Instructions for treatment with braces
Carriere Motion instructions
What should I do before starting orthodontic treatment?
When you decide to start orthodontic treatment, it is a good idea to see your dentist before your consultation with an orthodontist. Your dentist will examine your teeth in detail and draw up a plan of action. If the examination finds tooth decay or defective fillings, these must be treated first. Your teeth are professionally cleaned to remove tartar (scaling) and polished to remove built-up stains and plaque. If you have gum problems, they need to be under control when orthodontic treatment starts. In most cases, cleaning the teeth stops the gums from bleeding. Your dentist may also prescribe special therapy to manage the problem.
Does it hurt?
Having braces fitted does not hurt. You may feel tired from keeping your mouth open for a long time. When the archwire is placed, you will feel slight tightness, mostly in the more crooked teeth. This feeling fades or disappears within a few minutes. After about an hour, the tightness starts to turn into discomfort and pain. The sensation gets stronger over the next 8 hours and can become mild to moderate pain when you put pressure on your teeth (when eating). You will continue to feel it for the next 3-4 days. More sensitive patients may have discomfort for up to about a week. There is no way to know in advance what to expect – mild discomfort or moderate pain. This is a very individual feeling and depends on your pain threshold. You can take painkillers if you feel you need them. Any kind will help, but paracetamol is the most suitable because it does not interfere with tooth movement. Once this period has passed, your teeth no longer hurt.
Can “dead” teeth be moved?
“Dead” (non-vital) teeth are teeth that have had their nerve removed and the root canals cleaned. They are usually darker in colour and have a larger filling. If you have any such teeth, it is a good idea for your dentist to arrange X-rays of them, because inflammation is sometimes found that can develop without any symptoms. If such a problem is found, root canal re-treatment must be done first.
Do aesthetic braces turn yellow over time?
Ceramic and sapphire braces do not change colour in the mouth. If you notice yellowing of your teeth or braces, it is most likely caused by staining of the elastic ties (ligatures). When we want an orthodontic appliance that is as invisible as possible, we usually choose clear elastic ties to hold the archwire in the bracket. Clear silicone ties get stained by coloured foods and drinks – coffee, cigarettes, fresh juice, wine, red fruit. Within a month of being placed, they can turn a deep grey or yellow. Once your orthodontist replaces them with new ones, the braces look clean and white again.
Can braces be put on a tooth with a crown?
Brackets can be bonded to all surfaces, including crowns. However, you should know that a bracket bonds more strongly to a natural tooth than to a crown. If you are due to have a crown (“capping” a tooth) or a bridge, it is best to postpone the procedure until after your consultation with the orthodontist. More often, orthodontists want a temporary crown to be placed for as long as treatment with braces lasts; after the braces come off, a permanent crown or bridge can be made. If you are going to have aligner treatment, there is no reason to postpone having a permanent crown placed.
Do all wisdom teeth have to be removed before the teeth are straightened?
Wisdom teeth are the last teeth in the mouth and come through after the age of 18. Very often there is not enough room for them, so they may come through only partly or not at all. Some people never develop wisdom teeth. To assess your wisdom teeth, a panoramic X-ray is needed. It shows whether you have these teeth and whether they are likely to come through. You do not need to have them removed before your orthodontic examination. Your dentist may recommend removing them for other reasons – for example, if a tooth is decayed and cannot be treated. When it comes to straightening the teeth, wisdom teeth often get in the way, but you may not need to have them removed. In that case, the decision to remove them is entirely up to you and your dentist. For an orthodontic analysis, you almost always need two large X-rays – an orthopantomogram (panoramic X-ray) and a lateral cephalogram (side profile X-ray of the head). You do not have to bring these X-rays to your first orthodontic visit, but if you have them taken beforehand, you will get more detailed information about your condition during the examination. If you choose not to have X-rays before your first visit, the orthodontist will ask you to have them taken for your second appointment.
Do braces affect speech?
Braces on the front of the teeth do not affect speaking or singing in any way. This is not the case with lingual braces, where you need a period to get used to pronouncing words. Sometimes treatment with braces is combined with various appliances or wires on the inner side of the teeth and the palate, and in these cases speech may be temporarily affected.
Why choose clear aligner treatment?
