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Frequently Asked Questions

Is it painful?
Source: British Orthodontic Association

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.

How often will I need an appointment?
Source: British Orthodontic Association

Once your brace has been fitted you will
need frequent and regular appointments
for it to be adjusted

Will I still need to see my regular dentist?
Source: British Orthodontic Association

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?
Source: British Orthodontic Association

Will I need to wear another brace once

my treatment has finished?

Why might I need orthodontic treatment?
Source: British Orthodontic Association

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

Is it always possible to have braces as an adult?
Source: British Orthodontic Association Age is not necessarily a limiting factor. It more often depends on the type of bite you have, the position of your teeth and the condition of both your teeth and gums. For instance if you have active gum disease, it is important this is brought under control before having a brace
What types of braces are there?
Source: British Orthodontic Association

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

Does it have to be so visible?
Does it have to be so visible?

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

How long will treatment take?
Source: British Orthodontic Association

It usually takes 12 - 24 months but will vary

according to how complex your case is

If teeth need to be extracted who will do this?
Source: British Orthodontic Association

Your own dentist will usually do this


Is there anything else I can do to help keep my child’s mouth healthy?
Source: British Orthodontic Association

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


When do teeth start to come through?
Source: British Orthodontic Association

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

How may the cleft affect the teeth?
Source: British Orthodontic Association

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

Are baby teeth important?
Source: British Orthodontic Association

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

How can I keep my child’s teeth healthy?
Source: British Orthodontic Association

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

What happens if I am ready to start treatment?
Source: British Orthodontic Association

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.

When will treatment start?
Source: British Orthodontic Association

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.

Why have I been referred to the orthodontist?
Source: British Orthodontic Association

Your dentist would like specialist advice about the position of your teeth. The orthodontist will advise whether you would benefit from orthodontic treatment.

What will happen at my first appointment?
Source: British Orthodontic Association

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.

What is orthodontic treatment?
Source: British Orthodontic Association

Orthodontic treatment usually involves the wearing of braces (removable or fixed) often the extraction of teeth, and very occasionally jaw surgery.

Why might I need orthodontic treatment?
Source: British Orthodontic Association

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.

Will I need to wear another brace once my treatment has finished?
Source: British Orthodontic Association

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.



How often will I need an appointment?
Source: British Orthodontic Association

You will need regular appointments (usually every 5-8 weeks) during treatment for the brace to be adjusted.

Do I still need to see my regular dentist?
Source: British Orthodontic Association

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.



What if I play contact sports?
Source: British Orthodontic Association

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.

What if I play a musical instrument?
Source: British Orthodontic Association

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.



What do I do if my brace breaks?
Source: British Orthodontic Association

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.

Will it be painful?
Source: British Orthodontic Association

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.

Can I remove the brace?
Source: British Orthodontic Association

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.

Can I eat normally?
Source: British Orthodontic Association

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!

What about tooth brushing?
Source: British Orthodontic Association

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.

How long will treatment take?
Source: British Orthodontic Association

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.

Will I need to wear anything in addition to the fixed brace?
Source: British Orthodontic Association

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.

What happens if I keep damaging my brace?
Source: British Orthodontic Association

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

Do I need to change my eating habits?
Source: British Orthodontic Association

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.

Can I eat snacks?
Source: British Orthodontic Association

Eating 3 meals a day instead of snacking

is better for your health and teeth.

What food and drinks can I eat

What food and drinks can I eat between meals?
Source: British Orthodontic Association

Select healthy foods to eat if you

are hungry between meals. These

include: wholemeal bread, plain cheese,

dry crackers, breadsticks, fruit and

vegetables.

What will the operation involve?
Source: British Orthodontic Association

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

How long will I need to wear a fixed brace?
Source: British Orthodontic Association

Moving an impacted canine can be a very

slow process. It can often take more

than 2 years for the treatment to be

completed

Will I feel the tooth being pulled down?
Source: British Orthodontic Association

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

Will the treatment work?
Source: British Orthodontic Association

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.

What are impacted canines?
Source: British Orthodontic Association

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.

Why are the canines important?
Source: British Orthodontic Association

They help to give a pleasing, balanced

and symmetrical smile.

Why do canines become impacted?
Source: British Orthodontic Association

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.

What problems can occur?
Source: British Orthodontic Association

• 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.

Are my teeth more likely to decay if enamel is removed?
Source: British Orthodontic Association

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

How long will the mini-screw be in my mouth?
Source: British Orthodontic Association

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.

Will I look very different after the operation?
Source: British Orthodontic Association

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

Will I still need to see my regular dentist
Source: British Orthodontic Association

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

How often will I now need to be reviewed?
Source: British Orthodontic Association

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

Will the roots of my teeth be damaged?
Source: British Orthodontic Association

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

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Invisalign is a brand name for a type of thin transparent braces used to treat and correct the position

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