Introduction to Orthodontics

Orthodontics
Contemporary orthodontics is a lot different than days past!  Gone is the "Tin Grin" as it was once described.  Braces these days are smaller and more comfortable than ever and can be even be invisible in some cases.  The new materials used in orthodontic treatment are actually space-aged!  (The nickel-titanium alloy was originally engineered by NASA to automatically activate antennae or solar panels of spacecraft orbiting into the sun's rays.)  By utilizing the latest technological advances in orthodontics, we are able to achieve an outstanding treatment outcome, while always keeping patient comfort as a primary concern.

Dr. Joe understands that some people might be a little apprehensive about dental treatment.  He works very hard to make sure every patient and their family feel at home and have a good experience in the office.  His caring and compassionate personality makes children and adults of all ages feel comfortable and relaxed.

Orthodontics for Adults

Adult orthodontic treatment has become very popular over the last several years.  Recent technological advances have made adult treatment more patient friendly.  Our adult patients value the improved appearance and self-confidence after having their malocclusions corrected.  In addition, the health advantages of correcting mal-related teeth have become more obvious.

There are often several options involved in adult treatment, depending on your desired level of involvement.  In addition to the newest and most comfortable braces, to include tooth colored  ceramic brackets, there are other techniques, including Invisalign, that our office offers as an esthetic alternative to braces.  As with all of our patients, our initial exam to determine your needs is complimentary.

Orthodontics for Children

Interceptive (Early) Treatment

There are some types of orthodontic problems that are best addressed as early as seven years of age.  One of the most common types of early treatment is expansion of the upper jaw.  This is necessary when the upper jaw, or maxilla, is too narrow to fit well with the lower jaw.  At the early childhood ages, this expansion can be accomplished predictably and painlessly.  If left unaddressed until adolescence, the maxillary expansion may not be able to be done with a predictable result, or may require surgery to correct.
Other types of early interceptive treatment include correction of crowding, retraction of upper teeth that are too protrusive and may be at increased risk of fracture from trauma, and early correction of disfiguring tooth mal-relationships when they are adversely affecting the patient's developing self-image.  Interceptive treatment times typically range from 6-12 months. 

The American Association of Orthodontists recommends an evaluation by age seven.  If in doubt as to whether or not your child has an orthodontic problem that may require early treatment, we would be glad to perform a simple examination to determine the nature of the problem.  This is a courtesy visit.  The good news is that the vast majority of younger children do not require Interceptive Treatment.  We are very conservative with our treatment recommendations and only suggest Interceptive Treatment when it is absolutely necessary.

Adolescent (Comprehensive) Treatment

The ideal time for most patients to start comprehensive orthodontic treatment is between the ages of 10 and 12.  The dental development from patient to patient is extremely variable, and females typically mature dentally about six months ahead of males.  This stage of orthodontic treatment may involve not only braces, but also other appliances that may help guide the teeth and jaws as they develop during the adolescent growth spurt.  Adolescent treatment times typically range from 15-30 months.

While many adolescents like to show off their personality by customizing the color of their braces at each appointment, others would like to keep things more discreet.  For those patients, we are able to offer ceramic (clear, tooth colored braces), and Invisalign Teen, an esthetic alternative to braces, for those whose bite problem (malocclusion) meets the treatment criteria.

Emergency Care

Luckily, true orthodontic emergencies are rare, but if they do happen, they should be addressed.  Call the office to determine how to best handle the problem.  Often times, we can walk you through a solution that can make the patient comfortable.  Sometimes, we will ask you to come to the office to correct the problem.  If you have an after-hours emergency please call the office for further instructions.

You might be surprised to learn that you may be able to temporarily solve many problems yourself until you can be seen for an appointment with our office.  If you are able to alleviate the discomfort yourself, it is very important that you still call our office during normal office hours to schedule a time to repair the problem. Allowing your appliance to remain damaged for an extended period of time may result in disruptions in your treatment plan and increased treatment time.

