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Orthodontics - Braces

Why orthodontics?

Orthodontic treatment improves your smile. Think about how you react to someone with a pretty smile. Orthodontic treatment will make your smile look fantastic and it will last for the rest of your life. Wouldn't a beautiful symmetrical face with a winning smile be wonderful?

The benefits of orthodontic treatment go beyond making your face look wonderful. You will be able to chew your food easier. If your teeth are crooked, you will not be able to chew your food properly which can lead to recurrent indigestion.

Crooked teeth are hard to clean so that people with crooked teeth tend to have more cavities and gum problems than people who have straight teeth. Crooked teeth wear down in faster than they should. This puts extra stress on your teeth, gums and jaw, which can lead to problems later on. Children who get braces learn to take better dental care in later life.

Braces are one of the things you can do for children and adolescents to insure their health throughout their lifetime. Adults too can vastly benefit from orthodontics. People who have had braces look better and feel better about themselves. Presently, 30% of our orthodontic patients are adults, people as old as 60 have had successful orthodontic treatment.

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Orthodontics... how does it work?

Normally people have the idea that they have a strong solid jaw, but when you are growing your jaw is really soft and pliable like dough or clay. If you apply pressure to your jaw, you can get your jaw to react. If you pull your jaws, they will get wider. If you push your jaw back, it will slowly move back. When you pull on your jaw, your jaw grows in the direction of the pressure. The important thing is that when your braces pull on your jaw, the braces change the shape of your jaw. In the same way, if you push on your teeth, your teeth will move around in your mouth.

The orthodontist uses that fact that he can apply force to get your jaw and teeth to move, to stretch your mouth so all your teeth fit. If your top jaw is too small, the orthodontist can expand your jaw. If your teeth stick out, your orthodontist can push the back teeth back, or if the teeth are too far back you can get them forward. In fact they can be moved in any plane depending upon the required direction. An orthodontist is able to move around individual teeth and expand your jaw.

If babies use a pacifier for too long, they can develop an orthodontic problem. Orthodontic problems can also be caused if you suck your thumb when you are older than two. Fingernail biting, or lip biting can also cause orthodontic problems. Orthodontic problems develop because their teeth grow faster than the mouth.

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When is the right time to get "braces"?

You can get orthodontic treatment at any age. Kids are sometimes advised to start orthodontics early to avoid a problem later on. People as old as 60 sometimes get orthodontic treatment to fix crooked teeth or other related problems. Orthodontic treatment works best when you are 7 to 13 so we advise that you start orthodontic treatment then. Your jaw is growing the quickest at age 8 or 9 so it is usually best time to expand your jaw and reshape your mouth. Permanent teeth come in when you are 12 or 13 and so that is the best time to start full orthodontic treatment (braces). Moral of the story is that the best time to get orthodontic treatment is when you see a problem or anticipate a problem.

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Do adults get braces?

Many people did not get braces when they were young. Either their parents could not afford braces, or their teeth could not be straightened with the techniques of yesteryears. They can afford braces now, and want to do something for themselves because they realize that taking care of your smile is part of taking care of yourself.

When your teeth are crooked, they are harder to clean and will wear unevenly. Your gums can get inflamed and your teeth hurt. Orthodontic treatment can inhibit gum problems and prevent tooth loss. If you do not chew your food properly, the rest of you digestive system will have to work harder. Adult orthodontic treatment is basically the same, with a few minor differences different than teenage orthodontic treatment? As you get older, you heal more slowly. As a result, the orthodontist needs to be gentler with his treatment. The orthodontist can still move your teeth, but the orthodontist needs to move your teeth more slowly to let your mouth heal between tightening appointments. The orthodontist may have to remove some teeth to make everything fit while the orthodontist could have expanded your jaw if you had come in for treatment when you were a teenager. Nevertheless, orthodontic treatment still works.

It just goes slower some adults have gums, which have receded so much that orthodontic treatment cannot be done. Other adults have shallow roots from years of abuse. If your mouth has been really abused, it is sometimes impossible for you to get orthodontic treatment. Still, you should contact your orthodontist to be sure.

