The American Association of Orthodontists recommends that children have their first orthodontic evaluation by the age of 7. At this age, an orthodontist can assess the growth and development of your child's teeth and jaw. Early evaluation allows for the identification of any potential issues, such as overcrowding, bite problems, or jaw alignment issues, which can be addressed early on. Even if treatment isn’t needed right away, monitoring your child's dental development can help ensure they receive appropriate care when necessary.
Research indicates that serious orthodontic issues are easier to correct while a patient’s skeleton is still growing and flexible. By addressing skeletal problems at a younger age, we can better prepare the mouth for the eruption of permanent teeth. When there’s adequate space for these teeth to come in, they tend to emerge relatively straight. Straight teeth are less likely to become crooked again after braces are removed.
Typically, between ages 12 and 14, complete braces are applied for final adjustments and bite alignment. This final phase of treatment is generally quicker and less burdensome for the patient, lasting about 12 to 18 months and only starting once all permanent teeth have erupted.
Dividing orthodontic treatment into two phases yields excellent results and often helps the doctor avoid the need for removing permanent teeth or performing jaw surgery. The initial stage, which may be done while some baby teeth are still present, is referred to as Phase 1. The subsequent stage, occurring after all the permanent teeth have come in, is known as Phase 2.
Crowded teeth can result from several factors, including thumb sucking, tongue thrusting, premature loss of baby teeth, and a compromised airway due to enlarged adenoids or tonsils. Additionally, hereditary factors play a significant role. Conditions such as having extra teeth, large teeth, missing teeth, wide spacing, or small jaws can all contribute to the issue of crowded teeth.
Tooth movement is a natural reaction to gentle pressure applied over time. This pressure is created using various orthodontic devices, with braces or brackets being the most common. These brackets are attached to the teeth and linked by an arch wire, which is periodically changed to exert pressure on the teeth. Throughout treatment, your child may also use headgear, elastics, positioners, or retainers. Orthodontic appointments are typically scheduled every 4 to 6 weeks to allow sufficient time for the teeth to shift.
When teeth are initially moved, some discomfort may occur, typically lasting between 24 to 72 hours. Patients often notice that the pain decreases as treatment continues. Over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil) are generally effective in alleviating this discomfort.
The component of your braces responsible for moving the teeth is the arch wire. It connects to the brackets using small elastic bands or ligature wires. Throughout treatment, the arch wires are replaced regularly, with each change helping to guide your teeth closer to their ideal positions.
Brackets are the small attachments bonded directly to the surface of your teeth, forming part of your braces. They are where the dentist or assistant connects the arch wire.
If a bracket becomes loose and irritates your mouth, you can carefully remove it and keep it in an envelope to bring to your next appointment. Be sure to call the office promptly to schedule a visit for reattaching the bracket.
A band and loop is a type of dental appliance commonly used in orthodontics, especially for children. It consists of a metal band that is placed around a tooth, usually a molar, and a wire loop that extends from the band. This loop serves as a space maintainer, holding space for a missing tooth until the permanent tooth can erupt. The band provides stability and support, while the loop helps prevent neighboring teeth from shifting into the gap. Bands and loops are often used when a primary tooth has been lost prematurely to ensure proper alignment and spacing in the dental arch.
During your treatment, you’ll need to wear elastics to align your upper and lower teeth and improve your bite. Once the teeth start moving with the elastics, the process is usually quick and comfortable. However, if you only wear the elastics occasionally, it can cause discomfort and slow down your progress. Consistent wear is crucial; taking them off one day and putting them on the next can hinder treatment. If you experience soreness between appointments, it may be due to improper use of your headgear or elastics, or inadequate oral hygiene. Make sure to wear your elastics as instructed, keeping them on at all times unless told otherwise, and remove them while brushing. Remember to change your elastics as directed, typically once or twice a day.
Functional appliances are orthodontic devices that help correct bite issues and align the jaws, especially in growing children. They can be removable or fixed and work by applying gentle pressure to guide the growth and positioning of teeth and jaws. Common types include bite blocks, bionators, Herbst appliances, and twin blocks. Regular monitoring by an orthodontist is essential for effective treatment.
Commonly referred to as a "night brace," headgear is designed to address protrusion of the upper or lower jaw. It functions by restricting the forward growth of the upper jaw, limiting its downward growth, or promoting the movement of teeth forward when needed.
Another appliance designed to encourage the lower jaw to grow forward and “catch up” to upper jaw growth.
A lower lingual arch serves as a space maintainer for the lower teeth, keeping the molars in their original positions without moving them. It consists of bands placed on the molars connected by a wire that rests against the inside of the lower teeth. This device prevents the molars from shifting forward and ensures that space remains available for the development of future teeth. It's often used in cases of early loss of baby teeth or when lower teeth are slightly crowded in a growing child, allowing for correction without the need to remove any permanent teeth.
