Orthodontic treatment is used to correct a “bad bite.” This condition, known as a malocclusion, involves teeth that are crowded or crooked. In some cases, the upper and lower jaws may not meet properly and although the teeth may appear straight, the individual may have an uneven bite.

Protruding, crowded or irregularly spaced teeth and jaw problems may be inherited. Thumb-sucking, losing teeth prematurely and accidents also can lead to these conditions.

Correcting the problem can create a nice-looking smile, but more important, orthodontic treatment results in a healthier mouth. That’s because crooked and crowded teeth make cleaning the mouth difficult, which can lead to tooth decay, gum disease and possibly tooth loss. An improper bite can interfere with chewing and speaking, can cause abnormal wear to tooth enamel, and can lead to problems with the jaws.

What are braces made from?

Braces (also called orthodontic appliances) can be as inconspicuous—or as noticeable—as you like. Brackets—the part of the braces that attach to each tooth—are smaller and can sometimes be attached to the back of the tooth, making the brackets less noticeable.
Brackets may be made of metal, ceramic, plastic or a combination of these materials. Some brackets are clear or tooth-colored. There are brackets shaped like hearts and footballs, and elastics (orthodontic rubber bands) in school colors or holiday hues such as red, white and blue. And there are gold-plated braces and glow-in-the-dark retainers.

Are they left in the mouth or can they be removed?

There are two types of orthodontic appliances: fixed, which are worn all the time and can only be removed by the dentist, and removable, which the patient can take out of the mouth. The dentist selects the type based on your needs.

When should treatment begin?

Malocclusions often become noticeable between the ages of 6 and 12, as the child’s permanent (adult) teeth erupt. Orthodontic treatment often begins between ages 8 and 14. Treatment that begins while a child is growing helps produce optimal results. As a result, children should have an orthodontic evaluation no later than age 7. By then, they have a mix of primary (baby) teeth and their permanent (adult) teeth. Your child’s dentist can spot problems with emerging teeth and jaw growth early on, while the primary teeth are present. That’s why regular dental examinations are important.

How about adults wearing braces?

Children aren’t the only ones who can benefit from orthodontics. If you’re an adult, it’s not too late to correct problems such as crooked or crowded teeth, overbites, underbites, incorrect jaw position, or jaw-joint disorders. The biological process involved in moving teeth is the same at any age. Usually, adult treatment takes a little longer than a child’s treatment. Because an adult’s facial bones are no longer growing, certain corrections may not be accomplished with braces alone. No matter your age, it’s never too late to improve your dental health and beautify your smile.

Who provides orthodontic treatment?

Most dentists are trained to treat some minor orthodontic problems. If the dentist thinks the patient should see a specialist for treatment, he or she will provide a referral to an orthodontist. Orthodontics is a specialty area of dentistry that is officially known as Orthodontics and Dentofacial Orthopedics. The purpose of orthodontics is to treat malocclusion through braces, corrective procedures and other “appliances” to straighten teeth and correct jaw alignment. An orthodontist is a dentist who specializes in the diagnosis, prevention, and treatment of dental and facial irregularities. Read more about orthodontists and orthodontic treatment atwww.braces.org.

Although treatment plans are customized for each patient, most wear their braces from one to three years, depending on what conditions need correcting. This is followed by a period of wearing a “retainer” that holds teeth in their new positions. Although a little discomfort is expected during treatment, today’s braces are more comfortable than ever before. Newer materials apply a constant, gentle force to move teeth and usually require fewer adjustments.

Good oral hygiene is especially important when braces are present. Brushing regularly, as directed by the dentist, flossing daily and scheduling dental visits can help keep teeth healthy.
Patients with braces should maintain a balanced diet and limit between-meal snacks. Your dentist may recommend avoiding certain foods that could interfere with braces or accidentally bend the wires. These foods may include nuts, popcorn, hard candy, ice and sticky foods like chewing gum, caramel or other chewy candy.

Do braces hurt?

For the most part, braces do not hurt. The first time you get separators or new wires, your teeth may be sore for a few days. The soreness usually peaks during days 2-3, but should start getting better by days 4-5. Future adjustments may or may not cause you discomfort depending on what is being done to your teeth. To alleviate the discomfort, you can take whatever pain medications you would normally use for a headache.

Because your lips, cheeks and tongue are not accustomed to rubbing against the braces, you may experience sores or ulcerations inside your mouth. The sores may last for one to two weeks until your lips, cheeks, and tongue get used contacting your braces. If there is part of the braces that is irritating your mouth, you can place orthodontic wax to help smooth the rough area of the braces. After your lips, cheeks and tongue get used to the braces, you may even forget you have them on. Read more about common orthodontic emergencies.

