What is orthodontic treatment?

Orthodontic treatment is a way of straightening teeth, to improve the appearance of the teeth and how the teeth work. However it extends beyond just braces alone. It also includes treatment with appliances to correct jaw problems by modifying jaw growth in young children. Orthodontics is also required in non-growing patients that require jaw surgery to correct a jaw problem.

A straight set of teeth is easier to clean and therefore makes it easier to prevent tooth decay and gum disease. Orthodontics can sometimes improve speech and chewing, and prevent dental injuries as well.

What is interceptive orthodontic treatment?

Interceptive orthodontic treatment is performed for problems that, if left untreated, could lead to the development of more serious dental problems over time. The objective is to reduce the severity of a developing problem and to eliminate the cause. The length of braces treatment time may be reduced in future.

For example:

  • Correction of thumb and finger-sucking habits
  • Guiding permanent teeth into desired positions through tooth removal or tooth size adjustment
  • Gaining or holding space for permanent teeth
  • Lower the risk of trauma to protruded front teeth
  • Improve appearance and self-esteem

Interceptive orthodontic treatment can take place when patients have primary teeth or mixed dentition (baby and permanent teeth). A patient may require more than one phase of interceptive orthodontic treatment.

At what age should I have orthodontic treatment?

Orthodontic treatment can usually start as soon as all adult teeth have sufficiently erupted.

Orthodontic treatment is generally best carried out in children in their teens, but adults can have orthodontic treatment too. Healthy teeth can be moved at any age. The health of the teeth, the gums and the supporting bones will determine the prospects for treatment.

Growth modification treatment is sometimes started earlier, while the jaws are rapidly growing, to correct a jaw problem. This may avoid the need for jaw surgery in future. It is therefore good to bring your child at 7 years old to us for routine checkups.

Orthodontic treatment is also sometimes deferred till jaw growth has stopped for certain jaw problems.

What is a removable appliance?

Single tooth crossbite may be corrected with a removable appliance (a plate that can be taken out to be cleaned). It has delicate wires and springs attached, which moves the tooth using gentle pressure.

What is a functional appliance?

This appliance holds the lower jaw forward and guides eruption of the teeth into a more desirable bite while helping the upper and lower jaws to grow in proportion to each other. This appliance uses the power of the jaw muscles to correct jaw discrepancy.  Patient’s compliance in wearing this appliance is essential for successful improvement; the appliance cannot work unless the patient wears it.

What is facemask therapy?

Facemask therapy is used in growing patients to correct under bites by pulling forward and assisting the growth of the upper jaw, allowing the upper jaw to catch up. It needs to be worn approximately 14 hrs/day to be truly effective in correcting the under bite, usually anywhere from 6 to 18 months depending on the severity of the bite.

The appliance normally consists of a frame that is strapped to the child’s head, which allows for the attachment of rubber bands directly into the child’s appliance fitted in the mouth. This creates a forward ‘pulling’ force to pull the upper jaw forward.

Why do some people need braces with jaw surgery?

While orthodontics can usually correct bite problems when only the teeth are malaligned, orthognathic jaw surgery may be necessary to correct malalignment of the jaws.

Orthognathic surgery is performed by Oral and Maxillofacial Surgeons to correct major skeletal and dental irregularities, including the misalignment of jaws and teeth, which in turn can improve facial aesthetics, chewing, speaking and breathing.

Some of the conditions that may indicate the need for orthognathic jaw surgery:

  • protruding lower jaw
  • open bite (space between the upper and lower teeth when the mouth is closed)
  • facial asymmetry, unbalanced facial appearance from the front, or side
  • retruded lower jaw or small chin

Before your surgery, your teeth need to move into a new position via orthodontics. Because your teeth are moved into a position that will fit together after surgery, you may think that your bite has gotten worse rather than better. During the surgery, your jaws will be repositioned and your teeth will fit together properly after the surgery.  The cuts are made inside the mouth to reduce visible scarring. Surgical plates, screws, wires and rubber bands are used to hold your jaws into the new position. You are able to return to school or work one to three weeks after surgery. While the initial healing phase is about six weeks, complete healing of the jaws takes between 9 to 12 months. After your surgery, you will continue to move the teeth with orthodontic braces so that the teeth can have a good occlusion.