The following solutions may help you relieve your discomfort:

Poking Wire

Use a pencil eraser or kitchen spoon to push the poking wire back towards your teeth. If this does not solve the problem try placing wax on it to alleviate the discomfort. The wax sticks better if the braces or appliance are dry, so use a tissue or cotton swab to thoroughly dry the area first. Take a small piece of wax and roll it between your index finger and thumb to soften it; then, place it on the troublesome area.

Loose Bracket or Band

If your bracket or band is still attached to the wire, you should leave it in place and put wax on it. If the wire comes out entirely, remove the loose bracket or band and place it in a plastic bag to bring to the office. If the wire is sticking out the back, try to place a piece of wax to hold it in place. As a last resort, wrap a tissue or cotton ball around the back of the wire (to catch it) and use a fingernail clipper or wire cutter to clip the wire behind the last tooth to which it is firmly attached. Remove the piece of wire and save it in the same plastic bag.

Loose Wire

Using tweezers, try to place your wire back into place. If doing this and using wax does not help, as a last resort, wrap a tissue or cotton ball around the back of the wire (to catch it) and use a fingernail clipper or wire cutter to clip the wire behind the last tooth to which it is firmly attached.

Loose Appliance

A removable appliance that is not fitting well or is causing irritation should not be worn until it can be adjusted in our office. Call the office during normal business hours to schedule an appointment.

Normal Period of Adjustment

Remember that everyone goes through an initial period of adjustment to their new braces or appliance. This is completely normal and things will return to normal. This period normally lasts about a week, but can be more or less for some patients.  If speech is affected by a new appliance, talk out load as much as possible so that your tongue gets used to it. Teeth usually get sensitive when they first start moving. A soft diet for the firsts few days can help make this period more tolerable. Exercising your teeth with a rubber bite wafer can help make this adjustment period go more quickly. This will keep the blood flowing around your teeth and make them feel better.  An over-the-counter pain reliever, similar to one taken for a headache, can be helpful to relieve the discomfort experienced during the first couple days.  Follow the normal dosing recommendations on the bottle.  Also, your lips and cheeks might get irritated initially.  Wax is very good to soften an initially pokey area, and Orabase can help to soothe irritated spots and help protect them while they heal.  The good news is that sensitivity from braces is normal and is short-lived.

Treatment Alternatives

Since each patient is unique, we truly believe that each patient requires an individualized orthodontic treatment plan.  After thoroughly reviewing comprehensive diagnostic information, the doctor formulates a treatment plan specific to each patient. There are many possible combinations of treatment systems, often paired with a patient-friendly orthodontic appliance to achieve the desired result. 

While it is not possible to elaborate on all possible combinations of treatment alternatives, described below are some of the more common approaches to correcting a malocclusion.

1.  Invisalign:

Invisalign is the virtually invisible way to straighten your teeth without braces. The Invisalign system uses a series of clear, removable aligners to move the teeth over time to give you the smile that you've always wanted.
Invisalign has developed a new system of aligners called Invisalign Teen, which is intended for use by teenaged patients.
Not everyone qualifies for treatment with the Invisalign system. Certain, more complicated, bite and alignment problems require braces for more predictable correction.

Learn more about Invisalign on their web site at www.invisalign.com.

2.  MicroArch Braces:

MicroArch braces are very small, low profile braces milled from aerospace strength steel.  This results in greater precision, more patient comfort, and more predictable results. 
The arch wires used with our MicroArch braces are made of space-aged metal alloys that generate light, continuous forces, resulting in more patient comfort and faster tooth movement.
Patients can choose from over 25 different colors to customize their smile every time their braces are adjusted.

3.  Ovation C Ceramic Braces:

Ovation C Ceramic Braces are an excellent solution for those patients who desire a less noticeable appearance to their braces.  They provide an esthetic solution with exceptionally high translucency, blending-in very nicely to the patients surrounding enamel.

