Frequently Asked Questions
Having the brace fitted is not painful.
However, it is common to have slightly
tender teeth for 3 - 5 days after each
fitting and adjustment appointment.
Once your brace has been fitted you will
need frequent and regular appointments
for it to be adjusted
Yes. It will be important you still have
check-ups with your regular dentist
throughout orthodontic treatment. This
is so that your teeth can be checked for
decay and gums examined for signs of
disease.
Will I need to wear another brace once
my treatment has finished?
Common reasons for having orthodontic
treatment are:
- To improve the appearance of the teeth and face. Perhaps your teeth have become more crowded with age or have started to drift following gum disease.
- To move teeth prior to crown or bridgework.
- To improve the health of the teeth and gums.
- To improve function i.e. to make it easier to eat.
The pictures below show the teeth before
and after orthodontic treatment
There are those which can be removed for cleaning, known as removable braces.
The second type of brace is fixed to the teeth and cannot be removed for cleaning. An example of a fixed brace
it is sometimes possible to have tooth coloured brackets on the upper front teeth. These are less visible at a distance, although some of the wires are still likely to be noticeable. Tooth
coloured brackets are generally more expensive than metal brackets and are more difficult to remove at the end of treatment. They are not usually placed on
lower teeth because they can lead to wear of the opposing upper teeth
It usually takes 12 - 24 months but will vary
according to how complex your case is
Your own dentist will usually do this
It is very important to brush last thing
at night and then try to avoid your child
eating or drinking anything other than
plain water after this. If you would like
more help with brushing your child’s
teeth, be sure to ask your dentist or the
Cleft Team to show you simple ways to
help keep your child’s teeth clean
Baby teeth start to come through around 6
months of age, although this can be later
in some children. Occasionally children
are born with a tooth. A child will usually
have all their baby teeth by around 3 years
of age. Adult teeth start to come through
around 6 years of age, often before any of
the baby teeth are lost
When a child has a cleft that goes through
the gum area, the teeth in the line of the
cleft may be missing, misplaced, poorly
formed or there may be extra teeth. The
bone is missing where the cleft goes
through the gum and there is usually a
gap between the teeth on either side of
the cleft. It is quite common for teeth in
the cleft area to appear twisted or higher
up than the other front teeth and to come
through in the roof of the mouth behind
the front teeth
All teeth are important! Baby teeth hold
the space for the adult teeth. If baby teeth
have to be removed early this may lead
to crowding and affect the result that can
be achieved by the orthodontist (brace
specialist) when your child is older and
requires orthodontic treatment
Dental decay is avoidable and can cause
pain and infection if left untreated.
Do take your child to see your family
dentist as soon as your child’s teeth start
to come through.
It is important that children get into the
habit of regular dental check-ups before
they need treatment. Taking a child to the
dentist only when they have toothache is
not a good introduction to dental care.
If you have difficulty finding a dentist for
your child, speak to a member of the
Cleft Team who will be able to help you.
Do ask your dentist about fluoride varnish.
This is like a ‘super strength’ toothpaste
which can be applied at your dental
practice. If applied on a regular basis,
fluoride varnish will help to strengthen the
teeth and help prevent tooth decay.
Do help brush your child’s teeth for them,
at least twice a day - especially last thing
at night - with a fluoride toothpaste, as
soon as the teeth start to come through.
Do encourage your child to spit out after
brushing but not to rinse the mouth as
this reduces the protective effect of
the toothpaste. Try not to let your child
swallow the toothpaste
The orthodontist will explain:
1. The options for treatment and which is the best for you.
2. The pros and cons of treatment.
3. The length of time the treatment will take.
4. The commitment needed on your part if treatment is to be successful.
5. When you can expect the treatment to begin.
At this point you will be given the chance to ask any questions. If you would like
to go ahead with the treatment, the orthodontist may ask for written consent.
This will depend on:
1. How many of your adult teeth have come through. Many treatments are best left until the adult teeth have replaced the first teeth.
