TREATMENT

Guide to Orthodontics

For most people, a beautiful smile is the most obvious benefit of orthodontics. Other reasons people seek orthodontic care is to improve their bite, prepare for restorative treatment or even improve the alignment of the jaw and facial soft tissues.

Early Treatment

The American Association of Orthodontists recommends that children have their first orthodontic evaluation at the first sign of orthodontic problems or no later than age 7. Early evaluation allows Dr. Baldwin to detect potential issues related to jaw growth and eruption of the adult teeth. After evaluating your child, Dr. Baldwin may simply want to monitor them periodically while the permanent teeth erupt and the jaws and face continue to develop. Alternatively, she may recommend treatment and design a plan to guide and enhance your child's natural growth, establish proper jaw size, improve space for the eruption of permanent teeth, and improve the position of the upper and lower jaws in relation to one another. Treatment usually lasts 9 to 12 months after which the child is monitored while the remaining permanent teeth grow in. Most children will require a second, more comprehensive phase of treatment in order to perfect the alignment of all teeth and create a completely stable, functional and esthetic outcome.

Teen Treatment

The most common time for orthodontic treatment is between the ages of 11 to 15. By age 12, most of the permanent teeth have erupted and are in place, and crooked teeth, gaps and bite problems can be quite pronounced. Sadly, these problems will not correct themselves or improve with time. Fortunately, however, children at this age are growing rapidly, making it the most efficient and successful time to work on correction of the bite and alignment of the teeth. Teens also have the advantage of fast metabolisms, which helps to shorten the overall treatment time and ease the discomfort of orthodontic treatment. There are a several options for teenagers beyond traditional metal braces, for teenagers, if they are concerned about their appearance such as clear braces or invisible aligners.

Adult Treatment

Seeing an adult wearing braces or invisible aligners is not quite as unusual as it was in the past. According to the American Association of Orthodontists, 20% of orthodontic patients are over the age of 21. The advancements in aesthetics and comfort, with tooth-colored or clear braces and Invisible aligners, make getting orthodontic treatment more appealing. Adult orthodontic treatment is similar to treatment for teens, but there are some differences. In adults, growth is complete, so if if there is a skeletal discrepancy of the jaws, surgical repositioning is more often required. Additionally, adults more commonly have planned or existing restorative treatment such as crowns, veneers, bridges and implants; as well as periodontal issues such as gum disease and bone loss that must be accounted for. Dr. Baldwin works closely with other dental specialists, as needed, to plan and coordinate treatment to ensure a successful outcome.

Retainers

Retainers can come in different styles, from removable ones made of wire and acrylic or clear plastic, to permanent ones that are glued to the backside of the teeth. The purpose of all retainers is to keep the teeth from moving. For this reason, at the end of all orthodontic treatment, retainers are provided and patients are encouraged to wear them to maintain their teeth in their straightened positions. Unfortunately, teeth continue to move and shift with time unless stopped by something, so regular wear of retainers for the rest of one’s life is recommended. Click here to learn how to care for retainers.

Frequently Asked Questions

At what age should orthodontic treatment start?

Orthodontic treatment can be started at any age, however, many problems are easier to correct if detected at an early age before jaw growth has slowed. Early treatment may mean that a patient can avoid more complicated and lengthy treatment or even surgery later. The American Association of Orthodontists, therefore, recommends that every child first visit an orthodontist by age 7 or earlier if a problem is detected by parents, the family dentist, or the child’s physician.

What is Phase I and Phase II treatment?

Phase I, or early interceptive treatment, is limited orthodontic treatment (i.e. expander, headgear or partial braces) before all of the permanent teeth have erupted. Such treatment can occur between the ages of six and eleven. This treatment is recommended to make more space for developing teeth, to correct crossbites, overbites, and underbites, or harmful oral habits. Phase I is especially helpful in guiding the teeth and jaws of growing children into more favorable positions. Phase II treatment is also called comprehensive treatment because it involves full braces or invisible aligners when all of the permanent teeth have erupted, usually between the ages of eleven and thirteen.

Can adults get orthodontic treatments?

Yes! Orthodontic treatment can be successful at any age. Everyone wants a beautiful and healthy smile. Twenty to twenty-five percent of orthodontic patients today are adults.