What are self-ligating braces (Damon Braces)?

Damon braces use (sliding door) technology known as “self ligation” that allows the wire to slide back and forth within the bracket. This creates less friction thus more comfortable to the patient with less pain. In addition, teeth would be able to move faster with reduced pressure.

Why you should consider Damon Braces?

  • Less pain
  • Cut down treatment time by 6 months
  • Less visits to see our Orthodontist
  • Less visible if you use Damon Clear
  • Easy to keep clean
What is Invisalign?

They are clear plastic ‘aligners’ that are used to straighten teeth. Several sets of specially moulded aligners are made for each patient. Each set is worn for two weeks before being replaced with the next one. They are made from clear plastic and thus nearly invisible. The aligners need to be worn for 22 to 23 hours a day for best results. They can be easily removed for eating, drinking, brushing and flossing.

Benefits of Invisalign:

  • Clear aligners are virtually invisible
  • Smooth and comfortable
  • Easily removable for cleaning
  • Eat whatever you want
Will braces interfere with playing musical instruments?

Playing wind or brass instruments, such as the trumpet, will clearly require some adaptation to braces. With practice and a period of adjustment, braces typically do not interfere with the playing of musical instruments.

How long will it take?

The braces are put on over 3 appointments, a week apart (this usual sequence might be changed depending on the case).

Once you have decided to proceed with treatment, a set of records will be taken. This includes photos, x-rays and impressions of your teeth. Small rubber spacers will be placed to create a small space around the molars.

When you return to the clinic for the second appointment a week later, these spacers will be removed and metal rings are fitted onto the molars.

A week later, the brackets will be put on and the wires are tied in.

The length of braces treatment in total depends on how severe the problem is and the cooperation of the patient in turning up for their appointments and wearing their rubber bands. Rubber bands create the right amount of pressure to move teeth in directions that the braces alone can’t. It’s important to wear your elastics as prescribed and change them every day.  Most people can be treated in one and half years to two years.

How often are the appointments after I put on my braces?

Orthodontic appliances usually need adjusting every 4 to 6 weeks.

Will braces hurt?

Most orthodontic patients experience some discomfort while on braces. The discomfort usually starts a few hours after the braces are put on and after the braces are “tightened” after each subsequent review. The discomfort usually lasts only a few days. Common painkillers can be taken to control the pain.

Many patients develop ulcers after the braces are put on. This will be less common when the cheeks and lips got used to the braces.

Can orthodontics damage my teeth?

It is essential to maintain good oral hygiene while having braces treatment.  Appliances will not in themselves cause damage, but poor cleaning and too many sugary foods and drinks can cause permanent damage. Brackets, wires and braces can trap food and cause more plaque than usual to build up which may lead to enamel decalcification. Therefore the teeth and appliance need to be cleaned very thoroughly. We advised our patients to see our oral health therapist for routine cleaning once every four months.

Is orthodontic work permanent?

Even after retention, it is normal for minor tooth movements to happen throughout life, so no permanent guarantee can be given. The maintenance of straight teeth after braces depends very much on the motivation and cooperation of the patient in wearing their retainers.

Should the wisdom teeth be removed after braces?

Research suggests that wisdom teeth do not necessarily cause teeth to shift. However, most patients prefer to remove their wisdom teeth for dental health reasons rather than to prevent relapse of their straight teeth after braces. We will provide guidance regarding removal of wisdom teeth.

Can I still play sports?

Yes. A mouth guard is recommended for all sports.

Will I be able to eat and talk normally with braces?

Yes. Your teeth may hurt at the start of braces treatment and you should take on soft diet to reduce the discomfort. You may like to cut your food into smaller pieces. Thereafter, you should avoid sticky foods (e.g. chewing gum) and biting on hard stuff (e.g. ice) to avoid emergency appointments to repair broken or damaged braces. Most patients experience only minimal difficulties in speaking and usually overcome them very quickly.