Orthodontic treatment is the use of braces or aligners, most commonly to straighten crooked teeth or to correct prominent upper front teeth. The type of brace or aligner chosen depends on the problem that needs to be corrected. All the dental treatments that are available in the USA are now commonly available in the UK and the general standard of private dentistry is similar to that of the USA. In this article, we answer some of the most common questions asked by our patients on the orthodontic options available today.
This article has been provided by Dr Teresa Day, BDS LDSRCS, Clinical Director of Appledore Dental Clinic, a private dentistry clinic with locations in Milton Keynes, Bucks, and Binfield, Berkshire.
What happens on my first appointment?
At your first consultation, you would have your mouth examined and the type of orthodontic treatment required would be discussed. You may need to have x-rays at this visit. A further visit will include any other x-rays required and moulds of your teeth.
You will not have a brace fitted, or any other treatment, on this visit. You will get a full report on the treatment to be undertaken, as well as a full schedule of the fees payable.
Particular attention is paid to how well you brush your teeth! It is important to know that you are capable of keeping your teeth clean before a brace is fitted, since it is very much more difficult to clean them with a brace on. We insist that all patients are seen regularly by a hygienist to ensure that their teeth are kept in the best condition possible.
If you are ready for treatment, your next appointment will be to fit the appliances.
What is it like having a brace fitted?
Your teeth can become a bit sore a few hours after a brace is fitted or adjusted and this can last for two or three days. Simple painkillers will help a lot. We also recommend a soft diet for the first few days.
How long will the treatment take?
This depends on how much work there is to do. Fixed brace treatment can take between 12 and 24 months, but longer if the problem is particularly severe. If braces are broken frequently this can add a lot of time to the total. Combination treatment for difficult cases can take as long as 48 months. Invisalign treatment takes a similar amount of time.
How do I look after my teeth while wearing braces?
We recommend that you have quarterly hygiene visits to enable you to keep everything clean.
The Sonicare toothbrush is also recommended, as it cleans better between the teeth than any other brush. These are available at the dental clinics.
Retainer braces – why?
It is important to realise that once a brace is removed your teeth can drift back towards their original positions. They must, therefore, be held in their new positions for a long time with retainer braces until they have settled. Retainers are either removable appliances or thin wires stuck onto the tongue side of the teeth. Patients are encouraged to consider their retainers as ‘pyjamas for teeth’ and to wear them every night. The reason we can move teeth to straighten them is because teeth move! Without retainers, your teeth will tend to move and may crowd up again.
Will braces mark my teeth?
Your brace will not mark your teeth. If dental plaque is allowed to become thick around your brace the plaque itself may damage your teeth. Instruction will be given on the use of special brushes and a daily fluoride mouth rinse can be used to harden areas that are very difficult to clean. Care must be taken to choose an alcohol-free, pH-balanced rinse.
Certain foods and drinks may also lead to damage. You should avoid drinking lots of fizzy drinks and keep in-between-meal snacks to a minimum.
Do I have to avoid any food type during treatment?
Very crunchy and sticky foods can break your brace. Toffee and chewing gum must be avoided. Really enjoyable hard foods can be chopped up and chewed gently!
Broken braces must be fixed quickly, so if you have any problems please telephone your clinic as soon as possible. Do not wait until the next routine appointment because this may result in your treatment lasting much longer than it should. If you are in pain, follow the measures outlined on the instruction sheet provided when the brace was fitted.
What are the differences in the orthodontic treatments that are available?
There are three main types of brace, and the new system which uses aligners – Invisalign.
Invisalign - The newest and most invisible way to straighten your teeth
Instead of using fixed braces on your teeth, we can straighten your teeth with a series of invisible retainers. You will have a series of photographs and x-rays taken and a set of very accurate impressions. These are then sent to California to the Invisalign facility.
The impressions are scanned with lasers to make 3D images of your teeth which are then ‘straightened’ virtually on the computer, step by step.
Once your dentist has agreed the treatment plan, the computer images will be transferred to the manufacturing point to make you a series of custom retainers. Each retainer is worn for approximately 2 weeks, and you will see your teeth gently align.
Treatment times are similar to regular braces. This is a real boon to those in the public eye who want to have straight teeth, but cannot bear the thought of having visible braces.
You will need to have any fillings completed before you can have the records taken for the Invisalign orthodontic treatment. Once the treatment proposal has been returned from the States, you will then be advised of the total cost for your treatment.
The Invisalign appliances are a series of clear aligners, which are worn to gently move your teeth into their new positions. You will need to wear them all the time, except for eating and cleaning.
We will probably need to place some tiny attachments on your teeth to help your aligner to stay in position. These will be matched to your tooth colour so they will not be noticeable.
It usually takes 8-10 weeks before everything comes back from the USA in order to fit your first aligners.
You will then be seen every 6 weeks to check your progress.
Once the treatment has been completed you will wear the final set of aligners as retainers at night for at least a year. You may want to have a new set of retainers made yearly to wear at night long-term. You can then be certain that the teeth will stay in their new positions.
As of May 2007, the average price for Invisalign treatment is approx £4.5k, a simple case can be as low as £2.5k and a complex case can be more.
There are three main types of orthodontic braces:
Fixed braces - the teeth have small attachments glued to them. Fixed braces fitted to upper and lower teeth look a bit like railway lines, so some people call them "train-track braces". These are very good for correcting complex problems. When used for children, they are most commonly made of stainless steel, as they are easier to keep clean. Most adults would have the tooth coloured ceramic or acrylic appliances. They are much more aesthetic. We also use lingual fixed appliances - this is where the attachments are glued to the back of the teeth, very helpful for straightening teeth for people in prominent positions. Fixed braces are simply "glued" onto the teeth. There is no need for an anaesthetic injection. Fixed braces are adjusted every 4 weeks.
Removable braces - These can obviously be removed, but they must be worn full-time, apart from when they have to be cleaned. Simple removable braces are good for correcting simple problems, such as moving a single tooth. A removable brace is fitted very easily by clipping it onto several teeth. There is no discomfort involved. Removable braces are adjusted every 4-8 weeks.
Functional braces - These are also removable but have to be worn full-time, except for cleaning. They are used to correct the growth pattern of the jaws. They can be used when one jaw is bigger than the other, to correct asymmetry. They can be used in conjunction with headgear to help jaws to grow correctly.