FAQS: Teenage Orthodontic Patients

Q: Why Should I Get Braces?

A: There are a multitude of reasons why anyone should get braces. Here are a few major reasons:

Orthodontic treatment improves your smile: Your smile is the most striking part of your face. Look in the mirror. Do you like your smile now? Can your smile be improved? Think about how you react to someone with a pretty smile. Do you find them more attractive? Will you be more attractive with an appealing smile?an imbalance of the hormones estrogen and testosterone. Newborns, boys going through puberty and older men often develop gynecomastia as a result of normal changes in hormone levels. There are other causes as well.

Orthodontic treatment will make your smile look fabulous. The fabulous smile will last for the rest of your life. Think about how a fabulous smile will improve your life. Orthodontic treatment will also make your face look delightful. Wouldn’t a delightful face be wonderful?.

Braces Improve Your Health: You will be able to chew your food better. Chewing is the first step in digestion. If your teeth are not straight, you will not be able to chew your food correctly so partially unchewed food will go down to your stomach. That can give you an upset stomach.

Braces Help Avoid Dental Problems: If you do not get orthodontic treatment when you need it you will have problems with your teeth for years to come; your teeth will be hard to clean. Your gums will hurt. Your teeth will wear in ways that the should not. The effects are significant enough that many adults are now going back to the orthodontist for braces.

You may avoid developing a breathing problem. As you get older the roof your mouth can sometimes partially block the air passages in your nose. That makes you snore loudly, and may contribute to a condition called “sleep apnea”. If you get braces you can avoid this possibility.
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Q: Why do people need braces?

A: Orthodontic problems are built into your genes. The result is that most peoples teeth do not fit correctly in most people’s mouths. Your orthodontist moves around your teeth and possibly stretches your mouth so everything fits correctly.

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Q: Are there other reasons that people need braces?

A: Orthodontic problems can also be caused by injuries to your mouth, or if you suck you thumb when you are older than two. Some orthodontists also say that fingernail biting, or lip biting can also cause orthodontic problems. There is also some information about breastfeeding increasing orthodontic problems if the breastfeeding is stopped suddenly. Still, most people need braces because their teeth grow faster than their mouth. That is a natural part of growing up, and there is nothing you can do about it.

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Q: How many teenagers need braces?

A: About 70% of US teenagers need braces. Just look at your class at school. Probably, two out of three of the kids have braces or will have braces.
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Q: How Much Do Braces Cost?

A: Between $5,000 and $10,000 in the USA. Prices go up to $17,000 in Japan.
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Q: How does orthodontics work?

A: You usually think about your jaw as being solid like a rock, but when you are growing your jaw is really more like clay. If you apply pressure to your jaw, you can get your jaw to stretch. If you pull your jaw apart, your jaw will get wider. If you push your jaw back, your jaw will slowly move back. Your jaw does not actually stretch. Instead, when you pull on your jaw, your jaw grows in the direction you are pulling. Still, 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 pushes your jaw to stretch your mouth so all your teeth fit. He then pushes on your teeth so they are all in the proper places. If your top jaw is too small, your orthodontist can install a special gadget called a “palatal expander” to get your jaw to grow wider. If your teeth stick out, your orthodontist can install another gadget called a “facebow” to push your back teeth back. In that way, your orthodontist is able to move around individual teeth and expand your jaw so that all of your teeth fit correctly in your mouth.
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Q: At what age should I start orthodontic treatment?

A: You can get orthodontic treatment at any age. Kids as young as 4 are sometimes advised to start orthodontics early to avoid a problem later on. People as old as 90 sometimes get orthodontic treatment to fix crooked teeth. Still, orthodontic treatment works best and is the least painful when you are 8 to 14 so we advise that you start orthodontic treatment then.

Your jaw is growing the quickest when your are 8 or 9 so it is usually best to expand your jaw and reshape your mouth when you are 8 or 9. This is called “interceptive orthodontic treatment”. Then you should wait for most of your permanent teeth to come in. Usually, your permanent teeth come in when you are 12 or 13 and so that is the best time to start full orthodontic treatment when you are 12, 13 or 14.
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Q: What happens if I wait until I am older?

A: You can get braces at any age so if you are too afraid, you can wait a couple of years. However, as you get older the treatment takes longer and hurts more. Your jaw is growing fast when you are 8, so your jaw is easy to stretch. If you wait until you are 12, the orthodontist needs to push a lot harder to expand your jaw so it hurts. By time you are 20, you may need surgery to expand your jaw.

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Q: What is having braces like?

A: Generally, your mouth is usually sore for the first week after you get braces. Also, your mouth will be sore when the braces are tightened. 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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Q: Do Braces Hurt?

A: 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 in or when your braces are tightened.