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Different stages of orthodontic treatment?

Preventive

The objective is to attend to the situation before it becomes a problem. This is the stage that starts from birth and before.

Interceptive

The objective is to make your jaw wider and reshape your mouth so there is room for your permanent teeth. If you start interceptive orthodontic treatment when you are 8, it usually avoids extensive corrective treatment later on.

Corrective

This is the braces or correction stage where the teeth and jaws are moved and aligned.

Retention

The retainer keeps your teeth in perfect alignment after braces are removed so you keep an excellent smile as your mouth grows.

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What steps occur during orthodontic treatment?

Initial Examination:

The orthodontist will examine your mouth to see if you need orthodontic treatment. Is your mouth big enough to hold all of your teeth? When you close your mouth, are the top teeth lined up with your bottom teeth? Are any of your teeth crooked or not in the right place? Are there any missing teeth?

Records:

If treatment is required the orthodontist must know what is to be done and formulate a plan for the patient. He will require a panoramic X-ray, a Lateral Cephalometric X-ray, a set of study models, facial photographs and a detailed history from the patient.

Diagnosis and treatment planning:

With the help of the records and a system of measurements a diagnosis is made and a treatment plan and schedule for the patient is made by the orthodontist.

Consultation:

The patient and their parents (in case of minors) are called in for a special appointment where the case and diagnosis is discussed. The treatment plan is then explained and the type of treatment and choice of braces arrived at. The estimated treatment time and cost is also discussed. All queries and questions are discussed and the patient is well informed before the treatment is initiated.

Putting on your braces:

Depending upon the treatment plan and the stage of orthodontics the braces are placed. Fixed braces are place by a system of direct and indirect bonding which is done at the chair side and is painless.

Adjustment appointments:

The treatment is carried out by a system of adjustment to the wires, which is typically once every 3-4 weeks in our office for the duration of the treatment.

Retainers:

Usually, when braces are first removed, your teeth will all be in perfect alignment, and your smile is excellent. However, your gums, bones, etc will not have completely shifted into their new positions. The retainer holds your teeth in position until your gums, bones etc settle in to their new positions. You need to wear your retainer 24 hours a day for at least 6 months after your braces are removed. Then continue to wear the retainer a few nights a week and taper off the wear as per the orthodontists instructions.

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Extraction and non-extraction therapy

In cases where the tooth size is exceeding the available bone size the orthodontist has to resort to removal of teeth to gain space to correct and align the dental arches. Extraction is an acceptable means of gaining space. The most commonly extracted teeth are the premolars in the upper and lower arches. In cases where the front teeth are severely protruded there could be a possibility of only two teeth being removed. The teeth are usually extracted from both right and left side to maintain the midline of the face thereby keeping the symmetry. Patients and Orthodontists both prefer non-extraction treatments but in cases where the case warrants extraction this is the treatment of choice.

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Types of braces

Braces are the tools of the orthodontist to perform the required changes in the mouth. They can be broadly divided into removable and fixed. Removable braces are used in Interceptive types of treatments and for Phase type of treatment. Fixed braces are the ones that are placed on the teeth and come in lots of different shapes sizes and colours.

Old fashioned braces are big and clunky consisting of large unsightly bands on all the teeth. They can cut your lips, and are generally uncomfortable. Modern braces are smaller and more comfortable. They have low profile design, which is less irritating to your lips. They also have special contours to make your orthodontic treatment go faster and be more comfortable.

Will I be stuck with a "metal mouth or silver smile" look when I have braces? In today's time "invisible" braces are tooth coloured braces highly preferred by many patients for their aesthetic value. These braces are made of plastic/ceramic/fibre glass and afford the same levels of comfort to the patient as conventional metallic braces. These do cost more than regular braces but not all that much.

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How will my lifestyle be affected when I have braces?

You will be able to do everything you do now. Swim, kiss, talk, play, work or retire. You will not be able to eat a few things such as chewing gum, hard things like chikki and chewy things like éclairs. Chocolates can be eaten so long as they are without nuts or chewy and not from the fridge and you will have to wear a mouth guard when you participate in any rough or contact sports.

