Patient information
Having orthodontic treatment can massively improve your smile and self-confidence. It can also correct a lot of problems associated with the imperfect position of teeth. These problems can be aesthetic but can also affect how the teeth develop, how they meet on chewing, how easy they are to keep clean, risk of trauma to teeth or gums. Aesthetic considerations should not be underestimated. Certain orthodontic problems can have a profound impact on your quality of life.
Crowding
Crowding is due to a disproportion between the size of the teeth and the jaws. It is a very common orthodontic problem. Crowding can also make oral hygiene maintenance more challenging. It can be corrected by maintaining the space of baby teeth, regaining space that has been previously lost, by removal of some permanent teeth or reducing the width of certain teeth (enamel reduction). Your orthodontist will do a detailed orthodontic assessment taking into consideration the shape of your jaws, your facial profile or side view, growth potential, your smile, teeth present and the position of teeth and amount of crowding. They can then discuss the options with you and come up with a treatment plan to suit you or your child.
Overbite
Overbite is the vertical overlap of the top incisors over the lower incisors. An increased overbite (or deep bite) can sometimes lead to traumatic wear of the enamel of the incisors or the supporting gums. If the top teeth trap the lower teeth, this can restrict the growth of the lower jaw. Overbites are best corrected at a younger age and preferable during growth spurts (age 10-14, younger for girls, slightly older for boys). Overbites can be corrected in adults but involve more tricky orthodontic mechanics.
Overjet or protruding teeth
Overjet is the horizontal overlap of the top incisors relative to the lower incisors, sometimes known as buck teeth. Increased overjets are associated with an increased risk of trauma to the upper incisors. Often the top incisors are thought to be protruding, however, more often than not, the top incisors are in the correct position to the face and the lower jaw/teeth are set back in the face. Increased overjets may be associated with a narrow palate or thumb-sucking habit. Narrow upper jaws and relatively small lower jaws are best corrected again during growth spurts (age 10-14, younger for girls, slightly older for boys). Increased overjets can be corrected in adults but involve more tricky orthodontic mechanics or jaw surgery.
Spacing
Spacing or gaps between the teeth are either due to small teeth, large jaws, or missing teeth (hypodontia). Your orthodontist will do a full assessment to determine the cause of the gaps and then make a patient-specific plan for you. Options include the closure of spaces, replacement of missing teeth or composite build-ups or enamel bondings of small teeth. Each option has pros and cons and your orthodontist is best positioned to help you make the best decision for you.
Missing teeth/hypodontia
Missing teeth affects 5% of the population. The most common missing teeth are 2nd premolars and upper lateral incisors. Orthodontic treatment options for missing teeth are either to open the space for replacement teeth (bridges, implants or dentures) or close the space. Depending on the case, space closure can be a great option as you would not need long-term replacement teeth or implants.
The treatment plan will depend on several factors: crowding, remaining baby teeth, position and shape of the jaws, face, and smile aesthetics. Your orthodontist will help create a treatment plan for you taking into consideration all of the above and your personal preference of long-term maintenance of the spaces. Often, we need to involve your general dentist or specialist prosthodontist in the treatment plan as they would be involved with replacing the teeth or reshaping them as needed after the braces are removed.
Impacted canines
Impacted upper adult canines or canines that are developing in the incorrect position affect 2% of the population. Assessment for impacted canines should be done at age 10 by your dentist or orthodontist. If the canines cannot be felt under the gum at this age, an orthodontic referral is necessary to see where the canines are. Simple orthodontics can be done at this age to improve the position of the adult canine. This might involve extraction of the baby’s canines or widening of the top jaw to make more room for the developing canines. If the canines do not erupt by themselves, a small surgical procedure might be needed to expose the developing canine and then an orthodontic brace fitted to help move it into the correct position. Early intervention is best. If you are worried about impacted canines, book in with your orthodontist at age 10 for an assessment.
Crossbite
A crossbite most commonly involves the upper teeth biting inside the bottom teeth (normally the upper teeth bite outside of the bottom teeth). If left uncorrected, it can lead to traumatic wear of the enamel surfaces of the teeth. Crossbites can be due to crowding, a small upper jaw, a large lower jaw or asymmetric growth of the jaws. If this affects the incisors, it is one of the orthodontic problems that can be corrected early (interceptive treatment, age 7-10) to limit or reduce the need for orthodontic treatment later. This might be done with a short course of fixed braces, a removable brace or a fixed expander brace. Speak to your specialist orthodontist to discuss the options.
Open bite
Open bite is when the upper and lower incisors don’t overlap. It can be due to a habit, like thumb sucking, a prominent resting position of the tongue or vertical growth patterns of the jaws. Your orthodontist will do a full clinical examination to assess the underlying factors and then create a treatment plan for you.
When should my child see the orthodontist?
