All About Braces

Early Treatment
At what age should my child have an orthodontic examination?
Like the American Association of Orthodontists, Dr. Patel recommends that most children should have an orthodontic screening by age 7. This allows Dr. Patel to determine if orthodontic treatment will be required and the best time your child to be treated. With Dr. Trotter also carefully monitoring the development of your child’s teeth, Dr. Patel will provide the right orthodontic treatment at the right time for your child.

Why are children being evaluated at such an early age?
Early diagnosis and treatment can guide erupting teeth into a more favorable position, preserve space for permanent teeth, and reduce the likelihood of fracturing front teeth that stick out too far. Early treatment can also improve your child’s self-esteem if he/she is self-conscious about his/her appearance and smile.

If early treatment is indicated, Dr. Patel can guide the growth of the jaw and incoming permanent teeth. Early treatment can also regulate the width of the upper and lower dental arches, gain space for permanent teeth, avoid the need for permanent tooth extractions, reduce the likelihood of impacted permanent teeth, correct thumb-sucking habits, and eliminate abnormal swallowing or speech problems. To summarize, early treatment can simplify later treatment, after all the permanent teeth erupt.

Does early treatment benefit all children?
Early treatment does not necessarily benefit all children. Certain types of orthodontic problems can be more easily and efficiently corrected in the teen years when all the permanent teeth have erupted. Some skeletal orthodontic problems should not be addressed until growth is more advanced or completed. Dr. Patel develops a plan for treatment based on each individual child’s needs. If he decides your child is not ready for treatment, Dr. Patel will monitor your child’s growth and development and advise you when your child is ready for treatment.

What happens as Dr. Patel monitors the growth and development of my child?
As he evaluates the growth of development of your child, Dr. Patel will monitor the eruptive pattern of the permanent teeth. Sometimes, poor eruptive patterns of permanent teeth may be improved/eliminated with early removal of baby teeth and reduce the treatment time required for braces. We normally see patients every 6-8 months to observe their progress as they grow. There is no fee for these appointments, since it helps Dr. Patel determine the optimum time to begin treatment and achieve the best possible result for your child.

In addition to a beautiful new smile, what are some other benefits of orthodontic treatment?
Braces can improve function of the bite and teeth, improve ability to clean the teeth, prevent wear on the teeth, and increase the longevity of natural teeth over a lifetime.

If a child has treatment early, will this prevent the need for braces as an adolescent?
Early treatment can begin the correction of significant problems, prevent more severe problems from developing, and simplify future treatment. Because all of the permanent teeth have not yet erupted when early treatment is performed, their final alignment may not have been corrected. Typically, a shortened comprehensive phase of treatment in the teen years (after all the permanent teeth have erupted) is required to complete the correction.

Do we still need to see our dentist during orthodontic treatment?
Patients with braces and other orthodontic appliances require more effort to keep their teeth and gums clean. Because Dr. Patel wants to ensure the highest level of dental health for your child, he will encourage you to see your dentist for regular check-ups and cleanings during treatment. If your child is a patient of Dr. Trotter’s, he/she can be conveniently scheduled with both doctors on the same day.
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Adolescent Treatment
Between the ages of 11 and 15 is the most common time for comprehensive orthodontic treatment. The reason for this is that by age 12, most (if not all) of the permanent teeth have erupted and are in place, and crooked teeth, gaps, and poor bites can easily be detected. Since these problems will hardly ever correct themselves, this is the time that most parents decide to seek orthodontic treatment for their children.

This is also a great time for orthodontic treatment, since many negative associations of braces are not present. As many children at this age range undergo orthodontic treatment, children are more open to braces, since their friends are also wearing them. For young adults who are too self-conscious or do not want to have metal braces, we offer clear brackets and Invisalign® as more esthetic alternatives.

Besides the benefits of fitting in with their peers children at this age have high metabolisms, which can shorten overall treatment time and reduce the discomfort of orthodontic treatment.

Call our office for an initial FREE orthodontic examination! We will walk you through the orthodontic process and highlight the best treatment options available for your particular needs, including the expected treatment time to complete care and the approximate cost for the treatment.
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Adult Treatment
Orthodontics is not just for children and teens. In fact, 1 in every 5 patients in orthodontic treatment is an adult. No one is too old for orthodontic treatment!

Adults seek orthodontic treatment for many of the same reasons as children. Some adults had orthodontic problems as children but were unable to correct them until now. Others, who had treatment as children, may need further treatment as adults due to relapse or limitations of initial treatment.

