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Frequently Asked
Questions
Adult & General Orthodonics
Glossary| Emergencies | Statistics
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- What is orthodontics?
Orthodontics is the branch of dentistry that specializes in the
diagnosis, prevention and treatment of dental and facial irregularities.
The technical term for these problems is "malocclusion,"
which means "bad bite." The practice of orthodontics
requires professional skill in the design, application and control
of corrective appliances, such as braces, to bring teeth, lips
and jaws into proper alignment and to achieve facial balance.
- What is an orthodontist?
All orthodontists are dentists, but only about 6 percent of dentists
are orthodontists. An orthodontist is a specialist in the diagnosis,
prevention and treatment of dental and facial irregularities.
Orthodontists must first attend college, and then complete a four-year
dental graduate program at a university dental school or other
institution accredited by the Commission on Dental Accreditation
of the American Dental Association (ADA). They must then successfully
complete an additional two- to three-year residency program of
advanced education in orthodontics. This residency program must
also be accredited by the ADA. Through this training, the orthodontist
learns the skills required to manage tooth movement (orthodontics)
and guide facial development (dentofacial orthopedics).
Only dentists who have successfully completed this advanced
specialty education may call themselves orthodontists.
- At what age can people have orthodontic
treatment?
Children and adults can both benefit from orthodontics, because
healthy teeth can be moved at almost any age. Because monitoring
growth and development is crucial to managing some orthodontic
problems well, the American Association of Orthodontists recommends
that all children have an orthodontic screening no later than
age 7. Some orthodontic problems may be easier to correct if treated
early. Waiting until all the permanent teeth have come in, or
until facial growth is nearly complete, may make correction of
some problems more difficult.
An orthodontic evaluation at any age is advisable if a parent,
family dentist or the patient's physician has noted a problem.
- Why is orthodontic treatment important?
Crooked and crowded teeth are hard to clean and maintain. This
may contribute to conditions that cause not only tooth decay but
also eventual gum disease and tooth loss. Other orthodontic problems
can contribute to abnormal wear of tooth surfaces, inefficient
chewing function, excessive stress on gum tissue and the bone
that supports the teeth, or misalignment of the jaw joints, which
can result in chronic headaches or pain in the face or neck.
When left untreated, many orthodontic problems become worse.
Treatment by a specialist to correct the original problem is
often less costly than the additional dental care required to
treat more serious problems that can develop in later years.
The value of an attractive smile should not be underestimated.
A pleasing appearance is a vital asset to one's self-confidence.
A person's self-esteem often improves as treatment brings teeth,
lips and face into proportion. In this way, orthodontic treatment
can benefit social and career success, as well as improve one's
general attitude toward life.
- What does orthodontic treatment
cost?
The actual cost of treatment depends on several factors, including
the severity of the patient's problem and the treatment approach
selected. You will be able to thoroughly discuss fees and payment
options before any treatment begins. Most orthodontists offer
convenient payment plans to patients. Generally, treatment fees
may be paid over the course of active treatment. Arrangements
commonly offered in orthodontic offices may include an initial
down payment with monthly installments, credit card payment, finance
company agreements, and other innovative ways to make treatment
affordable. Insurance plans or other employer-sponsored payment
programs, such as direct reimbursement plans, may be helpful.
- How long will orthodontic treatment
take?
In general, active treatment time with orthodontic appliances
(braces) ranges from one to three years. Interceptive, or early
treatment procedures, may take only a few months. The actual time
depends on the growth of the patient's mouth and face, the cooperation
of the patient and the severity of the problem. Mild problems
usually require less time, and some individuals respond faster
to treatment than others. Use of rubber bands and/or headgear,
if prescribed by the orthodontist, contributes to completing treatment
as scheduled.
While orthodontic treatment requires a time commitment, patients
are rewarded with healthy teeth, proper jaw alignment and a
beautiful smile that lasts a lifetime. Teeth and jaws in proper
alignment look better, work better, contribute to general physical
health and can improve self-confidence.
- What are orthodontic study records?
Diagnostic records are made to document the patient's orthodontic
problem and to help determine the best course of treatment. As
orthodontic treatment will create many changes, these records
are also helpful in determining progress of treatment. Complete
diagnostic records typically include a medical/dental history,
clinical examination, plaster study models of the teeth, photos
of the patient's face and teeth, a panoramic or other X-rays of
all the teeth, a facial profile X-ray, and other appropriate X-rays.
This information is used to plan the best course of treatment,
help explain the problem, and propose treatment to the patient
and/or parents.
The profile X-ray, or cephalometric film, shows the facial
form, growth pattern, and inclination of the front teeth (if
teeth are tipped or tilted), which are essential in planning
comprehensive treatment. Panoramic or other dental X-rays are
used to locate impacted teeth, missing teeth, and shortened
or damaged tooth roots, to determine the amount of bone supporting
teeth, and to evaluate position and development of permanent
teeth that have not yet come in, among other things. From the
necessary records, a custom treatment plan is created for each
patient.
- Are there less noticeable braces?
