What constitutes an emergency in orthodontics? What can be done to take care of it? Who should I call?
A true emergency is when there is pain or difficulty in chewing your food. If there has been trauma to the mouth from sports such as a baseball in the mouth or a soccer collision, I prefer that you call my office and let me evaluate the situation. Sometimes it is necessary for me to meet you at the office or I may need to refer you to see an oral surgeon or I may be able to tell you how to remedy the situation over the phone.
If you have a loose band or bracket and it is not causing any immediate pain, call the office and schedule for the earliest available appointment during business hours. If a wire is poking, use some wax to cover up the area until you can get into the office to have it repaired.
If you have lost your headgear, biteplate or retainer, call the office to schedule an appointment to have it replaced. Each of these pieces has a very important purpose in your treatment and without them the treatment cannot progress as planned.
If you have an ulcer or red swollen gums, brush and floss the area to make sure there is no food caught below the gumline. Use Peroxyl mouthrinse swishing it for 60 seconds to bubble out the area. If it does not improve within a couple of days, call the office so that I can evaluate the area.
If you have a loose bonded retainer, call the office to schedule a repair as soon as possible. If the glue is no longer attached, the teeth can shift.
Emergencies can happen so we are available to help you if they do. We want you to be taken care of and have a good experience while achieving that smile you can be proud of.
Making the decision to get braces is exciting but the fear of the unknown may leave you wondering what to expect. Asking your friends is not always the best choice. They may not give you a true picture, so let’s talk about it.
One of the first things we do is place spacers. These are a little blue rubberbands that we floss in between the back teeth 1 week before the braces are place. They create a small space on either side of the molars so that we can fit the proper size band around the tooth. They may make your teeth tender for a couple of days as the teeth start to move. Taking an Ibuprofen and eating softer foods can get you through this time. Don’t eat anything sticky that could pull them out and don’t floss where the spacers are.
Putting the braces on involves trying on band sizes until we get the proper fit and then cementing them in place. The brackets are glued on the front of the teeth after they have been cleaned, dried and painted with a sealant. Most people are pleasantly surprised at how easy this appointment is. The teeth may become tender over the next few days as they start to move but it doesn’t last long. Getting used to the feel of the braces on your lips and tongue may take a few days but we give you wax to use if you need it to act as a bumper pad. You get so used to your braces that when we take them off you will actually think it feels funny.
It is very important that you follow your instructions carefully when brushing, flossing, eating and wearing your Headgear or rubberbands. This allows your treatment to stay on schedule. Wearing braces to align your teeth is an important decision, but nothing to fear. If you have questions, just ask. We love to teach you all about what is taking place so that you can know what to expect.
The American Association of Orthodontists recommends that children have their first orthodontic visit at age 7. There are several growth problems or problems with the eruption of the teeth that need to be addressed early. Most children ,however, are between the ages of 10-14 when they are ready to start full orthodontic treatment. It is never too late and many adults could benefit from orthodontic correction as well.
The orthodontist will do an initial evaluation including some measurements of the face and teeth, but to complete the evaluation, orthodontic records are taken. These include:
1. A panoramic radiograph which shows all of the teeth in the mouth and those developing in the jaw. You can also see the roots of the teeth, the surrounding bone and the jaw joint or TMJ. Unusual findings such as missing teeth or extra teeth, cysts, infection in the bone or impacted teeth can be discovered with this radiograph.
2. A cephalometric radiograph shows the entire profile and allows the orthodontist to measure the growth of the jaws.
3. Facial and Intaoral radiographs allow the orthodontist to assess facial proportions, symmetry of the smile and facial features such as the nose,lips and chin. They also give a close up picture of the teeth and bite.
4. Impressions of the teeth are taken to allow the orthodontist to make measurements of the teeth and study the alignment within the arches and how they match together.
From these records, an accurate diagnosis can be made and a plan formulated to reach the desired goal.
There are some adults who did not have the opportunity to have braces as a child or have had problems develop as they have gotten older. Whatever the case, it is not too late to improve your bite and your smile. There are differences with the correction of an adult bite compared to a child. First, the bones are more dense and sometimes it takes longer to move the teeth. There may be an underlying skeletal problem which requires a surgical procedure to correct the misaligned jaws so that the teeth will fit together. Growth modification can be done with a growing child but after growth has ceased, a surgical procedure is the only way to change the jaw position.
Misaligned jaws can involve one jaw or both jaws. The orthodontist works with the oral surgeon to plan and make the correction. The orthodontist places the braces and aligns the teeth within the arches prior to the surgical procedure so that the teeth will fit after the surgery. This preparation usually takes 9-12 months. Th surgery is done with the braces on. After the surgery, rubberbands are worn to complete the correction of the bite and this stage takes 9-12 months.
The entire correction takes 18-24 months with the surgery mid-treatment.
Some adults had braces as a child but have had some shifting over time. It may be possible to do some minor corrections with spring retainers or aligners.
Your smile is a connection between two people. You should be proud of it and use it often. Just remember, it is never too late to make improvements.
Rubberbands or elastics have a very important purpose as part of your orthodontic treatment. They can be worn to place a force on the teeth in a predetermined direction to move the teeth into the best chewing position. Each tooth has a specific function in the mouth whether it is to cut, tear or grind the food and it works best when it is in its optimal location. The rubberband wear is usually initiated toward the end of treatment when the teeth have been aligned within the arches separately. The last part, and the most important part is matching the upper teeth with the lower teeth so that the bite is right. We instruct our patients to wear the rubberbands all the time except when eating or brushing. They should also be changed each time you eat. Just remember, every time you take them out , the teeth tend to move backwards or rebound to their original position.
The rubberbands can be hooked up in a triangle, a box, a trapezoid, a straight line or even in a zigzag pattern. The direction of the hook up is determined by your particular bite. They can even be different from side to side.
Rubberbands are now made in fun neon colors so you can change them to match your outfit. When you get to the rubberband stage of treatment, you are headed toward the finish line! The more you wear them, the faster it works.
The day the braces are removed is such an exciting day. You are finally free of metal in your mouth and then they say you still have to wear a retainer. Okay, here is the bottom line – teeth don’t like to stay straight. There are little rubberband fibers that surround each tooth. When they are stretched to a new position, they want to rebound. We instruct our patients to wear the retainer fulltime except when they eat, brush or play sports, for the first 6 months. After that we go to nighttime wear. I never say “throw your retainer away you no longer need it” because our bodies are in a constant state of change and continue to shift throughout our lifetime.
I place a bonded retainer on the inside of the lower incisors because this is the most common place to see shifting occur. There is a natural drift toward the midline of the face so over time the lower incisors “pile up”. Rotated incisors are more difficult to clean and can lead to periodontal problems later in life.
There are different types of retainers. The most common type top retainer is called a Hawley which has acrylic covering the palate and a metal bar across the front of the teeth. This type is durable and adjustable. An invisible retainer is not as noticeable when you wear it but because it crosses the chewing surface, it can develop cracks from wear and tear.
We recommend that you clean your retainer daily with your toothbrush and toothpaste and once a week with Efferdent denture cleanser to kill the germs.
If the bonded retainer ever comes unglued from one of your teeth, it is important to have it re-glued as soon as possible to prevent shifting of the teeth.
You committed to straighten your teeth, now commit to keep them straight! It is worth it – your smile is the first thing people notice- share it with others.