Q&A

When the time to remove your braces finally arrives, it is very exciting. Unfortunately, it can be somewhat confusing, too, because you are faced with choosing between two kinds of retainers. Should you go with permanent, removable, or a combination of the two? It is always wise to follow your orthodontist’s recommendations, but knowing more about the two types of retainer beforehand can be helpful.

Removable Retainers
Removable retainers offer the advantage of easy use: you will generally put a removable retainer in at night and take it out in the morning. Regardless of your retainer schedule, you'll be able to enjoy some time with no retainer. However, a removable retainer can easily be forgotten at times, and this means you won't be taking full advantage of teeth retention.

Another potential advantage of a removable retainer is that you can take it out and brush and floss your teeth with ease, which is more of a challenge with a permanent retainer. Although removable retainers can be very effective, they don't tend to be as effective as permanent retainers, especially if they are not used as directed.

Permanent Retainers
Permanent retainers are the clear choice for patients who want to “get it and forget it.” Once your permanent retainer is placed in your mouth, you won’t need to worry about daily retainer schedules, since it is permanently affixed to your teeth.

Because teeth begin to shift naturally as we age, a permanent retainer typically offers better long-term results for teeth straightening than a removable one. You can't forget to put it in — it's already there! Temporary retainers get lost or are forgotten on trips, and often fail to get used as often as they should be.

One drawback to permanent retainers is flossing. Some patients find it more difficult to floss with a permanent retainer, but we can show you effective ways to floss fairly quickly with your permanent retainer.

Some orthodontists may recommend a combination of the two; for example, a removable retainer for the top teeth and a permanent one for the lower ones because the lower teeth are smaller and tend to shift more.

Ultimately, the most important thing to remember is that wearing your retainer as directed is extremely important. As long as you follow our orthodontist’s advice, you will get the best results from your retainer, regardless of its type.

Everyone wants a naturally aligned and beautiful smile, and it is no secret that orthodontic braces can help deliver one. However, there are greater benefits to wearing braces than just having straight teeth. You’ll gain many oral health benefits in addition to the cosmetic ones.

Tooth Decay and Gum Disease
Crooked or crowded teeth may overlap each other and create tight spaces in between. These can make it very difficult to brush and floss effectively, allowing bacteria and plaque to build up, and eventually leading to tooth decay and gum disease. With orthodontic treatment, your teeth will become properly aligned and spaced, which allows for more effective brushing.

Difficulties with Speech
Your teeth play an essential role in speech. When they are out of line or lean too far forward or backward, this can affect your speaking patterns, and possibly cause embarrassment and frustration. Braces can readjust the positioning of the teeth to allow for clearer, more professional speech.

Bone Erosion
Bone and gum tissues begin to erode when there are no teeth to support. This is also true for poorly aligned teeth that leave gaps and spaces or place too much pressure on the jawbone due to a bad bite. With braces, the bones and tissues are less likely to erode and can continue to support the teeth in their new alignment.

Digestion
Your teeth play an important role in digestion. Before food ever enters your stomach, it has been partially digested by the teeth. If teeth are severely out of line, however, they may not play their role in breaking down food as effectively as they should. With braces, your teeth will be straightened into optimal alignment for eating and chewing.

Are you thinking about orthodontic treatment to straighten teeth or correct jaw alignment?  Consider making your first step an orthodontic consultation. During the consultation we will address your questions, concerns, and talk about a treatment plan that would best suit your situation.

We want you to feel prepared and in charge of your orthodontic treatment decisions, so keep these questions in mind when you come in for your appointment.

• If I do need some adjustments to my teeth, what options will I have besides braces?
  (This will help you determine what approaches we use to straighten your teeth.)
• What kind of preparation is needed to get braces? How many visits will it take?
  (It’s important to know how many appointments may be needed and what you will need to do between appointments to be ready for braces.)
• Can I expect any pain when getting braces?
  (Ask about the ways we address pain management.)
• What determines how long I have to wear braces?
  (The length of treatment will vary from patient to patient.  During your consultation we can evaluate your teeth and jaw alignment to determine the correct course and length of treatment.)
• How will braces affect my lifestyle? Foods I can eat? Activities I can do?
  (You may find that little needs to change in your daily routine to have a successful orthodontic outcome. We can discuss and address any changes so you can be prepared before you get your braces.)
• Who will be involved in the orthodontic work?  Whom can I expect to see during my adjustment visits?
• What will my orthodontic work cost? What is the ”average” cost and what could be the maximum?
  (Make sure you are clear about what your insurance covers, who contacts the insurance company for pre-authorization, who files the insurance forms, and what flexibility there is to pay the remaining amount not covered.)