Today's braces are generally less noticeable than those of the
past when a metal band with a bracket (the part of the braces
that hold the wire) was placed around each tooth. Now the front
teeth typically have only the bracket bonded directly to the tooth,
minimizing the "tin grin." Brackets can be metal, clear
or colored, depending on the patient's preference. In some cases,
brackets may be bonded behind the teeth (lingual braces). Modern
wires are also less noticeable than earlier ones. Some of today's
wires are made of "space age" materials that exert a
steady, gentle pressure on the teeth, so that the tooth-moving
process may be faster and more comfortable for patients. A type
of clear orthodontic wire is currently in an experimental stage.
- How do braces feel?
Most people have some discomfort after their braces are first
put on or when adjusted during treatment. After the braces are
on, teeth may become sore and may be tender to biting pressures
for three to five days. Patients can usually manage this discomfort
well with whatever pain medication they might commonly take for
a headache. The orthodontist will advise patients and/or their
parents what, if any, pain relievers to take. The lips, cheeks
and tongue may also become irritated for one to two weeks as they
toughen and become accustomed to the surface of the braces. Overall,
orthodontic discomfort is short-lived and easily managed.
- Do teeth with braces need special
care?
Patients with braces must be careful to avoid hard and sticky
foods. They must not chew on pens, pencils or fingernails because
chewing on hard things can damage the braces. Damaged braces will
almost always cause treatment to take longer, and will require
extra trips to the orthodontist's office.
Keeping the teeth and braces clean requires more precision
and time, and must be done every day if the teeth and gums are
to be healthy during and after orthodontic treatment. Patients
who do not keep their teeth clean may require more frequent
visits to the dentist for a professional cleaning.
The orthodontist and staff will teach patients how to best
care for their teeth, gums and braces during treatment. The
orthodontist will tell patients (and/or their parents) how often
to brush, how often to floss, and, if necessary, suggest other
cleaning aids that might help the patient maintain good dental
health.
- Can orthodontic treatment do
for me what it does for children?
Healthy teeth can be moved at almost any age. Many orthodontic
problems can be corrected as easily and as well for adults as
children. Orthodontic forces move the teeth in the same way for
both a 75-year-old adult and a 12-year-old child. Complicating
factors, such as lack of jaw growth, may create special treatment
planning needs for the adult.
One in five orthodontic patients is an adult. The AAO estimates
that nearly 1,000,000 adults in the United States and Canada
are receiving treatment from an orthodontist. To learn about
correction of a specific problem, please consult your family
dentist or an orthodontist.
- How does adult treatment differ
from that of children and adolescents?
Adults are not growing and may have experienced some breakdown
or loss of their teeth and bone that supports the teeth. Orthodontic
treatment may then be only a part of the patient's overall treatment
plan. Close coordination may be required between the orthodontist,
oral surgeon, periodontist, endodontist and family dentist to
assure that a complicated adult orthodontic problem is managed
well and complements all other areas of the patient's treatment
needs. Below are the most common characteristics that can cause
adult treatment to differ from treatment for children.
No jaw growth: Jaw problems can usually
be managed well in a growing child with an orthopedic, growth-modifying
appliance. However, the same problem for an adult may require
jaw surgery. For example, if an adult's lower jaw is too short
to match properly with the upper jaw, a severe bite problem
may result. The limited amount that the teeth can be moved with
braces alone may not correct this bite problem. Bringing the
lower teeth forward into a proper bite relationship could require
jaw surgery, which would lengthen the lower jaw and bring the
lower teeth forward into the proper bite. Other jaw-width or
jaw-length discrepancies between the upper and lower jaws might
also require surgery for bite correction if tooth movement alone
cannot correct the bite.
Gum or bone loss (periodontal breakdown):
Adults are more likely to have experienced damage or loss of
the gum and bone supporting their teeth (periodontal disease).
Special treatment by the patient's dentist or a periodontist
may be necessary before, during and/or after orthodontic treatment.
Bone loss can also limit the amount and direction of tooth movement
that is advisable.
Worn, damaged or missing teeth: Worn,
damaged or missing teeth can make orthodontic treatment more
difficult, but more important for the patient to have. Teeth
may gradually wear and move into positions where they can be
restored only after precise orthodontic movement. Damaged or
broken teeth may not look good or function well even after orthodontic
treatment unless they are carefully restored by the patient's
dentist. Missing teeth that are not replaced often cause progressive
tipping and drifting of other teeth, which worsens the bite,
increases the potential for periodontal problems and makes any
treatment more difficult.
- I have painful jaw muscles and
jaw joints - can an orthodontist help?
Jaw muscle and jaw joint discomfort is commonly associated with
bruxing, that is, habitual grinding or clenching of the teeth,
particularly at night. Bruxism is a muscle habit pattern that
can cause severe wearing of the teeth, and overloading and trauma
to the jaw joint structures. Chronically or acutely sore and painful
jaw muscles may accompany this bruxing habit. An orthodontist
can help diagnose this problem. Your family dentist or orthodontist
may also place a bite splint or nightguard appliance that can
protect the teeth and help jaw muscles relax, substantially reducing
the original pain symptoms. Sometimes structural damage can require
joint surgery and/or restoration of damaged teeth.
- My teeth have been crooked for
more than 50 years - why should I have orthodontic treatment now?
Orthodontic treatment, when indicated, is a positive step - especially
for adults who have endured a long-standing problem. Orthodontic
treatment can restore good function. Teeth that work better usually
look better, too. And a healthy, beautiful smile can improve self-esteem,
no matter the age.
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