Dental braces is used to reposition teeth, align the dentition and improve on a person’s bite.
Benefits of braces treatment.
Patients undergoing braces treatment can look forward to a more attractive smile, enhanced oral health, better chewing function, speech and self-esteem.
How long will it take?
Active braces treatment takes between one and three years to complete. This treatment duration is dependent on the complexity of your condition, your age and motivation as well as the expertise of the orthodontist.
You can help reduce the treatment duration by being explicit about your desired treatment goals, keeping a high standard of oral hygiene, avoiding breakage or damage to the braces device, keeping appointments, complying with elastic wear and starting young. There is however no age limit for braces treatment.
When is the best time for the first consultation and treatment?
It is recommended to have your 1st visit with an orthodontist when the dentition is changing over to the permanent set (between the age of 6 and 12 years). The most common reason for maligned teeth is due to inadequate spacing which disrupts the normal eruption of the permanent teeth. During this transition stage, the bite may also be affected by poorly positioned teeth or uneven jaw bone growth.
A consultation at this stage provides a valuable window of opportunity to detect and manage (or minimize) such disruptions in approximately 5% to 15% of the population. Fortunately, that also means that a large majority of children will not require treatment at this age.
The common age for braces treatment is during the early adolescent years (between the age of 12 and 16 years) when most of the permanent teeth have erupted. The adolescent patient often benefits from a faster and better treatment outcome due to the favourable growth spurt that coincides with puberty.
For a small minority of individuals (less than 5%), the orthodontist may recommend that treatment be delayed until late adolescence / early adulthood due to the presence of significant disharmony between the jaw bones (which support the dentition). Delaying treatment to allow for skeletal maturation in these individuals allow for treatment to be more predictable and efficient.
Your orthodontist may take x-rays, impressions and photos of your teeth (and face) to better assess and monitor your condition during the consultation process.
What is the experience like?
The treatment experience can be variable between patients and is highly dependent on your condition and system (or device) being used.
You should expect teeth movement to cause mild to moderate discomfort (often describe by patients as a dull ache or tenderness affecting the teeth when biting) for 2 to 3 days after each adjustment appointment. Patients who are prone to apthous ulcers may experience an increase in incidence during treatment. This can be managed using braces relief wax and topical steroid or analgesic ointments. Most patients adapt to the presence of braces within the first 3 to 4 weeks and will be able to eat, sing or play musical instruments as per usual.
Some patients prefer a less conspicuous appearance during treatment. You are encouraged to discuss the suitability of ceramic brackets or aligners with your orthodontist if you have similar concerns.
What to expect after treatment?
You should expect to wear your retainers full time (morning and night) during the 1st year after braces treatment. They often feel strange and cause speech difficulties initially. The retainers can be removed for eating, brushing, sports and the occasional important event. Wearing the retainers well will allow the supporting bone and gums to mature, rewarding you with longer term stability. From the second year onwards, your orthodontist will likely convert you to part time wear (i.e. approx. 8 to 10 hours nightly). He may continue to review your progress every 6 to 12 months.
Patients who have difficulty complying with removable retainers should highlight this issue early so that a fixed retainer can be placed. A fixed retainer consist of a fine wire that is bonded on the back surfaces of the front teeth. They tend to trap food and make it harder for you to floss in between teeth. Regular preventive dental visits with your favourite dentist is an absolute must for patients with fixed retainers.
Are there any risks involved?
For most people, orthodontic treatment is an elective procedure that involves much effort, time and cost. It is therefore a common expectation that the treatment be safe and the outcome be lasting.
Relapse, whereby teeth that have been previously aligned tend to return towards their original position, is one of the common difficulties encountered by patients. This phenomenon affects approximately two thirds of all treated patients to varying degrees. Relapse is not entirely preventable as the position of the teeth is determined by the tone of the lip and tongue muscles as well as the supporting gums throughout life. Your orthodontist would have prescribed you with a set of retainers to prevent relapse and protect your investment.
Braces treatment is possible because of the ability of bone to remodel. During treatment, bone cells actively release enzymes that facilitate bone removal and deposition around the roots of the teeth. This may affect the roots themselves, causing them to shorten in predisposed patients (e.g. patient who suffers from endocrine disorders or have experienced trauma to the teeth prior to braces treatment). The degree of shortening is often mild (less than 1mm) and does not affect the longevity or health of the teeth. Only in rare instances, it is severe enough to warrant a discontinuation of braces treatment.
Teeth with deep fillings or a history of traumatic injury are susceptible to pulpal devitalisation during treatment. Such teeth often have a compromised blood supply and is less tolerant of movement. Your orthodontist will recommend root canal treatment for these teeth should it be needed.