Your initial orthodontic consultation may just be the first step in relieving a lot of pain and discomfort in your life. Going in with the right questions will help you to understand the entire process and prepare you to do your part for your own dental health. Be sure to bring a list of your questions!

Orthodontic treatments vary from dental treatment, in that they primarily address malocclusions, jaw spacing and tooth alignment, rather than the actual health of the teeth. That is why it is often more difficult for parents to determine when a child needs orthodontic treatment rather than dental treatment. So how can you know it is time to take your child to the orthodontist?
• Bad Bite - As the adult teeth begin to replace primary teeth, bite occlusions can develop. These often become visible to parents between middle childhood and the pre-teen years, although an orthodontist can identify a bad bite with early evaluation.
• Visible Tooth Crowding - If your child's newly emerging teeth are already crowded, you should make an appointment with our office to discuss braces.
• Tooth Grinding (Bruxism) - Children who grind their teeth at night may do so unconsciously, but the condition requires treatment to prevent the development of headaches, TMJ, and tooth damage. Oral appliances are available to correct nighttime tooth grinding.
• Difficulty Chewing, Biting, or Speaking - If your child is displaying difficulty speaking or eating, or if he or she often experiences cheek biting, schedule an orthodontic consultation.
• Asymmetry - If your child's face is asymmetrical, or if his or her teeth do not meet together in a natural way, orthodontic treatment may be necessary.
Evaluation and Preventive Care
Even if your child has no visible tooth or jaw alignment problems, the American Association of Orthodontists recommends that every child visit the orthodontist for an initial examination no later than age seven. The reason for early evaluation is because orthodontists are capable of finding subtle problems with the jaw and teeth growth and spacing before they become more pronounced and also more difficult to treat.

By bringing your child in for an evaluation, you may be able to treat orthodontic conditions with shorter and more simplified treatments that are also more affordable than treatment during the teenage and adult years.

Orthodontic treatments are used to correct malocclusion, a condition more commonly known as a bad bite. The length of treatment time varies depending on the severity of the bite problem.

What is a "bad bite"?
A bad bite occurs when spacing or alignment problems are present. This often includes teeth that are protruding, crowded, or crooked. Sometimes teeth appear straight, but have an uneven bite because the upper and lower jaws do not align properly. Teeth that are irregularly spaced - either too far apart or too close together - can also cause bite problems.

Frequent causes of bite problems:

• Heredity
• Thumb-sucking
• Premature tooth loss
• Accidents

Benefits of orthodontic treatment:

Appearance -
Correcting a bad bite often creates a more attractive smile, which frequently raises the patient's self esteem.

Preventing Decay -
It also results in a healthier mouth. It is much more difficult to thoroughly clean teeth that are crooked, protruding, overlapped, or crowed. This may allow plaque to build up, which can lead to gum disease, tooth decay and even tooth loss. Orthodontic treatment corrects these conditions, so cleaning can be more efficient.

Avoiding Alignment Issues -
An uneven bite can interfere with the motions of chewing and speaking. This can cause abnormal wear to tooth enamel, which may require pricey cosmetic restorative treatments, such as crowns or veneers, to correct. It can also lead to problems with the jaws. Orthodontic treatment lessens the likelihood of those issues, as well.

Types of orthodontic treatment:

- Braces: Metal or ceramic brackets are bonded to the front of teeth. Wires and elastics are attached to the brackets to straighten teeth.

- Invisalign®: Advanced 3D computer images of the patients' mouth are used to create clear, custom aligners that slowly move teeth. They are nearly invisible and are more comfortable than traditional braces. They are also removable, which makes it possible to continue with normal brushing and flossing.

- Retainers: A retainer is a removable piece worn inside the mouth that uses pressure to force teeth to move into proper alignment. They are used after braces are removed.

Length of orthodontic treatment:
Treatment typically ranges from 12 to 36 months. Factors include the age, cooperation level, and growth occurrence of the patient. The complexity of the case also impacts the treatment time.

A palatal expander "expands" (or widens) your upper jaw by putting gentle pressure on your upper molars and is used to make the bottom and upper teeth fit together better. It also makes more room for teeth and helps to promote a broader, more aesthetic smile.

Palatal expansion is usually not painful, but you may feel some minor discomfort. It’ll take a little time for you to get used to your appliance, so you may experience difficulty speaking and swallowing for the first day or two.

Adjusting your appliance as directed will ensure you keep on schedule with the rest of your orthodontic treatment plan. It takes about a few weeks to achieve the desired amount of expansion, after which you’ll keep wearing your expander for about six months, giving time for the new bone to form and stabilize. Our team at will give you detailed instructions about how to adjust your appliance and can answer any questions you may have about your palatal expander.