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Brushing my teeth with braces

Brushing and flossing is really important when you have braces because food can get caught in the braces and cause cavities. Also you will have terribly bad breath so no one will want to talk to you. Should brush and floss your teeth after every meal and before you go to bed. If you get a cavity with braces, your regular dentist will just fill it. If the cavity is underneath your braces, your orthodontist will have to remove your braces first.

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Do braces hurt?

It matters what kind of braces you use. Old fashioned braces will hurt a lot of the time. However, if you get modern braces, they will not hurt except when they are first put where they tend to feel new or when your braces are tightened. Unfortunately all braces are not designed to minimise pain Orthodontists who use only old fashioned braces have patients complaining of pain.

Generally, teenagers do not find braces to be any big deal. Your mouth is usually sore for a while after you get braces because you have something new in the mouth that you need to get used to. Also, your mouth will be sore when the braces are adjusted However, with modern braces, you should get so used to the braces, that you should not notice the braces, except when the braces are being tightened or if you get hit in the mouth.

If you start orthodontic treatment when you are 18 or older, it generally is more uncomfortable; your teeth feel like they are loose in your mouth. Still, the pain is worth the gain.

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Will braces cause ulcers in my mouth?

Initially, when you first get braces, there may be some blisters on your lips. If you rinse the sores in warm salt water, the sores will heal within a week. There can be an occasional sore when you get hurt in the mouth. However, the sores should heal rather quickly. If your lips get too sore during the first week, you can put wax on the braces to prevent the braces from rubbing and irritating the sore. Cold cream, vaseline or a chap stick helps in relieving sore lips.

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How long does orthodontic treatment take?

It varies a lot according how much your jaw needs to be adjusted and how much your teeth have to move.

If you start interceptive orthodontic treatment early it usually takes anywhere from 9 to 12 months to expand and widen the jaw. It takes longer if the orthodontist needs to reshape your jaw. If you get braces when you are 12 years old or after all the baby teeth have gone, it usually takes 15 to 18 months with corrective orthodontics. It will take longer if you do not do what the orthodontist tells you, if you break your braces often, loose your retainers or if there is something unusual about your bite.

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Will my friends laugh at me when I get braces?

Some friends laugh at anything especially if you get old fashioned, clunky braces. However most teenagers feel good about invisible or ceramic braces. Most of your friends will be getting braces too. Wouldn't it be excellent if your braces were better, smaller and cleaner than all of your friends' braces? Standard braces should not affect how you talk or the sound of your voice. You can talk, sing, yell, make fun of people, and act just as you do now. Braces will not stop you from having fun. Just do not get punched in the mouth.

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What precautions do I take with braces

You can still do everything. Just wear a mouth guard, and try to not get hit in the mouth. We recommend that you avoid sports where you will get hit in the face. Fighting, boxing, wrestling, karate can be very painful if you get hurt when you have braces.

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Can I eat when I get braces?

Yes! You can eat most of the good things that you can eat now. The one big limitation is that your mouth will get sore after you first get braces, so we recommend that you only eat softer foods for the first week. However, after that you should be able to eat normally.

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Can I chew gum with braces?

Gum is usually not recommended. The gum can get caught on the braces and pull the braces off it can also distort the wires and slow down treatment. Also the sugar in the gum can get trapped behind the braces and cause cavities.

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Is there anything else that I cannot eat?

You should not eat very hard or sticky foods. Chicki and chakli can pull the braces off your teeth. You also need to be careful with crunchy foods like carrots and apples that you do not knock your braces off your teeth.

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What happens if the braces come off?

The orthodontist will attach them again. If it happens lots of times, your orthodontic treatment will take longer and cost you more. The orthodontist cannot attach the braces any stronger that the braces cannot come off as the orthodontist needs to take off your braces at the end of the orthodontic treatment. If the orthodontist attaches your braces too firmly, the braces will not come off again at the end of your orthodontic treatment. It is usually not a serious problem if you swallow parts of your braces. The parts just pass through your digestive system.

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