When braces are finally removed, the “retention” phase begins for most individuals. The objective of this phase is to ensure the teeth do not regress back to their previous position. A retainer will be used to maintain the improved position of the teeth. A retainer is a fixed or removable dental appliance which has been custom-made by the orthodontist to fit the teeth. Retainers are generally made from transparent plastic and thin wires to optimize the comfort of the patient.
Retainers are worn for varying amounts of time, depending on the type of orthodontic treatment and the age of the patient. Perseverance and commitment are required to make this final stage of treatment successful. If the retainer is not worn as directed by the orthodontist, treatment can fail or take much longer than anticipated.
What types of retainer are available?
There are a variety of retainers available; each one geared towards treating a different kind of dental problem. The orthodontist will make a retainer recommendation depending on the nature of the original diagnosis and the orthodontic treatment plan.
The following are some of the most common types of retainers:
- Hawley retainer – The Hawley retainer consists of a metal wire on an acrylic arch. The metal wire may be periodically adjusted by the orthodontist to ensure the teeth stay in the desired position. The acrylic arch is designed to fit comfortably on the lingual walls or palate of the mouth.
- Essix – The Essix retainer is the most commonly used vacuum formed retainer (VFR). A mold is initially made of the teeth in their new alignment, and then clear PVC trays are created to fit over the arch in its entirety. VFR’s are much cheaper than many other types of retainers and also do not affect the aesthetic appearance of the smile in the same way as the Hawley retainer. The disadvantage of VFR’s is that they break and scratch more easily than other types of retainers.
- Fixed retainers – A fixed retainer is somewhat similar to a lingual brace in that it is affixed to the tongue side of a few teeth. Usually, a fixed retainer is used in cases where there has been either rapid or substantial movement of the teeth. It usually consists of a single wire. The inclination of the teeth to move rapidly means they are also more likely to regress back to their previous position if a fixed retainer is not placed.
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.
If you have any questions or concerns about retainers, please contact our office.
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.
There are two common types of fixed dental braces used to realign the teeth: Ceramic fixed braces and metal fixed braces. Both types of fixed appliances include brackets which are affixed to each individual tooth, and an archwire the orthodontist fits into the bracket slot to gently move the teeth into proper alignment. Elastic or wire ties will be applied to hold the wire in place. Some orthodontists may use self-ligating brackets which do not require a rubber or wire tie to secure the wire.
Fixed dental braces are used to treat a wide variety of malocclusions, including overbite, underbite, crossbite and overcrowding. If the orthodontist has determined that the malocclusion has been caused by overcrowding, it is possible that teeth may need to be extracted to increase the amount of available space to properly align the teeth.
What to expect when getting braces
Here is an overview of what you can expect when getting braces:
- Placement day – The placement of braces will not be painful in the slightest. It may take longer to eat meals, but this is largely because it takes some time to adjust to wearing the braces. In some cases, the teeth may feel more sensitive than usual. Hard, difficult to chew foods should be avoided in favor of a softer, more liquid-based diet for the first few days after placement of braces.
- Two days after placement – The first several days after placement of braces can be slightly uncomfortable. This is because the teeth are beginning the realignment process and are not used to the pressure of the archwire and orthodontic elastic bands. The orthodontist will provide relief wax to apply over the braces as necessary. Wax helps provide a smooth surface and alleviates irritation on the inner cheeks and lips. Additionally, over-the-counter pain medication (e.g., Motrin® and Advil®) may be taken as directed to relieve mild soreness.
- Five days after placement – After five days, any initial discomfort associated with the braces should be completely gone. The teeth will have gradually acclimated to the braces, and eating should be much easier. Certain hard foods may still pose a challenge to the wearer, but normal eating may be resumed at this point.
- Orthodontic appointments – Regular orthodontic appointments are necessary to allow the orthodontist to change the archwire, change the rubber or metal ties, and make adjustments to the braces. Fixed braces work by gradually moving the teeth into a new and proper alignment, so gentle pressure needs to be applied constantly. The first several days after an orthodontic adjustment may be slightly uncomfortable, but remember that this discomfort will quickly fade.