Clear aligners are an invisible orthodontic appliance that closely follows the shape of the patient's teeth. Their main advantage is their aesthetic appearance. They are more comfortable than fixed appliances because you take them out to eat. Aligners do not make it harder to clean your teeth. You spend less time at the orthodontic practice for check-ups and adjustments. Aligners have no metal parts that can injure the lining of your mouth. The disadvantages are a longer treatment time compared with braces and possible limits on what these appliances can be used for.
Can I play sport during orthodontic treatment?
You can do all kinds of sport. If your appliance is removable, take it out during sport, or during PE lessons for children. Aligners are the exception: they do not get in the way and can stay in during sport. If the appliance is fixed, such as braces, it will not get in the way, but a blow to the face may injure your lips or knock a bracket off. Patients who play such sports can wear a mouthguard, which can easily be shaped over teeth with braces after heating.
I travel often – is that a problem?
Travelling is not a problem, but bear in mind that if your orthodontist is far away and you have a problem such as a loose bracket or some discomfort from the appliance, you may need to visit another practice to have it fixed. If you are travelling for a long time and plan to be away for more than a month, this usually affects the length of your treatment by slowing it down.
Are braces a problem at airport security?
Braces and other orthodontic appliances that contain metal do not set off airport detectors.
Can I have an MRI scan if I have braces?
Metal braces are very small and do not cause problems during this kind of scan. Even so, doctors insist that everything metal is removed for the scan, so we usually have to take the brackets off and then bond them back on.
I am pregnant or planning a pregnancy – does orthodontic treatment affect pregnancy?
You can have your teeth straightened during pregnancy, but it has to be done more slowly, because hormonal changes in the body also change bone metabolism, which affects tooth movement. The risk of root resorption is also higher during this period. If you are planning a pregnancy, it is best to postpone the start of orthodontic treatment. If you become pregnant during treatment, make sure you tell your orthodontist. This will mean slowing down the movement of your teeth.
How long does treatment take?
The length of treatment varies from case to case. It usually takes one to two years. Whether or not the jaws are still growing, how complex the problem is and the method of correction are the main factors that determine the time. More complex cases take longer. Simple cases are those that do not need jaw correction. They take considerably less time to resolve. Treatment can take longer if the patient does not cooperate. Frequently missing appointments, not following instructions – for example, about wearing a splint or elastics with braces – and brackets coming off also make treatment considerably longer.
Eating and cleaning your teeth during treatment with braces
Once your braces have been fitted, the appointment continues with instructions on eating and on cleaning your teeth and the appliance. Straightening your teeth is the orthodontist's job, but your job is to keep your teeth clean, so that at the end of orthodontic treatment you have a beautiful, healthy smile. Looking after teeth with braces properly takes a few extra minutes. Brushing and flossing Plaque must be removed from your teeth at least twice a day. With fixed braces, this cleaning becomes even more important. All the parts and wires in your mouth are places where food gets trapped more easily and turns into plaque. What is plaque? Plaque is a mix of food, bacteria and saliva that sticks firmly to the teeth. Bacteria in saliva break food down into acids that attack tooth enamel. If the acid stays in contact with the enamel long enough, it starts to break it down and can cause white spots or tooth decay. Plaque also causes bad breath and swollen, bleeding gums. Decalcification spots, or white spots on the teeth, are permanent marks on the tooth surface around the braces. They do not develop under the bracket, only next to it. They are caused by plaque that builds up around the bracket over a long time. After the braces come off, these spots can be treated with various gels and pastes if they are small and smooth; if they are larger, they may need to be removed and replaced with fillings and tooth build-ups. If possible, brush your teeth with a toothbrush and toothpaste after every meal, or at least rinse your mouth with water. This will wash away some of the food, so less plaque forms. In pharmacies and shops you can find folding toothbrushes that are easy to carry in your bag. Brushing at least twice a day is very important, but you also need to clean between your teeth with floss at least once a day. The best time to do this is before bed. It is a good idea to see your dentist every 6 months for a routine check-up. This way your oral hygiene is monitored more closely and, if needed, your teeth are professionally cleaned and polished. Cleaning teeth with braces is not very different from usual. With an ordinary manual toothbrush of medium hardness, clean the part of the teeth above and below the brackets. When cleaning along the gums, use circular movements of your hand and the brush. The spaces between the brackets and under the archwire are cleaned with an interdental brush. These brushes come in different sizes, so your orthodontist needs to recommend the right one for you. Usually, 3-4 mm brushes are used for the upper teeth and 2-3 mm brushes for the lower teeth.