Orthodontic firms test their braces to try to find ways to make them hurt less. We have a number of designs for braces which minimize the pain you will feel. We have not yet found a way to avoid the pain when the braces are first put on, or when the braces are being tightened. Also your mouth will hurt if your friends punch you. However, we are working on reducing the pain.
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Q: Are all braces designed to minimize my pain?

A: Unfortunately, no. Some orthodontists will only use old fashioned braces so orthodontic companies still sell them. Still, companies try to sell comfortable braces whenever we can.
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Q: Will braces cause sores in my mouth?

A: Initially, when you first get braces, there may be some sores on your lips. If you rinse the sores in warm salt water or Amosan, the sores will heal within a week or two. Thereafter, there will be an occasional sore when, for example if you get into a fight. 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.
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Q: Are there other things I can do to reduce the pain?

A: Several over-the-counter medicines have been found to reduce the pain.
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Q: How long does orthodontic treatment take?

A: It varies a lot according how much your jaw needs to stretch and how much your teeth have to move.

If you start interceptive orthodontic treatment when you are 8, it usually takes anywhere from 3 to 6 months to stretch your jaw. It takes longer if the orthodontist needs to reshape your jaw.

If you get braces when you are 12 years old, it usually takes two to two and a half years to move around your teeth. It will take longer if you do not do what the orthodontist tells you to do or if there is something unusual about your bite.

 

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Q: Will my friends laugh at me when I get braces?

A: Only you know your friends. A lot of companies now make very stylish braces and look very cool.

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A: Only you know your friends. A lot of companies now make very stylish braces and look very cool.

A: Yes. 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. It hurts!

Occasionally the orthodontist needs to put in a gadget which gets in the way of your tongue. If so, you may have trouble talking clearly for a day or two, but then you will be able to talk fine.

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Q; Can I still play football, baseball, basketball, soccer, etc if I have braces?

A: Of course. You can still play football, baseball, basketball, soccer or any sports you are involved in. You can still go bowling. 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 when you have braces.

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Q: I play the trumpet. Will my ability to play be affected by my braces?

A: Be sure to mention your musical abilities to the orthodontist. The orthodontist will give you Kissable(tm) Kovers or lip protectors for your braces. The Kissable(tm) Kovers protect your lips and will make it possible for you to still play musical instruments. We have had reports of entire brass bands having braces with no problems.

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Q: Are there any other activities that I should avoid when I have braces?

A: We advise against you participating in activities where there will be many blows to your mouth. Sports like boxing, karate, and wrestling should be avoided. Fighting should also be avoided.

You should wear an orthodontic mouth guard whenever you participate in any sporting activity.

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Q: Can I eat when I get braces?

A: 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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Q: Can I still chew gum with braces?

A: Gum is usually not recommended. The gum can get caught on the braces and pull the braces off. Also the sugar in the gum can get trapped behind the braces and cause cavities.

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Q: Are there anything else that I cannot eat?

A: You probably should not eat hard sticky, gooey or crunchy foods. Caramel, taffy, peanut brittle can stick on your braces and pull the braces off your teeth. You also need to be careful with crunchy foods like carrots and apples and hard rolls so that you do not knock your braces off your teeth.

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Q: What happens if the braces come off?

A: The orthodontist will attach them again. Usually, this is no big deal, although if it happens lots of times, your orthodontic treatment will take longer.

 

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Q: Why cannot the orthodontist attach the braces strongly enough that the braces cannot come off during eating?

A: 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.

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Q: What happens if a piece of my braces comes off and I swallow it?

A: I know you are concerned, but it is usually NOT a serious problem if you swallow parts of your braces. All braces are tested so they are completely safe. The parts just pass through your digestive system.

Inhaling a part from your braces is a problem however. If you inhale a part of your braces, and the part gets into your lungs, it could cause a problem. Therefore, the orthodontist will normally the bracket ask an MD to remove the part of your braces from your lungs.

 

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Q: What is it like going to a school dance in braces?

A: A cool dude is still a dude with or without braces. Years ago, when glasses (eyeglasses) were old and clunky, people used to worry about going to the dance in glasses. Now it is no big deal. In the same way, years ago when braces were all big and clunky, people worried about going to a dance in braces. Now you can get stylish braces ™ so there is nothing to worry about.

 

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Q: What kinds of braces are there?

A: Braces come in lots of different sizes and colors.

Modern braces are smaller and more comfortable than old fashioned braces. They have what is called a low profile design, which is less irritating to your lips. They also have special contours to make your orthodontic treatment go faster and be less painful.

 

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Q: Are all modern braces the same?

A: No. Modern braces are made with three different manufacturing processes, “machining”, “metal injection molding”, and “casting”. Cast brackets are the most comfortable, so we, strongly recommend cast brackets to our customers.