In the old days, only stiff wires were available so there was more discomfort associated with braces. Now, with new technology and flexible wires, there is significantly less discomfort associated with tooth movement. In fact, some patients complain about not having any pain because they think that without pain, their teeth are not moving. Remember, “It does not have to hurt to work!”

Do I need to have shots?

No shots are generally needed for orthodontic treatment. Having said that, you may need shots if your orthodontist refers you out for other procedures such as extractions, surgical exposure of teeth, or miniscrews.

Are there clear or less noticeable braces?

Yes. Compared to 30 years ago, braces have gotten smaller and can be directly bonded (glued) to teeth. The bands or metal rings that used to be placed on every tooth now only need to be placed on the back teeth. In some patients, the braces can be bonded to even the back teeth so no bands are needed!
Besides smaller braces, there are also non-metal, clear braces or even lingual braces that are bonded on the tongue-side of the teeth. Another option to straighten teeth is not to use braces at all, but a series of clear trays such asInvisalign. Your orthodontist can determine which option would be best for you.

Can I get braces just on my top or bottom teeth?

That depends. Orthodontists are not only concerned with straightening your teeth, they are also concerned about correcting your bite if needed. Many times, if only one arch is treated, the bite will still be uncorrected. Over time, a malocclusion (bad bite) could cause damage to your teeth, tissues, and jaw joints.
With some bite problems, it may not be possible to treat just one arch. For example, some patients will come in with straight upper teeth, crooked lower teeth, and a deep bite. A deep bite means that the upper and lower front teeth overlap significantly, often preventing the lower teeth from moving forward. Straightening the lower front teeth often involves moving the lower teeth forward to create space. However, due to the deep bite in this case, the lower teeth would be prevented from moving forward, and it would be difficult to straighten the lower teeth. In this case, upper and lower braces would be needed to first open the bite so that the lower crowding could be corrected.

Can I get braces if I play sports?

Yes. Many orthodontic patients play sports. However, be sure to protect your braces from cutting the inside of your mouth by wearing a mouthguard. If you have questions on what protective guard is appropriate for you, ask your orthodontist. Your orthodontist will be able to tell you which mouthguard to get and wear to buy one. Some orthodontists will even make custom-fitted mouthguards for you.

Can I get braces if I play a wind instrument?

Yes, but the braces may feel a little rough on your lips. Ask your orthodontist about lip protectors specifically designed for wind instrument players. Alternatively, you can use wax to cover your braces when playing.

Can I get braces and return to school or work the same day?

Yes. Getting braces is not like getting a tooth extracted. It is relatively painless and you should be able to return to school or work the same day.

Can I get braces if I am “too old”?

As long as your gums and bone surrounding your teeth are healthy, your teeth can be moved to new and straighter positions. No patient is “too old” for braces. However, because adult bone is more mature than bone of a child, treatment may take slightly longer.

Can I go back to work the day I get braces?

Yes. Braces should not interfere with your ability to go back to school or work. That being said, your lips and cheeks may take some time to get adjusted to your braces. If you have an appliance inside your mouth, you may need some time to get used to talking with it.

Can I get braces if I am pregnant?

Yes, but you may need a letter from your obstetrician saying that it is ok to have X-rays taken. Because of hormonal changes during pregnancy, your gums may become swollen easier. However, as long as you practice good oral hygiene, you can still enjoy the benefits of orthodontic treatment when you are pregnant.

Can I get braces even though I have crowns and/or bridges?

Yes. Your orthodontist can put a band or bracket on the crowned tooth and move it just like any other tooth. Bridges, because they involve multiple joined teeth, will not move well with braces. If you need to move a bridged tooth, your orthodontist may have to section the bridge or have your dentist remove it.

Can I get braces even though I have missing teeth?

Yes, your orthodontist can align the remaining teeth and adjust the space of the missing teeth so that ideal restorations can be placed.

Can I get braces if I have my tongue pierced?

Wearing a tongue stud can cause breakage of orthodontic appliances and is not recommended.

Can I get braces if I have TMD or jaw joint problems?

It will depend on the severity of your TMD or jaw joint problems. Your treatment provider will first conduct a thorough clinical evaluation which may include taking a series of TMJ X-rays. For mild cases, your provider may choose to observe you or give you a splint to help stabilize your TMJ. For moderate to severe cases, your provider may refer you to a TMJ or Orofacial Pain specialist.

Do I still need to see the general dentist when I have braces?

Yes, you should continue to see your general dentist at least once every six months to have your teeth cleaned and checked.

Can I get braces if I am allergic to nickel?

Yes. If you have a nickel allergy, tell your orthodontist. There are nickel-free braces and appliances that your orthodontist can use. If the office does not stock nickel-free appliances, they can be ordered.