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When
should my child have an initial orthodontic examination?
The American Association of
Orthodontists recommends an initial orthodontic screening by seven years
of age. This is the time when the permanent incisors and molars are growing
in and enough jaw growth has occurred to enable detection of common orthodontic
problems. Treatment at this age often involves guidance of facial development
and tooth eruption (dentofacial orthopedics). Once a problem is detected,
the orthodontist can advise the optimum time to begin early intervention.
Why
is "early treatment" recommended for some children and not for
others?
Certain types of orthodontic
problems are more effectively eliminated at an early age, while other
types of problems are best treated after all of the baby teeth are lost.
All patients present different problems, so it's always best to have an
early evaluation to assess the proper time to start treatment of the patient's
unique condition. The goal of early intervention is to guide the growing
jaws and erupting teeth into more favorable positions; therefore reducing
the magnitude of the problem, or in some cases, completely eliminating
the need for complex treatment in the teen years. Thus, if the orthodontic
problem stems from underlying skeletal imbalances, or if the permanent
teeth that have erupted so far are in poor relationships, early treatment
may be suggested. In actuality, the majority of orthodontic problems are
best treated in the pre-teen to early teen years.
When
is an adult too old for braces?
Adults who have healthy teeth
and supporting gum tissues are never too old for orthodontic treatment.
Increasing numbers of adults are taking advantage of the lifelong benefits
of orthodontics. These are people who've made the choice to spend the
rest of their lives with an attractive, healthy smile and the confidence
that it brings. We are pleased to present our adult patients with tooth
colored ceramic braces or even the newest option, Invisalign®.
Why
are retainers so important?
Retainers are used to maintain
the teeth in their new positions while the fibers that hold the teeth
to the bone adapt to the new positions of the teeth. It takes months and
sometimes years for these gum fibers to re-adapt. That is why we recommend
that all orthodontic patients continue retainer wear for an extended period
of time. Your orthodontist will set up a schedule of retainer wear for
you after your braces are removed. To maintain your teeth as they are
the day that the braces are removed, you must faithfully wear your retainers
as instructed.
What
is the average cost of orthodontic treatment?
There really is no average
cost, as treatment needs differ from patient to patient. In our office,
we schedule a one hour appointment to obtain pertinent dental history,
to complete a thorough orthodontic examination, and to discuss the options
of treatment and the length of treatment. The cost of treatment depends
on the complexity and length of the treatment indicated.
How
does my orthodontic insurance work?
Once we receive information
regarding your insurance company and your specific policy, we will submit
the necessary insurance forms for your treatment. All insurance benefits
will be sent directly to the subscriber. If after contacting your insurance
company, you still have questions or problems regarding payments, we will
help you obtain the needed information. Keep in mind that having dental
insurance coverage does not automatically mean there is orthodontic coverage.
How
often would I need to come for appointments?
Treatment intervals for patients
undergoing conventional orthodontic treatment are usually 6-8 weeks apart.
Invisalign® patients are often seen at longer intervals, while retainer
patients are often seen once per year.
Are
appointments available after school or work?
We schedule as many appointments
during the after school/work time as we can; however, longer appliance
adjustment appointments must be scheduled during the day. It helps to
familiarize yourself with upcoming "days off" from school or
to know which classes are easier to miss so that appointments can be made
during the day hours.
What
happens if I must reschedule or miss an appointment?
Appointments are set up on
a 6-8 week interval and a make-up appointment may not be available for
some time. Thus, having to reschedule at the last minute can result in
prolonging treatment. We are often asked if we can squeeze a patient in,
but in many cases this is not possible, as unscheduled patients who are
squeezed into the schedule will cause a backup resulting in regularly
scheduled patients waiting 15-30 minutes for their appointment. It is
our goal to respect each and every patient's time. Please help us keep
this goal by keeping your scheduled appointments.
What
can I expect if I arrive to my appointment late?
If you arrive over half way
through your appointment, you will most likely be asked to reschedule.
We understand that traffic and other issues may cause late arrivals, so
we encourage you to come 5-10 minutes early for your appointment. By the
time the patient checks in and brushes their teeth, they have used approximately
8-10 minutes of their appointment time. We want you to complete orthodontic
treatment in a timely manner, and having to reschedule appointments delays
treatment. Please give us a call if you think you might be late and we
will try to maintain your appointment while still staying on schedule.
Do
I need to see my general dentist while in orthodontic treatment?
Our practice is limited to
orthodontics, so we must work hand in hand with your general dentist to
maintain the optimum health of your teeth and gums. We encourage you to
maintain regular 6 month check-ups and cleanings with your dentist. Adults
who have a history of periodontal (gum) disease may also need to see a
periodontist (gum specialist) on a regular basis throughout orthodontic
treatment.