Then one has to consider the style of the braces. Stylish Braces(tm) come in a series of styles and colors. There are tooth colored braces which blend in so they barely can be seen. Designer braces ™ in gold and sapphire to add a touch of class. Even Outrageous Braces ™ in bright purple, pink, green and black for a decidedly outrageous look. You can even add sparkles(tm) in your school colors to jazz up your look.

 

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Q: How do I get Stylish Braces(tm)?

A: Talk to your orthodontist. He should be able to get you some.

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Q: How much extra does it cost to get modern, designer braces(tm)?

A: Surprisingly little. Modern, low profile, cast brackets only cost pennies more to make than old, clunky braces, so we sell them to your orthodontist for about the same price as old fashioned braces.

Outrageous Braces ™ or Gold Designer Braces(tm) cost the orthodontist about $50 to $100 more than standard braces. Sapphire braces cost $100-200 more.

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Q: Do Sapphire Braces contain real sapphires?

A: Yes. We use synthetic polycrystalline sapphires.

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Q: Do gold braces contain real gold?

A: Yes and No! Manufacturers have made braces out of solid gold, but they did not work well. Gold is too soft so part of the braces would bend and break.

Now people use a combination of metals in our braces. Some parts are gold. Other parts contain gold mixed with other metals. We also coat some parts with something called “titanium nitride”. Titanium nitride was invented by NASA to protect rocket engines. It is super-strong. Titanium nitride costs about twice as much as gold, but we think it is worth it, because titanium nitride lasts.

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Q: What is interceptive orthodontic treatment?

A: Well, the objective of interceptive orthodontic treatment is to make your jaw wider and reshape your mouth so there is room for your permanent teeth.

Your orthodontist will install a gadget called a “palatal expander” to make your mouth bigger. He may also use a facebow to try to start to correct overbites and underbites. If you start interceptive orthodontic treatment when you are 8, it usually only takes 3-6 months, and avoids painful treatment later on.

Note: interceptive orthodontic treatment can take as long as 14 months if your bones grow slowly, or if you do not follow the orthodontists directions.

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Q: Does the palatal expander hurt?

A: You can experience a little pain as the palatial expander is stretching your mouth.
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Q: What steps are involved in full orthodontic treatment?

A: The objective of full orthodontic treatment is to continue to stretch your mouth, and move around your teeth so that your teeth are in the right places.

First there are a series of appointments where the orthodontist examines your mouth and figures out what is needed.

Next the orthodontist installs your braces. You usually you keep your braces in for two to two and a half years. During that time, your orthodontist’s assistant will “tighten” your braces every three or four weeks. The orthodontist may tell you to wear a facebow during that time.

Then your orthodontist will remove your braces and give you a retainer. You will need to wear the retainer 24 hours a day for a year, then a few nights a week until you stop growing (when you are 24).

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Q: How long does full orthodontic treatment take?

A: Generally, full orthodontic treatment takes about two or two and a half years for a typical case. It will take longer with a complicated case or if your do not follow the orthodontist’s instructions.

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Q: What can I expect on the first visit to the orthodontist?

A: Generally, it takes several visits to the orthodontist for you to start your treatment. On your first visit the orthodontist’s assistant will take a medical history. The orthodontist will then examine your mouth to see if you need orthodontic treatment.

The orthodontist will look at your mouth to see if everything is ok. 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? Are there any other problems like a breathing problem, or a problem with the joint in your jaw?

After the orthodontist looks at you, he will determine you need braces. About 70% of the teenagers in the US need braces.

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Q: If I need braces, what will the orthodontist do next?

A: The next step is called the “records appointment. You will come in for half an hour and the orthodontists assistant will take a number of measurements of your mouth. During this appointment the orthodontist’s assistant will take:

Panoramic X-Rays: You stand or sit in a special chair with your head very still, while a special x-ray machine sweeps around your head. The x-ray machine produces an image of all of your teeth and your jaw and parts of your skull. This x-ray tells the orthodontist if the roots of you teeth are OK, whether your jaw is OK, whether the joint is OK and whether there are any other complications such as extra teeth. We have been told that about 5% of people have extra teeth.
Cephalometric X-Rays: You go to a second x-ray machine, and the orthodontist’s assistant takes additional x-rays of your head. These x-rays tell the orthodontist if your bite is OK and if your mouth is growing normally. The orthodontist can also see cavities.
Bite Registration: You bite down on some special paper or wax, so the orthodontist can see if your top teeth line up with your bottom teeth.
Impressions: The orthodontist’s assistant will place a container containing something called “alginate” in your mouth and ask you to bite down. The alginate is like putty; it allows your orthodontist to build a model of your mouth so he can see exactly how your teeth come together. You will need to bite into the alginate twice, so the orthodontist can make a model of both your top and bottom jaw. Old fashioned alginate tasted awful so the alginate was the worst part of the records exam.
Pictures of your face and teeth: The last stage of the records appointment is to take pictures of your face and mouth. The orthodontist uses the pictures to keep track of how your smile is changing. The orthodontist’s job is to make your mouth look excellent, and the photo’s help.
Once the records appointment is done, the orthodontist will be able to figure out what he needs to do to fix your mouth. The orthodontist will then schedule a meeting with you and your parents called a “consultation” to discuss what the orthodontist needs to do to make your smile perfect and how much it will cost.