Can I receive orthodontic treatment even if I have crowns and missing teeth?

Yes you can! Crowned teeth move just like teeth that have simple fillings. When teeth are missing, orthodontic treatment will help align the remaining teeth.

How long does orthodontic treatment take?

Treatment times vary on a case-by-case basis, but the average time is from one to three years. Actual treatment time can be affected by rate of growth and severity of the correction necessary. Treatment length is also dependent upon patient compliance. Maintaining good oral hygiene and keeping regular appointments are important in keeping treatment time on schedule.

How do braces work?

Braces use steady gentle pressure to gradually move teeth into their proper positions. Brackets are placed on the teeth and archwire is placed into the brackets to connect them. Teeth begin to loosen and move, and the archwire applies pressure to move your teeth to their new, more ideal positions.

Do braces hurt?

The placement of bands and brackets on your teeth does not hurt. Once your braces are placed and connected with the archwires you may feel some soreness for one to four days. Your lips and cheeks may need one to two weeks to get used to the braces on your teeth.

Will braces interfere with playing sports or playing musical instruments?

Not at all. When playing a sport where a mouthguard is usually worn, we recommend continuing to wear one. Specialty mouthguards that fit over braces are available at sporting stores and online. When playing musical instruments, there may be an initial period of adjustment, and wax or other brace covers can be applied to prevent discomfort during this time.

Should I see my general dentist while I have braces?

Yes! Please continue to see your general dentist every six months for cleanings and dental checkups.

Will I need to have teeth removed for braces?

Removing teeth is sometimes required to achieve the best outcome. This is less common, however, than it ever has been in the past. A shift in the treatment philosophy of the orthodontic community as a whole in the last 20 years, places an emphasis now on preserving the entire dentition when possible.

COMMON CONDITIONS

There are many reasons why patients may need orthodontic treatment, and below is a list of conditions that most often lead people to seek orthodontic treatment.

ABNORMAL ERUPTION Abnormal eruption is when a tooth emerges through the gum in the wrong place.
EXCESSIVE SPACING Excessive spacing may result when one or more teeth fail to grow in, are lost to trauma or disease, or there is a discrepancy between jaw size and tooth size.
CROWDING Crowding results from a lack of space for the teeth to fit normally within the jaws, either because the teeth are too big or the jaws are too small.
OPEN BITE Open bite occurs when the upper and lower front teeth do not come together when biting, resulting in an open space between the two.
CROSSBITE Crossbite is when one or more of the upper teeth bite inside the lower teeth rather than outside.
UNDERBITE Underbite occurs when the lower front teeth extend past the upper front teeth.
OVERBITE Overbite (deep bite) is when the upper front teeth bite too far down over the lower teeth.
OVERJET Overjet (protrusion) is when the upper front teeth extend too far forward or the lower teeth don't extend far enough forward.

WEARING & CARING FOR RETAINERS

Patients should wear their retainers for a lifetime, so that their teeth remain straight and beautiful for the rest of their life. Retainers hold teeth in their new, corrected position after they have been straightened. Dr. Baldwin will instruct patients on how to care for their retainer and the the daily duration of wear. It is very important for patients to wear their retainer as directed in order to prevent regression of their treatment.

Important Tips:
  • Take retainers out when eating, and always put retainers in their case! Most appliances are lost in school lunchrooms or at restaurants when they are left on a tray, wrapped in a napkin, and thrown away
  • Keep retainers away from hot water, hot car dashboards, pockets, the washing machine, and pets who love to chew on retainers!
  • Keep retainers away from hot water, hot car dashboards, pockets, the washing machine, and pets who love to chew on retainers!
  • If tartar or stains start to build up on the retainers, patients can order 'Retainer Brite' online from Amazon or use denture cleaner from the grocery store
  • If retainers are lost or broken call us immediately to prevent shifting of your teeth.
  • If a bonded retainer wire has been bent or has come loose from one of the teeth, please call us so that it can be repaired, and teeth do not shift.
  • Always bring retainers to appointments.
If patients have any questions or concerns about their retainers, or their retainers need adjusting, please call us. Patients should not try to adjust their own retainers.