  • Benefits of Adult Treatment:
    • Align the teeth to create a more esthetic and beautiful smile
    • Correct relapse after previous orthodontic treatment due to a lack of long-term retainer wear
    • Improve the ability to brush and floss, especially for crowded or overlapping lower front teeth
    • Create a better or more comfortable bite and ability to chew
    • Address missing teeth by working with your dentist to help align your teeth for optimal tooth replacement
    • Close spaces between teeth
    • Reduce excessive wear on the teeth due to grinding or poor bite
    • Jaw surgery to correct a discrepancy between the upper and lower jaws
  • Appearance of Braces
    • Many adults are concerned with the appearance of braces. Often, Invisalign® (an “invisible” alternative to braces) can be used to treat adults. This technology involves clear removable aligners, fabricated through advanced 3-D imaging to align the teeth. For more severe problems, we have the option of clear ceramic brackets instead of the traditional metal brackets.
  • Soreness/Discomfort
    • Orthodontic treatment is no more uncomfortable for adults than children. Adults undergoing orthodontic treatment report the same level of soreness as children.
    • Typically, the teeth are most uncomfortable 12-24 hours after an orthodontic adjustment and will disappear within 3-5 days. Modern appliances are not only smaller and more comfortable to wear but also designed with new materials that put less pressure on the teeth, thereby decreasing the discomfort level while moving the teeth more efficiently.
  • Cost
    • The fee for adult orthodontic treatment is determined the same way as early or adolescent treatment. It is based on the severity of the problem, the complexity of the correction, the appliances used and the length of time to correct.

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Taking Care of Braces
The best way to ensure a clean and healthy smile is brushing and flossing. Food can accumulate on and around the teeth and in the braces. Over time, it hardens and turns into plaque if you are not brushing and flossing on a regular basis. The bacteria that thrives on plaque causes problems and can lead to gum disease, tooth decay, and even loss of teeth. To avoid these problems while you are in orthodontic treatment, take special care of your braces, teeth, and gums to ensure you will have the best possible result.

Brushing
Use a toothbrush with soft bristles and a small strip of fluoride toothpaste. When you brush your teeth, move the brush in small, circular motions to reach food particles that may be under your braces and under your gum line. Hold the toothbrush at an angle and brush slowly and carefully, covering all areas between your teeth, between braces and the surface of each tooth. It will take you several minutes to thoroughly brush your teeth. Brush up on the lower teeth, down on the upper teeth, and the outside, inside and chewing surfaces of your front and back teeth. Brush your tongue and the roof of your mouth before you rinse.

Especially during orthodontic treatment, brush your teeth at least 3 times daily to avoid the accumulation of food particles in your teeth and braces:

  • Morning (after breakfast);
  • After school;
  • Evening (bedtime)

You will need to replace your toothbrush more often due to your appliances. As soon as the bristles start to wear down or fray, replace your toothbrush with a new one. It may be difficult for your toothbrush to reach some areas under your archwire. Do not swallow any toothpaste; rinse your mouth thoroughly with water after you finish brushing. It is important to floss and use an antibacterial mouthwash and fluoride treatment throughout your orthodontic treatment and beyond for optimal oral hygiene.

We recommend that you spend most of your brushing and flossing time right after school, which may take you up to 20 minutes. At bedtime, brush for 2 minutes and rinse with a fluoridated mouthwash before sleeping. Please follow the instructions on how to use the fluoridated mouthwash.

Flossing

For areas between the teeth that a toothbrush cannot reach, use dental floss to remove food particles and plaque. Flossing takes more time and patience are wearing braces, but it is important to floss your teeth every day.

Use the “super-floss” or re-usable floss threader provided by our office to floss under your archwire daily. Pull a small length of floss from the dispenser through the threader and slide it up and down along the front of each tooth. You will be able to feel when the tooth is clean and hear the squeak of the floss against your clean teeth. Use care around your archwire and do not floss too forcefully around it or put too much pressure on it. After you floss between your archwire and braces, floss between your other teeth and gums.

When you first begin flossing around your braces, your gums may bleed a little. If the bleeding does not go away after the first few times, inform us at your next appointment.

Watch the video below to learn about the correct way to brush and floss your teeth during orthodontic treatment.

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Types of Braces
Traditional Metal Braces
Traditional metal braces are the most common type of braces and are more comfortable today than ever before. Made of high-grade stainless steel, metal braces straighten your teeth using metal brackets and archwires. With metal braces, you have the option of adding colored rubber bands for a more unique and colorful smile!