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Q: Is there anything that I need to do before the consultation?

In a typical procedure, an incision is made in an inconspicuous location – either on the edge of the dark skin around the nipple, or in the underarm area. Through the incision, the surgeon cuts away the excess glandular tissue, fat and skin from around the areola and from the sides and bottom of the breast. If your surgeon has determined that liposuction will be used in conjunction with excision to remove excess fat, the cannula can be inserted through the incisions. In a reduction involving greater amounts of excess tissue, larger incisions may be necessary and can result in more noticeable scars.

If your surgeon has determined that your Gynecomastia consists primarily of excessive fatty tissue, liposuction would be an appropriate surgical technique for removal of this tissue. At the edge of the areola, the dark skin that surrounds the nipple, a very small incision, less than a half inch in length is made. Depending on individual factors and preferences, the incision may be made in the underarm area. A cannula, which is a slim, hollow tube attached to a vacuum pump, is inserted into the incision. Your surgeon moves the cannula through the layers beneath the skin, breaking up the fat and suctioning it out.

In cases where large amounts of tissue have been removed, it may be necessary for excess skin to be removed so that the remaining skin will adjust to fit the new breast contour.

Occasionally, a small drain will be inserted through a separate incision to relieve excess fluids. Upon completion, the incisions are usually covered with a dressing and the chest may be wrapped with an elastic bandage to hold the skin firmly in place.

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Q: What questions should I ask the orthodontist at the consultation?

A: You should ask any and all questions that you have: What will you look like when your braces come off? Will there be anything you cannot do while you have braces? How will braces change you? What fun things can you do with your braces? Does the orthodontist offer the styles and colors of braces that you want? Is he going to provide you fun braces or old clunky ones? Will he provide flavored materials if you want?

It is your mouth and the orthodontist will need you to help him so the orthodontist should be happy to answer your questions.

At the end of the consultation, it is up to you and your parents whether to accept the orthodontist’s treatment plan or go somewhere else.

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Q: If you and your parents decide to go ahead, what is next?

A: If you and your parents decide to accept the orthodontist’s treatment plan, then the orthodontist will install “separators” between the teeth in the back of your mouth. The separators could either be little springs, or little plastic pieces to create space for bands on your back teeth.

You usually leave the separators on for a week or two, and then come back to the orthodontists office to have your braces put on.

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Q: What happens if I swallow a separator?

A: I know it sounds bad, but nothing bad should happen if you swallow a separator. The separator just passes through your digestive system.

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Q: What are the steps in putting your braces on?

A: Generally, the orthodontist needs to attach bands and buccal tubes to your back teeth, brackets to your front and side teeth, and then attaches an archwire.

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Q: What are the steps in putting the bands on?

A: The first step is to get your teeth ready for the bands. The orthodontist’s assistant will remove the separators from your mouth and polish your teeth until your teeth are perfectly clean. It takes a few minutes, but the orthodontist’s assistant needs to do this carefully, so that you do not get any cavities under your bands.

Once your teeth are clean, the orthodontist’s assistant will measure your teeth and try to determine what size bands you need. Bands, though, are like shoes. Even if the bands are the right size, the assistant needs to try them on to make sure they fit. It usually takes several tries before the orthodontist’s assistant finds a band which exactly fits your teeth. Do not worry though. Bands come in 50 different sizes, so there is sure to be one which fits.

Next the orthodontist or his assistant will attach the bands to your teeth. First, your teeth must be dried completely. The orthodontist or the orthodontist’s assistant will place cotton rolls on both sides of your teeth. They will also put a tube into your mouth which looks like a straw. The tube is attached to a small wet-dry vacuum to suck up all of the liquid from your mouth.

Next the orthodontist or the orthodontist’s assistant will put some special cement onto the band and push the band onto your tooth. The orthodontist will usually ask you to help him get the band on, by you biting down on a special “bite stick” to help push the band on the tooth.

The orthodontist or his assistant will repeat this process until they have installed bands on four of your teeth. Then you will be asked to bite down on cotton rolls for approximately 5 to 10 minutes to hold the bands in place until the cement hardens.

After the cement hardens the orthodontic assistant or orthodontist will take a special tool called a scaler to remove the excess cement from around the band.

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Q: What’s next?