- Dealing with discomfort – Over-the-counter pain medication and orthodontic relief wax will help alleviate any mild soreness and discomfort following placement o braces and orthodontic adjustments. Another effective remedy is to chew sugar-free gum, as this increases blood flow which helps reduces discomfort and can also encourage the teeth to align quicker.
If you have any questions or concerns about orthodontic treatment, please contact our office.
The following are the most commonly used terms in orthodontics. If you have any questions about orthodontics or would like to schedule an appointment, please contact our office.
Anterior Teeth: The upper and lower six front teeth on each arch.
Appliance: Any orthodontic device which moves or retains teeth. Appliances may also alter the positioning of the jaw.
Arch: The entire upper or lower jaw.
Archwire: The metal wire that connects orthodontic brackets. This wire guides the teeth into their new alignment.
Band with bracket: Metal bands (rings) that are generally cemented around the back teeth.
Braces: Fixed orthodontic appliances designed to align teeth.
Brackets: The tiny metal, ceramic or clear brackets that are affixed to each individual tooth on the arch.
Brushing: This is a crucial part of home dental care. Orthodontists recommend those wearing braces to brush after every meal and snack to eliminate bacteria and plaque.
Buccal: The outer (cheek) side of posterior teeth in the lower and upper arches.
Cephalometric Radiograph: A side x-ray of the face and head used to show growth and development.
Chain: Elastics connected together and placed around the brackets to stabilize the archwire and gently close spaces.
Class I Malocclusion: Molars are correctly aligned, but there is an anterior/posterior crossbite, an openbite or overcrowding on the arches.
Class II Malocclusion: Also known as an overbite. The upper front teeth are positioned further forward than the lower teeth.
Class III Malocclusion: Also known as an underbite. The lower front teeth are positioned further forward than the upper front teeth.
Closed Bite: The upper front teeth completely overlap the bottom teeth causing a deep overbite.
Congenitally Missing Teeth: Some permanent teeth fail to develop and erupt due to genetic factors.
Crossbite: A malocclusion in which the upper back teeth bite inside or outside the lower back teeth, or the lower front teeth bite in front of the upper front teeth.
De-banding: The removal of orthodontic bands from the teeth.
De-bonding: The removal of affixed orthodontic brackets from the teeth.
Diagnostic Records: Records used to assess, plan and implement treatments. These records usually include medical and dental history, radiographs, panoramic radiographs, bite molds and intraoral/extraoral photographs.
Digital Radiograph: Digital x-rays of the teeth which can be viewed, stored and transmitted via computer.
Elastics: Some braces may require that elastic rubber bands be attached to exert additional pressure to an individual tooth or a group of teeth.
Eruption: The way in which teeth surface through the gums inside the mouth.
Fixed Orthodontic Appliances: Orthodontic appliances which are affixed to the teeth by the orthodontist and cannot be removed by the patient.
Flossing: An essential part of home care that removes debris and plaque from above and below the gumline.
Functional Appliances: Orthodontic appliances that use the muscle movement created by swallowing, eating and speaking to gently move and align the teeth and jaws.
Gingiva: The gums and soft tissue around the teeth.
Headgear: A removable appliance comprised of a brace and external archwire. This device modifies growth and promotes tooth movement.
Impressions: Teeth impressions are taken to allow the orthodontist to see exactly how a patient’s teeth fit together.
Interceptive Treatment: Treatment performed on children who have a mixture of adult and baby teeth. Early treatment can help reduce the need for major orthodontic treatment in the future.
Invisalign®: A newer, removable type of dental aligner that is completely transparent and doesn’t interfere with eating because it’s removable. Not all patients are candidates for Invisalign®.
Ligating Modules: An elastic donut-shaped ring which helps secure the archwire to the bracket.
Ligation: Securing the archwire to the brackets.
Lingual Side: The side of the teeth (in both arches) that is closest to the tongue.
Malocclusion: Literally means “bad bite” in Latin, and refers to teeth that do not fit together correctly.
Mandible: The lower jaw.
Maxilla: The upper jaw.
Mouthguard: A removable plastic or rubber device that protects teeth and braces from sporting injuries.
