published December 5th, 2008

Orthodontic treatment is the use of braces, most commonly to straighten crooked teeth or to correct prominent upper front teeth. The type of brace chosen depends on the problems that have to be corrected. There are three main types of brace:

  1. Fixed braces – the teeth have small attachments glued to them. Fixed braces fitted to upper and lower teeth look a bit like railway lines, so some people call them “train-track braces”. Fixed braces are very good for correcting complex problems. These are commonly made of stainless steel, when used for children as they are easier to keep clean. Tooth coloured ceramic or acrylic appliances are also available, and are most often used for adults. They are much more aesthetic. We are investigating the use of lingual fixed appliances. this is where the attachments are glued to the back of the teeth, very helpful for straightening teeth for people in prominent positions.
  2. Removable braces – can obviously be removed, but they must be worn full-time, apart from when they have to be cleaned. Removable braces are good for correcting simple problems, such as moving a single tooth.
  3. Functional braces – These are also removable but have to be worn full-time, except for cleaning. They are used to correct the growth pattern of the jaws. They can be used when one jaw is bigger than the other, to correct asymmetry. They can be used in conjunction with headgear to help jaws to grow correctly.

What happens on the first appointment?

An initial short examination appointment is to discuss the possibilities of orthodontic treatment. This is followed by a full examination. A full examination is made which will include X-ray pictures and moulds of the teeth. You will not have a brace fitted, or any other treatment, on this visit. You will get a full report on the treatment to be undertaken, as well as a full schedule of the fees payable. Particular attention is paid to how well you brush your teeth! It is important to know that you are capable of keeping your teeth clean before a brace is fitted since it is very much more difficult to clean them with a brace on. We insist that all patients are seen regularly by a hygienist to ensure that their teeth are kept in the best condition possible. If you are ready for treatment, your next appointment will be to fit the appliances.

What is it like having a brace fitted?

A removable brace is fitted very easily by clipping it onto several teeth. There is no discomfort involved. Fixed braces are simply “glued” onto the teeth. There is no need for an anaesthetic injection.   Teeth can become a bit sore a few hours after a brace is fitted or adjusted and this can last for two or three days. Simple painkillers will help a lot. We also recommend a soft diet for the first few days.

What happens after the brace is fitted?

Your brace has to be adjusted regularly. Removable braces are adjusted every 4-8 weeks and fixed braces every 4 weeks.

How long will the treatment take?

This depends on how much work there is to do. Fixed brace treatment can take between 12 and 24 months, but longer if the problem is particularly severe. If braces are broken frequently this can add a lot of time to the total. Combination treatment for difficult cases can take as long as 48 months.

Retainer braces

It is important to realise that once a brace is removed the teeth can drift back towards their original positions. They must, therefore, be held in their new positions for a long time with retainer braces until they have settled. Retainers are either removable appliances or thin wires stuck onto the tongue side of the teeth.

Do braces mark the teeth?

The brace will not mark the teeth. If dental plaque is allowed to become thick around the brace the plaque itself may damage the teeth. Instruction will be given on the use of special brushes. A daily fluoride mouthrinse can be used to harden areas that are very difficult to clean. Care must be taken to choose an alcohol-free, pH-balanced rinse. Certain foods and drinks may also lead to damage. You should avoid drinking lots of fizzy drinks and keep in-between-meal snacks to a minimum.

Foods to avoid during treatment

Very crunchy and sticky foods can break your brace. Toffee and chewing gum must be avoided. Really enjoyable hard foods can be chopped up and chewed gently!

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