A: The next part of the process is called “bonding”. In bonding, the orthodontist attaches little “brackets” to your teeth. The brackets are used to hold the wires onto your teeth.

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Q: What are the steps in the bonding process?

A: First big plastic things, called cheek retractors are used to draw back your lips. You make a funny face, like you did in the mirror when you were little. Then your teeth are dried and a tube like a straw is put in your mouth to remove all of the liquid from your mouth. Once, your teeth are perfectly dry, a liquid called “etchant” is placed on the teeth for 30 to 60 seconds. The teeth are then rinsed and dried.

Next the orthodontist uses a special glue to attach the brackets to your teeth. Most orthodontists use a special glue called “light cure” which only hardens under ultraviolet light. It usually takes the orthodontist about an hour to attach all of the brackets to your teeth. The light cure hardens in about a minute, so it will not be sticky in your mouth.

Do not be afraid of this part of the procedure. Your cheeks sometimes get a little uncomfortable from the cheek retractor, but the bonding process should not hurt.

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Q: Wow, I have already been at the orthodontist for two hours. Do I have to do anything else?

A: Unluckily, yes. Your orthodontist’s assistant still has to put on your arch wire. Usually, the assistant sticks the wires through the buccal tubes on the bands at the back of your mouth, pulls them tight, cuts off the end of the wire, and then uses little rings called “ligating modules” to hold the wires into the brackets. This process only takes 15 minutes, but it is at the end of the process, so it seems longer. Just remember that it is almost over.
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Q: How long do the braces take to put on?

A: Depending on the case, two to two and a half hours.

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Q: Will it hurt to put the braces on?

A: Not usually. The orthodontist is usually just attaching the braces to your teeth. The pain comes later, when the braces first begin to rub up against your lips and your teeth begin to move. Generally, your mouth will hurt the first night you get braces. Ask the orthodontist to give you a Kissable Kover or some wax in case the braces begin to rub and be sure to ask your mom for some Aspirin or Tylenol if your mouth hurts. Aspirin or Tylenol really helps the pain. Putting salt or salt water on you gums can also lessen the pain.

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Q: Should I do anything special during my first week in braces?

A: Your mouth will hurt for your first week in braces. You should be careful about what you eat. You need to only eat softer foods and to be very careful with your mouth.

Manufacturers are working to find ways to reduce the pain during your first week in braces but we have not found anything yet. However, try to remember that the pain will be gone in a few days.

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Q: Is there any chance that the sharp ends of the braces will hurt the insides of my cheeks.

A: In the beginning part of orthodontic treatment, your teeth will move a lot. Sometimes the end of the wire will stick out past the end of the tube, and create a sharp edge. We recommend that you if you notice a sharp wire you go back to the orthodontist and ask the orthodontist’s assistant to trim the sharp edge before the wire before it cuts your cheeks.

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Q: How often should I go back to the orthodontist after my initial visit?

A: Your orthodontist will usually tell you to come back in 4-6 weeks after your initial visit, and every 3-4 weeks from then on.

 

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Q: What happens on all of those visits?

A: Sometimes the orthodontist just looks at your mouth. Sometimes your braces are “tightened” and sometimes the orthodontist changes wires. Each time the braces are tightened your teeth are pushed a little closer to where your teeth need to be.

The orthodontist may install rubber bands sometime during your treatment or ask you to wear a facebow. Rubber bands and facebows are used to make your teeth in your lower jaw line up with your teeth in your upper jaw.

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Q: Why do my braces need to be tightened?

In the USA, the average total cost of GRS is around $6000 to $7,500, broken down as follows:

  • Surgeon’s fee: $3,000 to $5,000
  • Certified Operating Facility fee: $1,500 to $1,800
  • Anesthesia fee: $275/hr. (Board Certified Anesthesiologist)
  • Miscellaneous costs: Compression vest, lab tests, pathology and prescriptions

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Q: Will tightening hurt?

A: Unfortunately, tightening does hurts but the pain does not last long.

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Q: What Happens When I am Done?

A: Eventually, your orthodontist will remove your braces, give you a retainer and tell you that you are done. You should wear the retainer 24 hours a day for the first year, and then a few nights a week until you are 24. After that it is up to you. One of my orthodontist friends told me that teeth start to move again when you are around 30, so you might keep your retainer until you are 35.

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Q: Will It hurt to remove my braces?

A: Do not worry; it should not hurt to remove your braces. The brackets are easy to remove. They just twist off. Sometimes, removing the bands at the back of your mouth is painful. If so, please tell the orthodontist. He can cut the bands so it does not hurt.

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Q: How often should I brush my teeth when I have braces?

A: Brushing and flossing is really important when you have braces because food can get caught in the braces and cause cavities. You should brush and floss your teeth after every meal and before you go to bed. You may want to brush with a special fluoride jell to make sure that you do not get any cavities.