Open Bite: Upper and lower teeth fail to make contact with each other. This malocclusion is generally classified as anterior or posterior.
Orthodontics: The unique branch of dentistry concerned with diagnosing, preventing and correcting malocclusions and jaw irregularities.
Orthodontist: A dental specialist who prevents, diagnoses and treats jaw irregularities and malocclusions. Orthodontists must complete two or three additional years of college after dental school and complete a residency program.
Palatal Expander: A removable or fixed device designed to expand the palate in order create room on either the upper or lower arch.
Panoramic Radiograph: An extraoral (external) x-ray that shows the teeth and jaws.
Plaque: The sticky film of saliva, food particles and bacteria that contributes to gum disease and tooth decay.
Posterior Teeth: Back teeth.
Removable Appliance: An orthodontic brace or device that can be removed at will by the patient. It must be worn for the designated amount of time each day to be effective.
Separators: A wire loop or elastic ring placed between the teeth to create room for the subsequent placement of bands or orthodontic appliance.
Space Maintainer: A fixed appliance used to hold space for permanent (adult) tooth. This is usually used when a baby tooth has been lost earlier than anticipated.
Wax: Orthodontic relief wax is a home care remedy used to alleviate irritations caused by braces.
Wires: Attached to the brackets to gently move the teeth into proper alignment.
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. Orthodontists are dentists who specialize in the treatment of malocclusions and other facial irregularities.
The following are three main classifications of malocclusion:
- Class I – The occlusion is typical, but there are spacing or overcrowding problems with the other teeth.
- Class II – The malocclusion is an overbite (the upper teeth are positioned further forward than the lower teeth). This can be caused by the protrusion of anterior teeth or the overlapping of the central teeth by the lateral teeth.
- Class III – Prognathism (also known as “underbite”) is a malocclusion caused by the lower teeth being positioned further forward than the upper teeth. An underbite usually occurs when the jawbone is large or the maxillary bone is short.
Reasons for treating a malocclusion
A severe malocclusion may lead to skeletal disharmony of the lower face. In a more extreme case, the orthodontist may work in combination with a maxillofacial dentist to reconstruct the jaw. It is never too late to seek treatment for a malocclusion. Children and adults alike have completed orthodontic realignment procedures and have been delighted with the resulting even, straight smile.
Here are some of the main reasons to seek orthodontic treatment for a malocclusion:
- Reduced risk of tooth decay – A malocclusion often causes an uneven wear pattern on the teeth. The constant wearing of the same teeth can lead to tooth erosion and decay.
- Better oral hygiene – A malocclusion can be caused by overcrowding. When too many teeth are competing for too little space, it can be difficult to clean the teeth and gums effectively. It is much easier to clean straight teeth that are properly aligned.
- Reduced risk of TMJ – Temporomandibular jaw syndrome (TMJ) is thought to be caused by a malocclusion. Headaches, facial pains and grinding teeth during sleep all result from the excessive pressure to the temporomandibular joint. Realigning the teeth reduces pressure, and eliminates these symptoms.
How is a malocclusion treated?
A malocclusion is usually treated with dental braces. The orthodontist takes panoramic x-rays, conducts visual examinations and bite impressions of the whole mouth before deciding on the best course of treatment. If a malocclusion is obviously caused by overcrowding, the orthodontist may decide an extraction is the only way to create enough space for the realignment. However, in the case of an underbite, crossbite or overbite, there are several different orthodontic appliances available, such as:
- Fixed multibracket braces – This type of dental braces consists of brackets cemented to each tooth, and an archwire that connects each one. The orthodontist adjusts or changes the wire on a regular basis to train the teeth into proper alignment.
- Removable devices – There are many non-fixed dental braces available to treat a malocclusion. Retainers, headgear and palate expanders are amongst the most common. Retainers are generally used to hold the teeth in the correct position whilst the jawbone grows properly around them.
- Invisalign® – These dental aligners are removable and invisible to the naked eye. Invisalign works in much the same way as fixed dental braces, but do not impact the aesthetics of the smile. Not all patients are candidates for Invisalign®.