 

Since we are able to incorporate our space-aged arch wires, we are able to provide an esthetic solution when the case may be too complex for a predictable result with Invisalign. 

 

Living with Braces 

Braces and appliances are something completely new to your mouth.  There will be a period of adjustment.  For most patients, this usually lasts a few days.  Your teeth might get sore and you might develop some areas of irritation along you cheeks, lips and gums.  You might also notice increased saliva and slight speech impairment.  This is normal and will go back to normal.  It’s like having a new pair of shoes that are a little snug in some areas.  After wearing them for a few days, you get used to them.

We provide our patients with a kit to help them get used to their new braces.  The kit contains the following:

  • Wax is used to cover areas that are causing irritation.  The wax will stick best if the area is dry before application.  The area can be dried with a tissue or Q-tip.  Take a small piece of wax between your finger and thumb and roll it into a ball.  This will soften the wax and make it easier to apply.  Just push the soft piece of wax on the area that is bothering you.  Don’t worry if you swallow the wax.  It won’t hurt you. If the wax won’t stick, some patients like to get a wet cotton ball and place it in the area of irritation.  This acts like a pillow and is especially useful at night.
     
  • Orabase can be applied to areas that are already irritated.  Orabase will form a layer over top of the irritation that will prevent it from getting worse.  It also has a medicine in it that will numb the area and make it feel better while it is healing.
     
  • Rincinol can be swished in your mouth (and then spit out) when you have a lot of small areas of irritation.  It will have a similar effect as the Orabase.
     
  •  Peroxyl or Warm Salt Water can also be used to rinse (and then spit out) to make areas feel better.  These will both help to keep irritated areas clean and help them heal faster.
     
  • The Bite Wafer is used to exercise your teeth.  During the first few days you want to eat a softer diet.  This is more comfortable since your teeth might be a little sore.  Exercising your teeth with the bite wafer will help the blood flow around your gums and make the soreness go away faster.
     
  •  Each patient is unique, and their needs are different.  For some people, the use of an over-the-counter medicine similar to that taken for a headache can be used to help the soreness.  If this is needed, it is usually only for a day or two.

Brushing and flossing your teeth and braces:

  • Keeping your teeth and braces clean is one of the most important things that you can do to guarantee a good result.  Poor oral hygiene during braces can lead to increased treatment time, poor overall results, and staining or cavities on the teeth.
     
  • You should try to brush your teeth after every meal.  You are being provided with a Travel Toothbrush to keep in your pocket.
     
  • The Hourglass Toothbrush Timer should be used at home while brushing your teeth.  This timer lasts three minutes.  It takes longer to clean around and under your braces, so use this timer to make sure that you are not brushing too quickly.
     
  • Use the Proxy Brush to get under the wires and above the braces.  The area between the braces and gums is commonly missed by patients with braces.  Be sure this area is clean.
     
  • You need to Floss your teeth at least once a day while wearing braces.  Use the Floss Threader to get the floss under the wire.

To prevent broken braces and keep your teeth healthy, follow these Food and Drink Restrictions:

  •  Avoid sticky foods such as taffy, caramels, gummy candies, starburst, skittles, and gum as they might loosen the bands.  Also, avoid hard foods such as ice, nuts, and hard candy as these might cause a bracket to become loose.
     
  • Certain foods such as apples will need to be cut up and then eaten.  Don’t bite into an apple as this might cause your braces to become loose.
     
  • Carrots can still be eaten, but they should be cut into long, thin pieces that aren’t hard.
     
  • Avoid crunchy bread, bagels and hard pizza crust.
     
  • You can eat popcorn, but only a piece at a time.  This way you can make sure there are no kernels that you might bite down on.
     
  • Limit the number of sugary drinks that you have in one day.  Too many can lead to cavities.
 

For more information on Orthodontics in the Ashburn, VA area call Ashburn Pediatric Dental Center at (703) 726-4333 today!