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Q: Will it hurt to brush my teeth with braces?

A: Brushing might hurt the first week after you get braces but then everything might hurt your first week in braces. Fortunately, you can get through it.

After the first week, brushing should be fine. Flossing is a little harder. However, a waterpic works great. There are also special brushes and floss designed to clean around your braces. Be sure to ask your orthodonists for some. Also, please ask your orthodontist’s assistant for help flossing every time you get your braces tightened. The orthodontist’s assistant can do a great job cleaning your teeth.

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Q: What happens if I skip brushing with braces?

A: Your breath will smell terrible and you will get cavities.

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Q: What happens if I get a cavity with braces?

A: It is hard to say. If it is a normal cavity, 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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Q: I have noticed that some of my friends have rubber bands in their braces. What do the rubber bands do?

A: The rubber bands are used to move teeth forward or back in your mouth. For example, they could be used to move your lower teeth forward or back, to move a tooth that is in the wrong place, or to close a gap between your teeth.

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Q: Will I get rubber bands too?

A: Most people get rubber bands.

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Q: How often should I change rubber bands?

A: Orthodontic rubber bands break after they have been chewed a few times. Usually, the rubber bands will snap suddenly when you open your mouth wide. The rubber bands will hurt your jaw. The only way to avoid the pain is to change your rubber bands frequently. Take off your rubber bands before each meal and put in new ones when you are done eating. Change your rubber bands before you go to bed to make sure that the rubber bands do not snap when you are snoring in the middle of the night.

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Q: Do rubber bands ever hurt?

A: If you leave the rubber bands in too long, they will snap and hurt you. Be sure to change your rubber bands before every meal, and before you go to bed.

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Q: What happens if I leave off my rubber bands?

A: Your braces will need to stay on for up to a year longer and your teeth will hurt more.

Changing rubber bands is not hard, so there is no reason not to change them. Old fashioned rubber bands used to taste awful, but people now make flavored rubber bands which taste like candy breathmints. With flavored rubber bands, changing your rubber bands after every meal is like eating a piece of candy after every meal, but using a flavored rubber band does not cause cavities.

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Q: What happens if accidentally I swallow a rubber band?

A: Nothing; the rubber band is safe unless you are allergic to it. The rubber band just passes through your digestive system, and comes out in your feces. Just do not swallow a whole pack of rubber bands. They will give you indigestion and you might have a bad allergic reaction.

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Q: What does a retainer do?

A: 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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Q: Why do I need the retainer?

A: 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. At the end of your orthodontic treatment, your smile will be wonderful and your will look excellent. You need to wear your retainer to keep yourself looking excellent.

Also, you are still growing after your braces are removed. Sometimes, your mouth will grow unevenly. If so a retainer can be used to make sure your teeth stay perfect as you grow. Cool dudes all have perfect teeth.

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Q: What happens if I do not wear the retainer?

A: Your gums and bones will not settle into their new positions so your teeth will move part way back to their old positions. Your fabulous smile will dwindle. You may even need to get your braces put on again. Don’t let that happen! Be just like cool dude. Wear your retainer..

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Q: Does the retainer hurt?

A: It should not. If your retainer hurts after the first week, it means that the retainer was fitted wrong. Go back to your orthodontist and ask him to give you a new retainer.

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Q: How long should I use a retainer?

A: You need to wear your retainer 24 hours a day for at least a year after your braces are removed. Then continue to wear the retainer a few nights a week until you are 24 and stop growing.

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Q: What happens if I break the retainer?

A: Ask your orthodontist for a new one.

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Q: Won’t the retainer wear out after a while?

A: A well made retainer should last for years. If your retainer breaks ask your orthodontist for a new one.

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Q: What happens if I swallow a part of the retainer.

A: Nothing. The part will just pass through your digestive system.

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Q: Tell me about fixed retainers

A: Fixed retainers are an alternative that is sometimes used when you keep “forgetting” to wear your retainer. The orthodontist cements a retainer in your mouth and you cannot take the retainer off for a year.

If this happens, be sure to clean the retainer every night or else your breath will smell awful.

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Q: I notice that some braces have little colored rings around the brackets. What do the colored rings do?

A: The colored rings are called ligating modules. They hold the wires into the brackets.

Ligating modules can be fun. You can get them in 24 colors! There are orange and black ligating modules for Halloween, red and green for Christmas and red or pink for Valentines day. Red, white and blue for the fourth of July. You can get ligating modules in your favorite colors, your school colors, your favorite teams colors or even your mom’s least favorite colors. Ligating modules allow you to make your braces match your personality. Enjoy!

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Q: What happens if I swallow a ligating module?