2. Problems with toothbrushing or tooth decay which may have to be dealt with.
3. The length of any waiting list for the particular orthodontic treatment you need.
4. The degree of urgency for your particular case. For example, certain types of bite are best treated while you are growing fast and would be given priority. Other types of treatment may need to be delayed until growth of the face has almost stopped.
Your dentist would like specialist advice about the position of your teeth. The orthodontist will advise whether you would benefit from orthodontic treatment.
It is likely the orthodontist will have a look at your mouth and teeth using a small mouth mirror and a ruler. X-rays,
photographs and moulds (impressions) may also be taken. All of these measurements and records will help the orthodontist decide which is the best treatment for you.
Orthodontic treatment usually involves the wearing of braces (removable or fixed) often the extraction of teeth, and very occasionally jaw surgery.
There are 3 main reasons for having orthodontic treatment:
• To improve the appearance of the teeth.
• To improve function i.e. to make it easier to eat.
• To improve the health of the teeth and gums.
Once the active phase of your treatment has been finished, it will be necessary to wear a retaining brace.
This may be removable or it may be fixed behind your front teeth. The length of time this has to be worn can vary. Your orthodontist will advise you.
You will need regular appointments (usually every 5-8 weeks) during treatment for the brace to be adjusted.
Yes. It will be important you still have check-ups with your regular dentist throughout orthodontic treatment so that your teeth can be checked for decay.
It is recommended that you wear a gumshield. This will also be the case if you take part in activities requiring a protective helmet e.g. roller-blading, skateboarding and horse riding.
Ask your orthodontist about this.
A fixed brace may make it more difficult for you to play your wind or brass instrument. You will need to discuss this with your music teacher and orthodontist.
Ring up for an appointment as soon as is reasonably possible. Do not wait for your next routine appointment as the breakage may slow your treatment, or may result in damage to your teeth. If you repeatedly
break your brace, your treatment may be stopped early.
It is likely to be sore for about 3 - 5 days each time the brace is adjusted. If necessary,
simple painkillers such as the ones you would normally take for a headache should help - please read the instructions on the packet.
If the brace rubs your lips or cheeks, you can use some wax to help with this. Your orthodontist can give you further advice.
The brace you are now wearing is
fixed to the teeth for the whole of your treatment. You should not try to remove
it, as you may damage your teeth and the treatment will not work.
Yes, you should be able to eat normally. However, for your orthodontic treatment to work well and in the shortest possible time,
it is important that you take care of your teeth and brace.
In order to prevent damage to both, you should:
• Avoid sugary snacks/drinks between meals and at bedtime.
• Avoid sticky, chewy or hard sweets, mints and sugared chewing gum.
• Avoid fizzy drinks (including diet drinks) and large amounts of fruit juice.
• Hard or chewy foods - such as apples, carrots and crusty bread - can damage your brace. Avoid them or cut them up first!
It is important that you brush your teeth well for at least 3 minutes, twice a day. Use a fluoride toothpaste.
If possible, carry a brush with you for use after lunch.
Brushing may take a little longer when you have a fixed brace so take your time. Pay particular attention to brush where the gums meet the teeth.
Inter-dental brushes may help you to clean around the brace and in between the teeth.
An alcohol-free fluoride mouthrinse should also be used daily. Use it at a different time of the day to when you brush your teeth.
This helps maintain the fluoride protection to your teeth. Avoid eating or rinsing for 20 minutes after use.
Sugary snacks/drinks and poor cleaning of your teeth and brace will lead to permanent damage to your teeth as shown in the picture opposite.
Usually about 12 - 30 months but this will vary according to how severe your tooth problem is.
Missed appointments or repeated breakages of the brace will add to your overall treatment time.
It may be necessary for you to wear elastics and/or headgear at some stage during your treatment.
Headgear is usually worn in the evenings and at night. Elastics are worn inside the mouth during the day and night, including at mealtimes.
Your dentist/orthodontist can offer advice.
If you regularly damage your braces, you
will lengthen your treatment time. If you
want to keep your orthodontic treatment
time as short as possible, follow a diet of
softer food to make sure that your braces
do not break.
