American Association of Orthodontists (AAO) recommends an orthodontic
screening for children by the age of 7 years. At age 7 the teeth and jaws
are developed enough so that the dentist or orthodontist can see if there
will be any serious bite problems in the future. Most of the time
treatment is not necessary at age 7, but it gives the parents and dentist
time to watch the development of the patient and decide on the best mode
of treatment. When you have time on your side you can plan ahead and
prevent the formation of serious problems.
Research has shown that serious orthodontic problems can be more easily corrected when the patient’s skeleton is still growing and flexible. By correcting the skeletal problems at a younger age we can prepare the mouth for the eventual eruption of the permanent teeth. If the permanent teeth have adequate space to erupt they will come in fairly straight. If the teeth erupt fairly straight their tendency to get crooked again after the braces come off is diminished significantly. After the permanent teeth have erupted, usually from age 12-14, complete braces are placed for final alignment and detailing of the bite. Thus the final stage of treatment is quicker and easier on the patient. This phase of treatment usually lasts from 12 - 18 month and is not started until all of the permanent teeth are erupted.
orthodontic treatments in two steps provides excellent results often
allowing the doctor to avoid removal of permanent teeth and jaw surgery.
The treatment done when some of the baby teeth are still present is called
Phase-1. The last part of treatment after all the permanent teeth have
erupted is called Phase-2.
teeth, thumb sucking, tongue thrusting, premature loss of baby teeth, a
poor breathing airway caused by enlarged adenoids or tonsils can all
contribute to poor tooth positioning. And then there are the hereditary
factors. Extra teeth, large teeth, missing teeth, wide spacing, small jaws
- all can be causes of crowded teeth.
movement is a natural response to light pressure over a period of time.
Pressure is applied by using a variety of orthodontic hardware
(appliances), the most common being a brace or bracket attached to the
teeth and connected by an arch wire. Periodic changing of these arch wires
puts pressure on the teeth. At different stages of treatment your child
may wear a headgear, elastics, a positioner or a retainer. Most
orthodontic appointments are scheduled 4 to 6 weeks apart to give the
teeth time to move.
teeth are first moved, discomfort may result. This usually lasts about 24
to 72 hours. Patients report a lessening of pain as the treatment
progresses. Pain medicines such as acetaminophen (Tylenol) or ibuprofen
(Advil) usually help relieve the pain.
Wire / Brackets
& Loop (B&L) / Elastics
part of your braces which actually moves the teeth. The arch wire is
attached to the brackets by small elastic donuts or ligature wires. Arch
Wires are changed throughout the treatment. Each change brings you closer
to the ideal tooth position.
Brackets are the “Braces” or small attachments that are bonded directly to the tooth surface. The brackets are the part of your braces to which the dentist or assistant attaches the arch wire.
a bracket may come loose and become an irritation to your mouth. You can
remove the loose bracket and save it in an envelope to bring to the
office. Call the office as soon as possible and make an appointment to
re-glue the bracket.
A Band & Loop is routinely used to hold space for a missing primary (baby) posterior (back) tooth until the permanent tooth can grown in.
some time during treatment, it will be necessary to wear elastics to
coordinate the upper and lower teeth and perfect the bite. Once teeth
begin to move in response to elastics, they move rapidly and comfortably.
If elastics (rubber bands) are worn intermittently, they will continually
"shock" the teeth and cause more soreness. When elastics are
worn one day and left off the next, treatment slows to a standstill or
stops. Sore teeth between appointments usually indicate improper wear of
headgear or elastics or inadequate hygiene. Wear your elastics correctly,
attaching them as you were told. Wear elastics all the time, unless
otherwise directed. Take your elastics off while brushing. Change elastics
as directed, usually once or twice a day.
are used to help modify the growth of the jaws in children. The theory
behind their action is that if you hold a jaw in a specific position long
enough, that it will grow into that position. What you usually get is a
combination of a little jaw growth with a lot of tooth movement. These are
not universally accepted, as they do not always work.
lower lingual arch is a space maintainer for the lower teeth. It maintains
the molars where they are, it does not move them. This is fabricated by
placing bands on the molars and connecting them to a wire that fits up
against the inside of the lower teeth. It keeps the molars from migrating
forward and prevents them from blocking off the space of teeth that
develop later. This is used when you have the early loss of baby teeth or
when you have lower teeth that are slightly crowded in a growing child and
you do not want to remove any permanent teeth to correct the crowding.
Poor positioning of the teeth.
Types of Malocclusion:
The alignment and spacing of your upper and lower teeth when you bite down.