If you have any questions about malocclusions, please contact our office
In much the same way as doctors choose to specialize in areas such as cardiology and neurology, dentists can also choose to specialize. Orthodontics is a dental specialty which aims to prevent, diagnose and treat facial and dental irregularities, such as malocclusions (bad bites). Many orthodontic practices are limited to dentofacial orthopedics and general orthodontics but can successfully treat patients of any age.
Orthodontists are fully qualified dentists who embark on a further three years of university-based study and gain extensive clinical experience in an orthodontic residency program. The American Association of Orthodontists (AAO) is the regulating body for this branch of dentistry. Selecting an orthodontist who is a member of this organization adds the assurance that treatment is being administered by an individual with specialty education in oral biology and biomechanics. The AAO recommends that children should first be examined by the orthodontist around the age of seven, to ensure that jaw and tooth irregularities are not beginning to form.
What does an orthodontist do?
Orthodontists are experts in correcting misalignments of the teeth and jaw. There are many debilitating problems associated with misalignment, for example, speech defects, difficulties chewing and difficulty maintaining adequate oral hygiene.
Here is a brief overview of some of the most common issues an orthodontist can successfully treat:
- Anteroposterior deviations – Common examples of anteroposterior deviations include underbite (the lower teeth are positioned further forward than upper teeth) and overbite (the upper teeth are positioned further forward than the lower teeth). Both of these deviations can cause difficulty articulating and chewing.
- Overcrowding – Overcrowding is one of the most common problems orthodontists treat. On occasion, lack of jawbone space means adult teeth cannot erupt in alignment with existing teeth. The orthodontist is able to realign the teeth using a number of unobtrusive devices and treatments.
- Aesthetic issues – In some cases, the shape of the whole face is negatively impacted by malocclusions or a bad bite. The orthodontist can restructure and realign the jaw, lips and teeth to create a beautiful, even smile.
How does an orthodontist realign jaws and teeth?
Initially, the orthodontist conducts a thorough examination of the jaw and teeth. Panoramic x-rays and study models (bite impressions) will be taken prior to the orthodontist making treatment recommendations. The orthodontist will recommend the best treatment plan for the patient’s particular condition.
Here is a brief overview of some of the treatments orthodontists may use:
- Dental braces – The combination of brackets (which are affixed to each individual tooth), and an archwire (which connects each bracket) are commonly placed to gently train the teeth into proper alignment. Dental braces can be made of metal, ceramics or clear (“invisible”) materials.
- Headgear and facemasks – These devices are generally used to correct a developmental problem, such as an overbite or an underbite. In addition to the dental braces, the orthodontist will design the headgear and/or facemask which fit around the head and attaches to the braces. This structure will further encourage the teeth and jawbone into alignment.
- Retainers – After the orthodontist has realigned the teeth using dental braces, removable devices or a headgear, a retainer may then be provided to ensure that the teeth do not begin to move back toward their original positions. Retainers are generally worn until the underlying bone has reformed into the correct position.
If you have any questions about orthodontists and the treatments they provide, please contact our office.
Orthodontics is one of many dental specialties. The word “orthodontics” is derived from the Greek words orthos, meaning proper or straight and odons meaning teeth. Orthodontics is specifically concerned with diagnosing and treating tooth misalignment and irregularity in the jaw area. Initially, orthodontic treatments were geared toward the treatment of teens and pre-teens, but these days around 30 percent of orthodontic patients are adults.
There are many advantages to well-aligned teeth, including easier cleaning, better oral hygiene, clearer speech and a more pleasant smile. Though orthodontic treatment can be effective at any age, the American Dental Association suggests that an orthodontic assessment should be performed around the age of seven. The earlier orthodontic treatment begins, the more quickly the problem can be successfully resolved.
What problems can be treated with orthodontics?
Orthodontics is a versatile branch of dentistry that can be used alone, or in combination with maxillofacial or cosmetic dentistry.
Here are some of the common conditions treated with orthodontics:
- Anteroposterior deviations – The discrepancy between a pair of closed jaws is known as an anteroposterior discrepancy or deviation. An example of such a discrepancy would be an overbite (where the upper teeth are further forward than the lower teeth), or an underbite (where the lower teeth are further forward then the upper teeth).