A: I know it is scary, but orthodontic ligating modules are safe. Orthodontic ligating modules are made of a medical grade polyurethane which is similar to the grade of polyurethane used for medical implants. The polyurethane is safe to eat. If you swallow a ligating module, the ligating using just passes through your digestive system.

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Q: What are lingual braces, and what are their advantages and disadvantages?

A: Lingual braces are an old technique where braces are mounted behind a patients teeth. They were used years ago, before the advent of stylish or orthocosmetic(tm) braces. Now lingual braces are rarely used.

Occasionally an orthodontist can be convinced to use lingual braces when the patient insists that the braces absolutely cannot show. Generally, lingual braces are much more uncomfortable than standard braces. The orthodontic treatment is much more painful, and the treatment takes almost twice as long as with standard braces. Also the patient often has trouble talking with lingual braces.

Today, most orthodontists refuse to put on lingual braces. However, there are a few orthodontists who still use the procedure if the patient is very insistent.
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Q: What is the purpose of a facebow?

A: A facebow is designed to push your rear teeth back so that there is space for the teeth in the front of your mouth.

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Q: What Happens If I “Forget” to wear my facebow?

A: If you do not wear your facebow, your orthodontist will not be able to stretch your mouth so all of your teeth fit. Usually, the orthodontist will try another alternative. He may wire in the facebow, so you cannot take it out! He may try a more painful appliance. You need to wear your facebow! Your braces will not work unless you wear them.

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Q: How do I use a facebow?

A: Generally, you should wear the facebow for about 12 hours a day. The facebow should be inserted into the two holes on the buccal tubes at the back of your mouth. The facebow should then be connected to the breakaways, and on to the neckpad or other headgear. A facebow should never be worn without a safety strap or breakaway.

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Q: Are there any dangers with a facebow?

A: A facebow uses headgear to provide the force needed to move your jaw. There is so called “high pull” headgear, which has straps over the top of your head, and around your neck, and “cervical headgear” which only have straps around your neck.

Many manufacturers do not sell high pull headgear because we consider high pull headgear risky. High pull headgear has been known to snap a facebow. In rare cases, the parts from the facebow have been known to go into a person’s eye. Sometimes, high pull headgear is the only alternative to surgery, and so an orthodontist will prescribe it. Still, we recommend that parents and children be very cautious around high pull facebows.

Be sure that the facebow is inserted properly. Be sure you wear a safety strap. Be very cautious to make sure that the facebow does not come loose and hurt you.

If you find your facebow coming loose at night be sure to tell your orthodontist about it immediately. If the facebow comes loose, it could hurt you or even poke you in the eye. If the facebow comes loose, ask the orthodontist to adjust your safety strap. The safety strap needs to be tight enough that the facebow cannot come out of your buccal tubes. Use the tightest hole possible. Try out the facebow to make sure that it cannot come loose and hurt you.

Cervical headgear is less risky than high pull headgear but still not 100% safe. Some kids try to bend their facebows to make them more comfortable. They can weaken the facebow as they bend it which can cause the facebow to snap. DO NOT BEND YOUR FACEBOW – IT COULD SNAP AND HURT YOU. Insist that the orthodontist give you a facebow with breakaway modules and/or a safety strap. Ask the orthodontist’s assistant to carefully instruct you on the use of the facebow. Make sure that you do not bend the facebow, and uses the break away modules or safety strap whenever you are wearing the facebow.

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Q: What causes the facebow to snap?

A: Something called “metal fatigue”. When you bend a wire enough times, the wire will break. You can see this with a solid copper wire like the wires in the wall in your house. If you take a piece of solid (unstranded) copper wire and bend it several times, the wire will break. Facebows are made of a special stainless steel wire which is resistant to breakage. However, all wire will break if the wire is bent enough times.

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Q: I have lots of allergies. Are there any special concerns when I comes in for orthodontic treatment?

A: There are always special concerns with an allergic patient, so your parents will need to discuss your allergies with your orthodontist. You can be allergic to something in the orthodontist’s office, or allergic to the orthodontic materials.

There are two kinds of allergies to orthodontic materials: allergies to nickel chrome and copper and allergies to latex. Allergies to nickel, chromium, or copper happen a lot, but are not very dangerous. Latex allergy is very rare but can be life threatening. Further details about latex allergy, and nickel, chrome and copper allergy are given later in this document. If you are worried about allergic reactions your orthodontist can provide you with latex, nickel, chrome and copper free orthodontic materials.
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Q: I have Spina Bifida. Is there anything to fear?

A: About 40% of spina bifida patients can develop class I latex allergy. Class I latex allergy is very dangerous. People occasionally die from it. Be sure to inform your orthodontist that you have spina bifida before you start orthodontic treatment and make sure that he uses latex free products. Also ask the orthodontist to make your appointment the first appointment of the day so there is no latex dust in the air when you are treated. For further information about latex allergy and Spina Bifida, consult the Spina Bifida Association Of America Home Page

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Q: I have heard that some orthodontists take orthodontic materials out of one patients mouth and then “recycle” the orthodontic materials to another patient’s mouth. Is this true?