Ceramic Braces
Ceramic braces are made of clear materials and are therefore less visible on your teeth than metal braces. For this reason, ceramic braces are used mainly on older teenagers and adult patients who have cosmetic concerns. While they are virtually less prominent, they do require more attention to oral hygiene, as ceramic braces are larger and more brittle than their metal counterparts. For these reasons, ceramic braces tend to be used more on upper front teeth than on the lower teeth.

“Invisible” Braces
Clear appliances (such as Invisalign®) use a series of clear, removable and comfortable aligners to straighten your teeth. Plus, no one can tell you are wearing those aligners, since they are virtually invisible! Since the aligners are removable, you can eat and drink what you want while in treatment. Additionally, brushing and flossing are less of a hassle.
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Retainers
The benefits of orthodontic treatment will last a lifetime if you keep these important patient responsibilities in mind:

Dental examinations and cleanings
Patients should continue with proper oral hygiene procedures at home, including thorough brushing and flossing techniques. Patients should be seen by his/her dentist at least every six months for cleaning and dental examinations.

Removable Retainers
Once the active orthodontic appliances are removed, you will receive retainers to stabilize the dental correction. Because the bone and soft tissues surrounding the teeth are stabilizing for several months after braces are removed, it is imperative that the retainers are worn as instructed. Failure to wear the retainers may result in undesirable movement of the teeth, which could necessitate re-treatment.

How retainers are worn
Because teeth can continue to move throughout life, we feel that individuals who have undergone orthodontic therapy should wear retainers indefinitely. This is because, as you get older, the muscles that surround your teeth will get tighter and place pressure on your teeth, causing them to move or crowd. A patient should wear retainers for a minimum of 12 hours after the removal of braces or Invisalign. After one year, retainer wear can be reduced to sleeping time.

How to care for retainers
Retainers are made of a thermoplastic material that is sensitive to excessive heat, so they should be kept away from heaters, dishwashers, car dashboards or any place where the temperatures exceed 115 degrees (Fº). Retainers should be kept in the proper retainer case when they are not in the patient's mouth. They should also be kept away from any family pets, as they like to chew on them. Retainers should be cleaned before and after placement in the mouth. Because the material used for fabrication is slightly porous, plaque tends to cling to the surfaces.

Gentle scrubbing with a toothbrush and a mild liquid soap will remove the plaque. A denture cleaning solution, such as Efferdent, will aid in the removal of plaque and tartar. Be sure to rinse the retainers thoroughly after cleaning to remove any cleanser residue.

Because retainers are worn for years, they will need periodic replacement. Your original treatment contract includes one set of retainers after the braces are removed. If the retainers are lost or damaged due to neglect, there will be a charge for replacement. If the retainers become loose or break, contact our office immediately.

Fixed retainers (Bonded Wire)
This wire should stay in forever. The only exception is if your dentist says you are not keeping it clean and it is beginning to cause gum or bone problems. If this should occur, please have the wire removed, and replace it with a removable retainer. The removable retainer should then be worn as Dr. Patel prescribes. The fixed wire will protect the teeth as the patient gets older and your facial muscles get tighter. Please have this wire monitored by your dentist at your six-month check ups.

Habits or Conditions that Require Stronger Retention

  • Mouth breathing
  • Clenching and/or grinding of teeth (muscle hyperactivity)
  • Tongue thrusting, low tongue posture or abnormal tongue posture
  • Playing a musical instruments with a reed
  • Lip sucking
  • Pen or pencil biting
  • Spacing between the teeth prior to treatment
  • Severely rotated teeth

Our goal is to help your smile stay beautiful and healthy for a lifetime! Your cooperation is essential in order to achieve this goal.

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Eating with Braces
Don't worry - you'll be eating popcorn and snacking on potato chips again in no time! However, before you can start enjoying some of the treats you love, you will need to take special care to avoid any foods that could damage your new braces.

Foods to avoid with braces:

  • Chewy foods - bagels, licorice
  • Crunchy foods - popcorn, chips, ice
  • Sticky foods - caramel candies, chewing gum
  • Hard foods - nuts, hard candies
  • Foods that require biting into - corn on the cob, apples, carrots

Foods you CAN eat with braces:

  • Dairy - soft cheese, pudding, milk-based drinks
  • Breads - soft tortillas, pancakes, muffins without nuts
  • Grains - pasta, soft cooked rice
  • Meats/poultry - soft cooked chicken, meatballs, lunch meats
  • Seafood - tuna, salmon, crab cakes
  • Vegetables - mashed potatoes, steamed spinach, beans
  • Fruits - applesauce, bananas, fruit juice
  • Treats - ice cream without nuts, milkshakes, Jell-O, soft cake

Click here to download a copy of our "Life with Braces" PDF

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