- Overcrowding – Overcrowding is a common orthodontic problem. It occurs when there is an insufficient space for the normal growth and development of adult teeth.
- Aesthetic problems – A beautiful straight smile may be marred by a single misaligned tooth. This tooth can be realigned with ease and accuracy by the orthodontist. Alternatively, orthodontists can also work to reshape and restructure the lips, jaw or the face.
Orthodontics is a technologically advanced field which offers many sophisticated solutions to malocclusions and other cosmetic problems. The orthodontist will generally perform a visual examination, panoramic x-rays and study models (bite impressions) in order to assess the exact nature of the discrepancy.
When a diagnosis has been made, there are a variety of orthodontic treatment options available.
Here is an overview of some of the most common treatments:
- Fixed orthodontic braces – A metal or ceramic dental base is affixed to each tooth, and a dental wire is inserted through each base. The orthodontist is able to gradually train the teeth into proper alignment by regularly adjusting the wire. When the desired results are achieved, the fixed dental braces are completely removed.
- Removable appliances – There are a wide range of removable appliances commonly used in orthodontics, including headgear that correct overbites, Hawley retainers that improve the position of the teeth even as the jawbone reforms, and facemasks which are used to correct an underbite.
- Invisalign® – This is a newer, removable type of dental aligner that is completely transparent. Invisalign® does not interfere with eating because of its removable nature, and mechanically works in the same way as the traditional metal dental braces. Not all patients are candidates for Invisalign®.
If you have any questions or concerns about orthodontics, please contact our office.
Orthodontics is a specialized branch of dentistry that is concerned with diagnosing, treating and preventing malocclusions (bad bites) and other irregularities in the jaw region and face. Orthodontists are specially trained to correct these problems and to restore health, functionality and a beautiful aesthetic appearance to the smile. Though orthodontics was originally aimed at treating children and teenagers, almost one third of orthodontic patients are now adults. A person of any age can be successfully treated by an orthodontist.
A malocclusion (improper bite) can affect anyone at any age, and can significantly impact the individual’s clarity of speech, chewing ability and facial symmetry. In addition, a severe malocclusion can also contribute to several serious dental and physical conditions such as digestive difficulties, TMJ, periodontal disease and severe tooth decay. It is important to seek orthodontic treatment early to avoid expensive restorative procedures in the future.
What problems can orthodontics treat?
Orthodontics can treat a wide range of dental problems and in most cases, completely realign the teeth. Orthodontists may work alone, or in combination with a maxillofacial surgeon.
The typical irregularities requiring orthodontic treatment are as follows:
- Overcrowding – An overcrowded mouth means there is insufficient space within the jaw for all of the adult teeth to fit naturally. Overcrowding may lead to displaced, rotated or completely misaligned teeth.
- Overbite – An overbite refers to the protrusion of the maxilla (upper jaw) relative to the mandible (lower jaw). An overbite gives the smile a “toothy” appearance and the chin looks like it has receded.
- Underbite – An underbite, also known as a negative underjet, refers to the protrusion of the mandible (lower jaw) in relation to the maxilla (upper jaw). An underbite makes the chin look overly prominent. Developmental delays and genetic factors generally cause underbites and overbites.
How can orthodontics help?
- Orthodontic dentistry offers techniques which will realign the teeth and revitalize the smile. There are several treatments the orthodontist may use, depending on the results of panoramic x-rays, study models (bite impressions) and a thorough visual examination.
- Fixed dental braces can be used to expediently correct even the most severe case of misalignment. These braces consist of metal or ceramic brackets which are affixed to each tooth and an archwire which is used to gradually move the teeth through the duration of the treatment.
- Removable appliances include headgear (which consists of a metal wire device attached to customized braces), retainers, Invisalign® aligners (which are almost invisible to the naked eye), palate expanders and tooth movers. Faceguards are generally used to correct developmental delays in both the upper and lower jaw, and palate expanders are used to combat overcrowding.
- Whatever the dental irregularity or the age of the individual, orthodontic appliances can properly realign the teeth and create a beautiful smile.
If you have any questions or concerns about orthodontic treatments or how they can benefit you, please contact our office.