jaws, teeth and face. Crowding of teeth, spacing, extra or missing teeth and/or upper and lower jaw growth abnormalities are some examples of orthodontic problems.

Finger habits, enlarged tonsils and adenoids, allergies, asthma, premature loss of baby and/or permanent teeth, and poor dental care are not inherited. Whether inherited or not, these factors affect the position of teeth as they erupt and the jaw develops throughout the growing years.

What is the best age for treatment?
Each orthodontic problem determines its best starting time. However, the American Association of Orthodontics recommends all children be evaluated by an orthodontist by age 8, even earlier, if the problem is noted by either parent or the family dentist. Developmental problems relating to facial growth or eruption of teeth can be improved or corrected, if diagnosed early.

Orthodontic treatment, for any age, is possible as long as there is healthy bone, teeth and gum tissue. The following signs may indicate that you or your child needs evaluation by an orthodontist:

• thumb or finger sucking
• overlapping or crowding of permanent teeth
• broken or missing teeth
• difficulty chewing food
• mouth breathing due to allergies, enlarged tonsils and/or adenoids
• jaw joints which click, pop or you experience discomfort
• developing underbite, overbite, crossbite or abnormal bite development
• teeth wearing unevenly or excessively
• spaces between the teeth
• lower jaw shifts from one side to the other when biting together

Why is orthodontic treatment important?

• Crowded and crooked teeth are difficult to clean. This may cause tooth decay, gum disease and/or tooth loss
• Reduces or eliminates abnormal tooth wear
• Improves poor chewing habits which causes excessive stress on gum tissue and the bone that supports the teeth. TMJ dysfunction of the jaw joints may result and cause headaches, neck problems, and joint pain.
• Left untreated, most orthodontic problems become worse. Orthodontics is usually less expensive than the additional dental care required to treat more serious problems which may develop in later years.
• A beautiful, healthy smile is a personal asset that will follow the young and remain with the old, throughout life. A great smile is vital to one's self-confidence and improves one's general attitude towards life.

How long is the initial exam?
This initial appointment takes approximately one hour. Our objective is to communicate proposed orthodontic treatment, if required, in a friendly, caring, and enjoyable atmosphere. The treatment coordinator will review the orthodontic treatment plan determined by the orthodontist during the initial exam. She will also discuss financial arrangements and answer questions regarding insurance, appointments, and treatment concerns, if indicated at that time.

Since we like to evaluate children by age 8, many children are not ready to begin treatment until more permanent teeth erupt. After their new patient exam, children that are too young to begin treatment are placed on our Recall Program. This program enables the orthodontist to monitor the eruptive pattern of the permanent teeth. Sometimes, poor eruption of permanent teeth can be eliminated with early removal of baby teeth. It can also reduce the treatment time required for braces. We normally see these young patients every 8-12 months to observe progress as they grow. There is no fee for this program. It enables the orthodontist to determine the optimum time to begin treatment and achieve the best possible result for your child.

How long is orthodontic treatment?
Treatment time typically ranges from one to two years, depending on age, the growth of the patient's mouth and face, the severity of the problem, and patient cooperation. Patients will respond differently to orthodontic treatment, so the time to case completion may change from the original estimate. Wearing rubber bands as directed, proper oral hygiene, following the recommended diet to avoid emergencies and keeping scheduled appointments are important factors in completing treatment on time. Phase I or early treatment procedures, may take as little as six months, depending upon the problem.

What is Phase I and Phase II treatment?
Phase I (early interceptive) treatment, is limited orthodontic treatment (ex: expander or partial braces) before all the permanent teeth erupt. This treatment is sometimes recommended to make more space for developing teeth, to correct crossbites, overbites, underbites, or harmful oral habits.

Phase II treatment involves full braces when all the permanent teeth erupt, usually between the ages of eleven and thirteen. The female patient’s permanent teeth normally erupt one year earlier than the male patient’s permanent teeth. Treatment normally starts when the majority of permanent teeth erupt. Heredity plays a part in early or later eruption of permanent teeth and affects at what age the braces are placed.

How does orthodontic treatment work?
Orthodontic appliances or braces can be made of metal, ceramic or plastic. They may be removable or they may be brackets bonded to the teeth. By placing a constant, gentle force in a carefully controlled direction, braces or Invisalign aligners slowly move teeth to a corrected position.

This is a great time to wear braces! You can choose brackets that are clear or metallic color. You can choose the color of the ties that hold the wire into the brackets. Wires are also less noticeable than they used to be and the latest titanium heat reactive wires and Damon braces move teeth faster, with less discomfort and with fewer appointments. Patients are normally seen for adjustments every 10-12 weeks. This helps a lot with busy school and work schedules.

	Standard metal brackets. Colored elastics are available.
	Clear ceramic brackets.
	Invisalign – invisible braces for adults.

Do braces hurt?
The placement of bands and brackets or Invisalign on your teeth does not hurt. Once your braces are placed and connected with the archwires or your Invisalign aligners are inserted, your teeth begin to move. You may feel some soreness of your teeth for one to four days. With the use of the Damon Braces System, soreness of teeth is significantly reduced or eliminated. Tylenol or Advil works well to alleviate any discomfort you may have. Your lips and cheeks may need one to two weeks to get used to the braces on your teeth. Your orthodontic hygienist will provide you with all the information necessary to make this transition as easy as possible after the appliances are placed.

How do we take braces off?
We use a special plier to break the bond to the plastic adhesive on the back of the bracket. The brackets remain attached to the wire and everything is removed, at once, in less than a few minutes with little discomfort. If any bonding material remains on the tooth, it is smoothed off with a polishing disk. When braces are removed, your teeth feel very smooth and strange. It has been a long time since you felt the real thing!

Will braces interfere with playing sports?
No. However, we recommended that patients protect their smiles by wearing a mouth guard during any sporting activity. We supply our patients with special orthodontic mouth guards that come in a variety of styles and colors. Please let us know if you require a mouth guard when treatment begins.

Will braces interfere with playing a musical instrument?
No. However, there may be an initial period of adjustment. Brace covers or wax are provided to prevent discomfort while the lips and cheeks callous. Your orthodontic hygienist will instruct you on how to apply when the braces are placed. Please let us know if you play a musical instrument.

How long do I wear my retainers?
Upon completion of orthodontic treatment, retainers will be made to maintain your new beautiful smile. Retainers are worn every night for approximately one year. Even after the teeth become stable, it is important to continue to wear your retainers at least a few nights a week, indefinitely. This is your insurance policy that you will maintain your new smile for a lifetime.

Should I see my general dentist while I wear braces?
Yes. You should continue to see your general dentist, at least every six months, for cleanings and dental check-ups.