When you begin your orthodontic treatment, you'll receive guidance on how to care for your braces. Maintaining oral hygiene is crucial after every meal, as braces can trap food easily, leading to potential enamel damage. Keeping your mouth clean is essential; if food accumulates, you might experience symptoms of gum disease, such as swollen and bleeding gums, which can slow down tooth movement.
Brushing: Aim to brush your teeth 4-5 times daily.
- Start by brushing between the wires and gums to dislodge food particles.
- Then, brush as if you don’t have braces. Begin with the outer surface of your upper teeth, holding the brush at a 45-degree angle to the gums. Use a circular motion, scrubbing two or three teeth at a time with ten strokes before moving on.
- Next, repeat this process on the inner surfaces of the upper teeth.
- Move to the lower teeth and follow the same steps.
- Check in a mirror to make sureensure you haven't missed any spots; all teeth, brackets, and wires should be free of food and plaque.
Note: If your gums bleed while brushing, continue to brush gently to stimulate the area. Make sure to angle the toothbrush to clean under the gum line. After a few days of consistent brushing, the bleeding should cease, and your gums should become healthier.
Flossing: Use a special floss threader designed for braces and make sure to floss at least once a day.
Fluoride Rinse or Gel: This may be recommended as a preventive measure.
To clean your retainer, brush it with toothpaste. If you have a lower fixed retainer, make sure to carefully brush the wire and the inner surfaces of your lower teeth. Always bring your retainer to your appointments. Avoid flipping the retainer with your tongue, as this can damage your teeth. When you take it out, store it in its plastic case. Never wrap it in a paper napkin or tissue, as it might get thrown away. Avoid putting it in your pocket, as it could break or get lost. Also, be mindful that excessive heat can warp and damage the retainer.
If you wear your elastics (rubber bands) only occasionally, they can "shock" your teeth and lead to increased soreness. Experiencing sore teeth between appointments often suggests improper use of headgear or elastics, or insufficient oral hygiene. Make sure to wear your elastics as instructed, keeping them on at all times unless told otherwise. Remove them while brushing and change them as directed, typically once or twice a day.
Avoid sticky foods such as:
Caramels Skittles Candy bars with caramel Starbursts Fruit Roll-Ups Toffee Gum Gummy Bears Candy or caramel apples
Avoid hard or tough foods such as:
Pizza Crust Ice cubes Nuts Bagels Hard Candy Popcorn Kernels Corn Chips
Cut the following foods into small pieces and chew with the back teeth:
Apples Pears Carrots Celery Corn on the cob Chicken wings Pizza Pizza Spare ribs
Please feel free to contact the office if you are experiencing any discomfort or if you have any questions. Below are a few simple steps that might help if you are unable to contact us or if you need a “quick fix”:
Sometimes, a glued bracket may become loose. You can either remove the loose bracket and save it in an envelope to bring to the office or leave it in place if it isn't causing any irritation. Please call the office as soon as you can so we can schedule a time to re-glue the bracket.
If a wire is poking your gums or cheek, there are a few things you can do until you can visit the office. First, try placing a ball of wax on the irritating wire. You can also use a nail clipper or cuticle cutter to trim any excess wire that’s sticking out. In some cases, you can safely bend the poking wire down to alleviate discomfort. To do this, use a pencil eraser or another smooth object to tuck the wire back into place.
Be cautious to avoid hard or sticky foods, as they can bend the wire or cause it to come loose from the back brace. If that happens, you can use needle-nose pliers or tweezers to reinsert the wire into the back brace. If you can't do this, you can clip the wire to relieve discomfort. Please call the office as soon as you can to arrange an appointment for replacing the wire.
Some brackets have small hooks for wearing elastics, which can sometimes irritate your lips or cheeks. If this occurs, you can gently push the hook in using a pencil eraser, or apply a ball of wax on the hook to smooth the area.
It’s normal to feel some discomfort after starting treatment or when changing wires or adjusting appliances. This should lessen within 24-72 hours. Here are a few suggestions to help relieve the discomfort:
- Rinse with warm water, stick to a soft diet, and take acetaminophen (Tylenol) or ibuprofen (Advil) as instructed on the packaging.
- Chewing on the sore teeth might cause temporary discomfort but can help you feel better more quickly.
- If the pain lasts longer than a few days, please call our office.
3237 Route 112, Bldg 6, Suite 7B, Medford, NY, 11763
631 320 08801030 West Jericho Turnpike, Smithtown, NY, 11787
631 486 6364148 Islip Avenue Unit 28,
Islip, NY, 11751
300 Garden City Plaza, Suite 214, Garden City, NY, 11530
516 280 6734