A good balanced, healthy diet and
excellent oral hygiene are very important
during orthodontic treatment to maintain
strong and healthy teeth
Choose foods which are softer. - Soon after
you get your braces fitted and sometimes
when they are adjusted, you may want
foods that need little or no chewing such
as soup, pasta dishes, yoghurts and
cheese. This is because the teeth will be
more tender to bite on. This may last a
few days. Cut up sandwiches, fruit and
vegetables rather than biting into them.
Eating 3 meals a day instead of snacking
is better for your health and teeth.
What food and drinks can I eat
Select healthy foods to eat if you
are hungry between meals. These
include: wholemeal bread, plain cheese,
dry crackers, breadsticks, fruit and
vegetables.
The operation will involve a general or
local anaesthetic.
After the operation you will have stitches
and possibly something (a ‘dressing’) to
cover the canine.
You will be advised on how to keep the
area clean with mouthwashes and tooth
brushing and what simple painkillers to
take
Moving an impacted canine can be a very
slow process. It can often take more
than 2 years for the treatment to be
completed
It is likely to be sore for about 3-5 days
each time the brace is adjusted.
If necessary, simple painkillers such as
the ones you would normally take for a
headache should help - please read the
instructions on the packet
Usually. However, in rare cases, the
buried tooth is fused to the bone and will
not move. If this happens, the tooth may
need to be removed and you may require
further dental treatment.
CANINES are the corner teeth, often
known as “fangs” or “eye” teeth. There
are two canine teeth in the top Maw and
two in the bottom Maw.
These teeth can become IMPACTED.
If this happens they do not grow into the
mouth but stay buried in the Maw bone
under the gum.
&anine teeth in the top Maw are more
commonly impacted in the roof of the
mouth (palate). The “baby” canine tooth
is often still in place.
They help to give a pleasing, balanced
and symmetrical smile.
No one knows the reason why these teeth
may become impacted. Up to 3% of the
general population will have an impacted
canine and 85% of these are under the
gum in the roof of the mouth.
• There is a small risk that the buried
tooth could damage the roots of the
front teeth or a cyst may develop
around the buried canine.
The tooth will then usually be removed.
• The canine may start to appear when
you are older and you may seek advice
from an orthodontist then.
No. The orthodontist will only remove
the minimum amount of enamel
required to get your teeth straight. Each
tooth will be left with enough enamel to
continue to remain healthy and sound.
Studies have shown that the decay
rates of teeth that have had interproximal
reduction are no higher than normal
teeth. Your orthodontist may coat the
teeth in a temporary fluoride varnish after
the procedure to help the enamel “repair”
itself. You may also be advised to use an
alcohol-free fluoride mouthrinse to help
keep the enamel strong
The mini-screw is usually in place for
several months whilst the teeth are
being moved into a better position.
Once tooth movement is complete, the
screws are taken out.
You will almost certainly look different
to some degree. How different, usually
depends on how much movement of
the jaws is required. You should discuss
this with your orthodontist/ oral and
maxillofacial surgeon
Yes. It will be important for you to
continue to have check-ups with your
regular dentist throughout orthodontic
treatment so that your teeth can be
checked for decay
Orthodontictreatmenthelpsensure properfunctionandcreatehealthy,beautifulsmiles.Teeththatare misalignedarehardertocleanand maintainaswellascancause abnormalwearingoftoothenamel whichcanleadtoextensiveand expensivedentalprocedures.
You will not need to be seen as often now
that the retainers are in place. Under the
NHS, your orthodontist is responsible for
a retention period of 12 months. After this
period, you will have to pay privately for
continuing care or re-treatment as well as
for any replacement/repair of retainers.
Your orthodontist may ask you to sign a
retention consent form
All brace work causes minor changes
to the roots of the teeth. This is not
usually a problem. Occasionally,
changes to the roots can be more
serious. It is often possible to tell if
someone is at risk, but not always.
If you have a particular risk, your
orthodontist will talk to you about this