The best time for your child to see an orthodontist is at the age of 10-11 years, or 5th/6th class in primary school. At this age, a child may have some baby teeth left. Baby teeth are bigger than their corresponding adult too so they can be used to relieve developing crowding issues. Secondly, the child is just about to start their growth spurt which is when orthodontics works best. Thirdly, if the child has to wear a removable brace first, compliance with this brace is best at this age and we can therefore get the best results!
We often see children of 6-7 years of age if there is a problem with the developing teeth (crossbite, teeth not erupting, early loss of baby teeth). If you or your dentist have any orthodontic worries about your child, then we will happily see you sooner.
We also see many teenagers in our clinic. Treatment will be very successful at this age too. We can help choose a brace your teenager will be happy to wear and that will work for them. Getting patient cooperation with braces is so important.
Eating
A softer diet is recommended when you have braces on your teeth (soups, scrambled eggs, minced meat, chicken, pasta, rice, noodles, salads, and softer fruits). You can generally eat most foods, you may just need to cut them up smaller, take your time and eat gently on your back teeth (eg apples, carrots). Opt for softer breads rather than hard baguettes. Avoid chewing gums, hard sweets, and sucky sweets.
Brushing
You will need to brush your teeth more when you have braces fitted. I would advise brushing for 2 minutes 3 times a day. You will also need to use interproximal brushes and fluoride mouthwash to keep your teeth and gums healthy.
Braces tend to be sore after they are initially fitted. This can be managed with painkillers such as paracetamol and ibuprofen. It is normally a pressure pain rather than a toothache pain. The braces may rub on the cheeks or lips and cause ulcers. Ulcers tend to heal within 7-10 days as the skin in the mouth hardens up and gets used to the braces. Much like wearing a new pair of shoes. We will provide you with special orthodontic wax to cover the brace for when you do get some ulcers. Ulcers occur more at the start and less so throughout the treatment.
Teenagers take about 2 weeks to adjust fully to the brace and adults take a little longer.
Braces are stuck to the teeth with a small amount of dental glue or composite. They are tough but can become loose if you bite too hard on them. The wires we use can bend or break if put under too much pressure. Removable braces break if they are constantly clicked in and out. They should be kept in their retainer box when out of the mouth.
You need to be careful with your brace. This means eating gently and taking your time. Avoid hard, chewy foods and biting pens or nails.
Broken braces slow down your treatment and ultimately lead to you being in braces for longer. If you are worried about your brace being broken, just give us a call and we will guide you through what best to do. If it is a loose bracket, and it is not causing any pain, it can sometimes be left until your next appointment.
If a wire is long and hurting the gum, then you might need to pop in the practice where we can fix this for you. Because we are a specialist orthodontic practice, there is an orthodontist here every day to help you and our staff are trained to manage orthodontic emergencies. You are generally seen on the same day as you have a problem. There is no waiting around if you are in trouble!
Below is a really helpful link from our colleagues at the American Association of Orthodontists on how to manage orthodontic emergencies if you can’t get to see us. https://www.aaoinfo.org/system/files/media/documents/OrthoEmergency-FLYER-13-hl.pdf
Have you always dreamed of the perfect smile? At Fermoy Orthodontics, we want to make this dream become a reality. Becoming a patient has never been easier.
- Initial Meeting: Meet the orthodontist and discuss your concerns.
- Plan: Create a treatment plan.
- Fitting: Braces fitted.
- Routine Appointments: Braces are adjusted every 6 weeks.
- Removal: Braces removed and retainers fitted.
- Review: Follow-up retainer check.
At your first appointment, you will get to meet your orthodontist. You can chat with your orthodontist about your concerns, reasons for seeking treatment and what type of braces you would like. The orthodontist will do a full orthodontic assessment of your teeth and face, including dental imaging, impressions of your teeth and x-rays of your teeth and jaws. They can then provide a fully comprehensive treatment plan which is tailor-made for you, which will include what treatment is needed, which braces are suitable, how much it will cost and how long it will take.
X-rays or dental radiographs are an essential part of your orthodontic treatment planning. You will routinely have 1 or 2 X-rays taken at your first appointment. These may be repeated mid-way through your treatment. X-rays are hugely beneficial. They are taken to ensure it is safe for you to have brace treatment, plan your orthodontic teeth movements and check the progress of your care. Your orthodontist can also look at your wisdom teeth, check for dental decay and assess the health of the bone supporting the teeth and jaws. As with any radiological assessment, x-rays do come with some risks, albeit a low risk for the benefit gained. A typical orthodontic X-ray (OPG, lateral cephalogram) is equivalent to 1-2 days of background radiation.
We aim to reduce this risk at Navan Orthodontics by taking only necessary X-rays, using digital X-ray equipment, and continuous staff training to ensure optimal results and safe storage of your images. At your second appointment, you will meet your orthodontist again for a detailed chat about your treatment with the help of your clinical photos, X-rays and plaster models of your teeth. Any risks and benefits will be discussed with you so you are fully informed about your orthodontic treatment and comfortable to go ahead. You need to have this time to make sure it is the right treatment for you.
If you have any questions or would like to put your name on the waiting list, please get in touch and we will arrange this for you.