Types of Occlusion:
O rings, also called A-lastics, are little rings used to attach the arch wire to the brackets. These rings come in standard gray or clear, but also come in a wide variety of colors to make braces more fun. A-lastics are changed at every appointment to maintain good attachment of the arch wire to the bracket, enabling our patients to enjoy many different color schemes throughout treatment.
let me pick different colors for my braces -
An appliance which is placed in the roof of the mouth to widen the upper dental arch. The maxilla, or upper dental arch, is joined in the center by a joint, which allows it to be painlessly separated and spread. Temporarily you may see a space develop between the upper two front teeth. This will slowly go away in a few days. Once this has occurred, the two halves knit back together and new bone fills in the space.
of appliance: Brush as usual. Brush the appliance and roof of the mouth
thoroughly. Rinse often to clean any food lodged between the arch and
plastic or rubber donut piece which the dentist uses to create space
between your teeth for bands.
You will be shown the proper care of your braces when your orthodontic treatment begins. Proper cleansing of your mouth is necessary every time you eat. Teeth with braces are harder to clean, and trap food very easily. If food is left lodged on the brackets and wires, it can cause unsightly etching of the enamel on your teeth. Your most important job is to keep your mouth clean. If food is allowed to collect, the symptoms of gum disease will show in your mouth. The gums will swell and bleed and the pressure from the disease will slow down tooth movement.
BRUSHING: You should brush your teeth 4-5 times per day.
Look in a mirror to see if you have missed any places. Your teeth, brackets and wires should be free of any food particles and plaque.
Note: If your gums bleed when brushing, do not avoid brushing, but rather continue stimulating the area with the bristles. Be sure to angle your toothbrush so that the area under your gum line is cleaned. After 3 or 4 days of proper brushing, the bleeding should stop and your gums should be healthy again.
FLOSSING: Use a special floss threader to floss with your braces on. Be sure to floss at least once per day.
RINSE OR GEL: May be recommended for preventive measures.
don’t get mad at me when I eat something
the retainer by brushing with toothpaste. If you are wearing a lower
fixed retainer be extra careful to brush the wire and the inside of the
lower teeth. Always bring your retainer to each appointment. Avoid
flipping the retainer with your tongue, this can cause damage to your
teeth. Place the retainer in the plastic case when it is re-moved from
your mouth. Never wrap the retainer in a paper napkin or tissue, someone
may throw it away. Don't put it in your pocket or you may break or lose
it. Excessive heat will warp and ruin the retainer.
elastics (rubber bands) are worn intermittently, they will continually
"shock" the teeth and cause more soreness. Sore teeth between
appointments usually indicate improper wear of headgear or elastics or
inadequate hygiene. Wear your elastics correctly, attaching them as you
were told. Wear elastics all the time, unless otherwise directed. Take
your elastics off while brushing. Change elastics as directed, usually
once or twice a day.
feel free to contact the office if you are experiencing any discomfort
or if you have any questions. Below are a few simple steps that might
help if you are unable to contact us or if you need a “quick fix”.
a glued bracket may come loose. You can remove the loose bracket and
save it in an envelope to bring to the office or leave it where it is,
if it is not causing any irritation. Call the office as soon as possible
in order for us to allow time to re-glue the bracket.
a wire is poking your gums or cheek there are several things you can try
until you can get to the office for an appointment. First try a ball of
wax that we gave you on the wire that is causing the irritation. You may
buy additional wax at the store by the toothbrushes, or use a piece of
be careful to avoid hard or sticky foods that may bend the wire or cause
it to come out of the back brace. If this does happen, you may use
needle nose pliers or tweezers to put the wire back into the hole in the
back brace. Please call the office as soon as possible to schedule an
appointment to replace the wire.
brackets have small hooks on them for elastic wear. These hooks can
occasionally become irritating to the lips or cheeks. If this happens,
you may either use a pencil eraser to carefully push the hook in, or you
can place a ball of wax on the hook to make the area feel smooth.
You may be experiencing some discomfort after beginning treatment or at the change of wires or adjusting of appliances. This is normal and should diminish within 24-72 hours. A few suggestions to help with the discomfort:
The explanations regarding early orthodontic treatment can be confusing, so the following may serve to clarify the terms and descriptions in a helpful way:
STAGES OF DENTITION: There are three general stages of dentition:
STAGES OF BODY GROWTH: Although a child grows fastest during his/@ first year of life, there are two additional growth periods that are of great importance in orthodontic treatment:
TIMING OF ORTHODONTIC TREATMENT: There is now nearly universal agreement among dental professionals that many children with malocclusions should be examined and treated during the mixed dentition growth period. Treatment between ages 6 and 10 years is commonly called INTERCEPTIVE or 1st PHASE ORTHODONTIC CARE.
ADVANTAGES OF PERFORMING EARLY (1st PHASE) ORTHODONTIC TREATMENT:
NOTE: EVEN IF 1ST PHASE TREATMENT IS PERFORMED DURING MIXED DENTITION, NEARLY ALWAYS THERE WILL BE A NEED FOR TEEN-AGE ORTHODONTIC TREATMENT UTILIZING FIXED BANDED/BONDED APPLIANCES.
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