A: Unfortunately, yes. As disgusting as this sounds, it has been estimated that as many as one US orthodontist in three “recycles” some of their materials from one patients mouth to the next patients mouth.

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Q: What can I do to prevent me from getting orthodontic materials which have been previously in someone elses mouth?

A: Talk to your orthodontist about it. Most orthodontists will not use “recycled” materials (materials that have already been used in a previous patient’s mouth) without your consent or your parent’s consent.

Look what the orthodontist does when the orthodontist takes off a wire. Does the orthodontist throw out the used wire or does the orthodontist save the wire that has been in your mouth and “recycle” it to another patient. Does the orthodontist throw out the bands and brackets he has removed from your mouth, or does he save them for “recycling”.

If the orthodontist is saving materials from you, think about what he is using in your mouth. Tell the orthodontist that you only want materials that have never been in someone elses mouth. Be sure to tell all of your friends so they know to ask him too.

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Q: I have heard about allergies to nickel, chromium and copper? How common are these allergies, what are the symptoms, and how serious are they?

A: Nickel, copper and chromium allergy occur in 30% of orthodontic patients with peirced ears, 1-3% of all other orthodontic patients. The symptoms are generally an inflammation of the mouth, and possibly inflammation at points where metal such as a watchband comes in contact with your skin. If you mouth stays sore for more than 2 weeks after you get braces, or if you notice stuffy ears, you probably have an allergy to the metals in your braces.

It has been found that patients sometimes develop sensitivity to nickel, chrome or copper during the orthodontic treatments. If you are concerned about nickel, chrome or copper allergies, talk to your orthodontist.

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Q: I have heard about latex allergy? How common is it, and do I have anything to fear?

A: There are two kinds of latex allergies, a so called class IV allergy, which is not very serious, and a so called class I allergy, which can be life threatening. The class VI allergy causes a slight inflammation of the patients mouth, but it goes away after the latex is removed. Class IV latex allergy is fairly common, affecting perhaps 1% of the orthodontic patients.

The Class I allergy is much more insidious. Class I latex allergy is quite similar to penicillin allergy. You get the allergy from continued exposure to natural latex rubber. You usually do not have any symptoms when you are first exposed to latex. After you are exposed to latex for a long time, you get sensitized to it. First break out in a rash. Then you become very sensitive to latex. You might break into hives when exposed to a rubber glove or a condom. We have even heard of a case where a dentist became so sensitive to latex that she cannot be in the same room as a rubber glove. When she walks into a hospital or doctors office or airplane which contained a rubber glove an hour earlier, she goes into shock.

The estimates of how common Class I latex allergies are varies considerably. The US Food and Drug Administration (FDA) estimates that approximately 14% of dentists, 6% of physicians and 2% of other health workers will eventually get latex allergy. Latex allergy is said to be less prevalent in orthodontic patients. Still the FDA estimates that 1% of the general population eventually gets latex allergy.

Orthodontic rubber bands can contribute to your developing latex allergy, although class I latex allergy will normally take many years to develop. If you are worried about this, insist that your orthodontist use all latex free materials.

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Q: What are the symptoms of Class I latex allergy

A: There can be several different symptoms. Some patients with class I latex allergy develop hives and/or swelling in their face and hands perhaps 20 to 50 minutes after being exposed to latex. Other patients have difficulty breathing. Occasionally, there are no visible symptoms. IF YOU BREAK OUT INTO HIVES SOON AFTER CHANGING YOUR ORTHODONTIC RUBBER BANDS, OR IF YOUR HANDS OR FACE SWELL UP, OR IF YOU HAVE DIFFICULTY BREATHING, GO IMMEDIATELY TO AN URGENT CARE FACILITY OR A HOSPITAL EMERGENCY ROOM. DO NOT WAIT HOPING THAT THE SYMPTOMS WILL GO AWAY.

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Q: What can I do to avoid latex allergy?

A: Ask your orthodontist to use only Latex free materials.

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Q; Are there any concerns about sterilization of orthodontic materials?

A: Orthodontic materials can be sterilized in dry heat sterilizers, autoclaves, or a solution called “glutaraldehyde”. A recent study shows that when used properly, dry heat sterilizers and autoclaves kill all known infectious agents. However, the glutaraldehyde solution does not always kill the Aids virus. The chances of you catching AIDS in the orthodontist’s office are slim. Still, we recommend that you make sure that your orthodontist is using a dry heat sterilizer or autoclave on all of the orthodontist’s instruments and orthodontic materials.

You probably should also make sure that your orthodontist changes his or her gloves after each patient.

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