Orthodontics is the speciality of dentistry concerned with the diagnosis, management and treatment of irregularities and abnormalities of the teeth, face and jaws.
Treatment is by the use of braces to improve the position of teeth, and in a growing patient, the modification of growth of the jaws, helping to correct discrepancies in the jaw size and improve a patient’s facial appearance.
Improved function of the teeth.
Improved dental health and increased resistance to dental disease.
Prevention of trauma to prominent teeth.
Some problems with the teeth are visible but other issues can only be spotted by a dental professional. One reason to keep your regular dental check-ups is so that your dentist can identify a developing problem and refer you for an orthodontic opinion. Approximately 1/3 of 12 year old children will need orthodontic treatment.
Everyone grows at different rates and therefore there is no set age for an orthodontic assessment to be made. 10 years of age it may be possible to make an assessment as to the best time at which to start treatment and sometimes an early diagnosis leads to early treatment which helps reduce treatment times in the future. This is especially important if a discrepancy in jaw development requires correction. Often if the problem is crowding then it is necessary to wait untilall the second teeth have erupted.
The majority of orthodontic treatment with fixed braces is carried out during the teenage years.
No. More and more adults are requesting orthodontic treatment, either because they missed out as children, or have seen at first hand what can be done as they follow their own children’s orthodontic treatment!
Less teeth are removed as part of orthodontic treatment now compared to a few years ago but it is still true to say that on many occasion the only way to gain space in order to align teeth is to extract and if this is the case we normally ask your own dentist to do this.
Usually a fixed brace is adjusted on average, every 8 weeks, with a range of 6 – 10 weeks depending on what is happening with your brace.
Having a brace fitted does not need any injections or drilling, and the main sensation is of occasional pressure as the parts of the brace are glued onto the teeth. It takes about a week to get used to the brace and occasionally some patients need to take a couple of painkillers after 24 hours when the brace starts to work.
Paracetamol is probably the best, but make sure that you follow the manufacturer’s instructions. Ibuprofen and other anti-inflammatory drugs can be taken by those with no contra-indications. If the brace is rubbing, use the wax that was demonstrated when you had the brace fitted.
All the materials used in braces have been chosen so that they do not interact with the teeth or gums. The glues used often release fluoride to help protect the enamel from the most common cause of damage to the teeth – POOR TOOTHBRUSHING.
Brush after each meal and before bedtime – that’s at least 4 times a day, and you should take your toothbrush to school. It takes about 5 minutes to clean your brace. Various toothbrushes are shown to you when the brace is fitted, together with recommendations for fluoride mouthwash and fluoride toothpaste. We keep the recommended stock of products at reception.
Fixed braces don’t affect speech, but removable braces and retainers that have a plastic palate will cause slight speech problems for 1-2 days.
Most wind instrument players can adapt to play with the brace, and the more accomplished you are, the easier it will be. Some brass instrument players may find that pressure from the mouthpiece can be uncomfortable the more the instrument is pushed against the lips.
Yes. Removable braces should be taken out for contact sports and swimming and placed in a protective brace box. For fixed braces, gum shields will inevitably be a compromise because the teeth are moving, and any gum shield that fits over a brace will have to be slightly bigger than normal. Gum shields from sports shops that can be adapted in hot water are usually sufficient, alternatively, we stock a silicone based gum shield designed specifically for fixed braces.
Fixed braces – Normal “wear and tear” may result in occasional breakages to the wires and brackets of the brace, and sometimes a wire may start to stick out at the back. If this is causing you pain and discomfort, please Contact us as soon as possible for advice. Constant breakages due to careless actions will always result in longer treatment times. Removable braces – please bring the brace with you as we will try and repair it in our laboratory. There may be a charge to replace a broken brace that is beyond repair. If you lose your brace please let us know as soon as possible, and if a replacement is needed, there will be a charge.
Most treatments with a fixed brace are completed in approximately18 months followed by a period of retention which is at least a further 12 months but often for the whole of teenage years as the jaws continue to grow.
Retainers help to stabilize the teeth after they have been moved by an orthodontic brace. They can be removable or fixed, depending on what the orthodontist feels is appropriate. Removable retainers are usually worn full time for 6 weeks, then night time for at least 12 months. Fixed retainers are usually permanent for life.
Yes. Relapse is when the teeth start to return to their original positions, especially if teeth were rotated, spaced or severely overcrowded. The commonest cause of relapse is failure to wear the retainers. Some patients (about 3/4) continue to grow in their late teens, and this can affect the position of the teeth, especially the lower incisors. These patients may well need to continue wearing their retainers during their early 20‘s.
Yes. For the child’s first visit we need a parent (or legal guardian) to accompany a child under 16 in order to consent for examination/treatment. A parent may be needed on further occasions only if the child was not ready to start treatment, or if we are experiencing problems during treatment, such as poor cooperation with instructions or toothbrushing.
Parents are welcome in the surgery if they wish, although it is not necessary for children to be accompanied at every visit. Orthodontics is a “non-invasive” speciality, with no drilling or injections needed, and as such can be an ideal opportunity for children to get used to the idea of being in the dentists chair by themselves.
Yes. You should see your dentist for your normal dental check-ups whilst you are having your orthodontic treatment.
90% of our patients are of school age, and in order to run an efficient and effective service, the majority of appointment times will fall inside school hours. Schools have a legal obligation to allow pupils time off for medical and dental appointments and we are more than happy to supply written confirmation of appointment times if requested. We can usually schedule appointments to coincide with a different lesson each time. We are sensitive to the needs of patients sitting their GCSE and A-level exams, and will try to be flexible in these situations.
The general rule is that if you are late for your appointment, then in fairness to other patients who are on time, we will give you the option of re-booking or waiting until a suitable time becomes available. Where longer appointments are concerned, for example, new patient consultations, fitting or removing fixed braces, then it is unlikely that a suitable time will be available that day, and rebooking will be necessary. Please take into account that road traffic in the city is very heavy, especially in the morning and journey times will be correspondingly longer.
NHS treatment is free, and our contract with the PCT allows us to treat patients on the NHS up to and including 18 years of age. We are allowed however to charge a fee for replacing a lost or irreparable brace.
We will always offer appointments to see patients who are in pain within 24 hours. True emergencies are very rare during orthodontic treatment, and most problems can be dealt with by using painkillers, or even cutting a wire with scissors. If in doubt, please contact us for advice during normal office hours, or NHS Direct outside normal hours.