How
important is patient cooperation during orthodontic treatment?
Successful orthodontic treatment
is a "two-way street" requiring consistent, cooperative effort
by both the orthodontist and patient. To successfully complete orthodontic
treatment, the patient must carefully clean his or her teeth, keep appointments
as scheduled and occasionally wear rubber bands, headgear, or other appliances
as prescribed by the orthodontist. Damaged appliances and unhealthy gum
tissue can lengthen the treatment time and may undesirably affect the
outcome of treatment. The teeth and jaws can only move toward the desired
position if the patient follows home care instructions as prescribed.
How
will my diet be affected by braces?
Your
diet directly affects the health of the supporting gum and bone tissues
around your teeth. If you are careful about the type of food you select
and the way you eat your food, your teeth and gums will stay healthy
throughout treatment, and your orthodontic appliances will remain in
good working condition.
I . DIFFERENT FOODS
AFFECT DIFFERENT TYPES OF BRACES
The braces on your front
teeth are bonded to the surface of your teeth. These braces may shear
off when biting into hard food. In general, try not to bite into any
food with your front teeth. Cut or tear food into small pieces, then
chew on the back teeth.
The braces on your back
teeth are actually bands that go all the way around each tooth. These
bands are more resistant to shear than the braces on the front teeth.
However, sticky foods may pull at the bands and eventually break the
cement seal. Once the cement seal is broken, plaque begins to leak
in and cause decay.
A. HARD AND CRUNCHY FOODS
Unfortunately, most of
what we normally think of as “healthy food” is very hard
on braces. Since it is very important to maintain a healthy diet,
fresh fruits and vegetables that are hard and crunchy should be either
cut into small bite-sized pieces or cooked until tender.
Examples:
- Apples, carrots, celery,
broccoli, etc – Cut into bite sized pieces and chew with the
back teeth.
- Corn – should
be cut off the cob
- Meat – should
be cut off the bone
B. STICKY FOODS
Any food that sticks and
pulls at the teeth or creates suction between the teeth should be
avoided. These types of foods usually have a high sugar content as
well. Sugary foods that become lodged between the teeth and the braces
will increase the risk of cavity formation.
Foods
to Avoid:
- Ice
- Caramels
- Hard candy
- Toffee
- Hard crusted bread
- Taffy
- Hard pretzels
- Now and Laters, etc.
- Popcorn
- Sugary gum
II. WHAT ABOUT GUM?
Most gum isn’t sticky
enough to actually pull bands off teeth. However, frequent or extended
periods of gum chewing put orthodontic appliances through a lot of
wear and tear. Eventually, the band cement will begin to wear thin
and wash away, leaving areas for plaque to seep in and cause decay
and cavities. So, if you must have gum, keep the chewing period very
short – only a few minutes at a time.
III. TIP FOR DEALING WITH
SORE TEETH
You’ll notice that
when you come in for adjustments, your braces will feel tight for
several hours. This tightness is usually followed by a period of a
few days when your teeth may feel sore. Believe it or not, it’s
actually a good idea to chew gum immediately after an appointment,
or whenever your wires feel especially tight. Why? Chewing will result
in an increase in blood circulation around the roots of the teeth,
thereby helping to clear out the biochemicals that are associated
with pain. Keep the gum chewing period to a minimum, and by all means,
chew only sugarless gum.
REMEMBER:
- Loose or broken
braces prolong treatment time. If the teeth are not attached
properly to the wires, they are not under control and my move in
the opposite direction than what was planned.
- Plaque can seep under
loose braces where it impossible to clean. This trapped
plaque causes rapid tooth decay and cavities.
- Sugar leads to an increase
in the acidity of plaque, therefore promoting the formation of “white
spots” (decalcification or early cavities). The longer
the sugar exposure, the higher the risk of forming cavities and
permanent discoloration of the teeth.
What should I do if something is loose or broken on my braces, or if
a wire poking my cheek?
Loose or broken braces prolong treatment time. If the teeth are not attached properly to the wires, they are not under control and may move in the opposite direction than what was planned. If you have something loose or broken, you should contact our office immediately. In the event you notice the problem during the evening, you may call the office and leave a message. Almost all repairs can wait until the office reopens and we will schedule a repair as soon as possible. In the rare event of an emergency, please call our office and you will be instructed on how to reach Dr. McNutt or a staff member after hours. If your wire is poking your cheek, you may cover it with wax or clip it with a nail clipper. Please call the office to schedule an appointment to have this repaired.
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Copyright 2007 Matthew David McNutt, DDS, MS
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