Everyday life during treatment

Question 1

Can I whiten my teeth while I have braces or aligners?

Accepted Answer

Whitening your teeth while wearing braces or aligners is possible, and it will not leave ‘spots’ on your teeth, as is often believed. According to research, it can be done, but it is considerably less effective, because the whitening agent does not reach the whole surface of the tooth. Braces and aligner attachments (buttons) prevent the product from spreading evenly. With at-home whitening methods, the result does not differ significantly from that in patients who are not wearing orthodontic appliances. Even so, my advice is to wait until your orthodontic treatment is finished before you start whitening your teeth.

Question 2

When is the best time to whiten my teeth – before or after treatment?

Accepted Answer

If your teeth have already been whitened, it is advisable to wait at least three weeks before having braces or aligners fitted. Scientific papers show that the bond strength of brackets and aligner attachments (buttons) on recently whitened teeth is about 16% weaker, which can make the appliance less stable. That is why it is best to whiten your teeth after your orthodontic treatment is complete.

Question 3

Can I have lip filler during orthodontic treatment?

Accepted Answer

There is no medical reason why you cannot have lip filler during orthodontic treatment. One possible issue, however, is that the orthodontic treatment plan takes into account the position of the teeth in relation to the soft tissues of the face, including the lips, nose and chin. The shape, volume and projection of the lips can influence how the alignment of the teeth is planned. If your lips change during treatment, the orthodontic plan may need to be adjusted. For this reason, it is recommended that cosmetic soft-tissue treatments are done after orthodontic treatment is complete.

Question 4

Will braces or aligners change the way I speak?

Accepted Answer

Braces are usually fitted on the front surface of the teeth and are visible when you smile, but they do not change your speech. This is because sounds are formed by the tongue touching the inner side of the teeth, the palate and the lips. If no appliances are placed on these surfaces, your speech is not expected to be affected. There are also lingual braces, which are bonded to the inner side of the teeth for better aesthetics. These can affect speech, but the tongue adapts quickly and patients get used to them within a few days. Aligners are thin, rigid, clear trays that cover the teeth both on the outside (the lip side) and on the inside (the tongue side). They can also change your speech slightly for the first few days after you start wearing them, but you adapt fairly quickly. To get used to them more easily, it helps to read aloud regularly and talk as much as you can.

Question 5

Can I have my teeth straightened while I'm pregnant?

Accepted Answer

Orthodontic treatment can be carried out during pregnancy, but with extra care. The biggest risk concerns the health of the gums, as pregnancy often makes women more prone to inflammatory conditions such as gingivitis. In some cases, the inflammation can worsen and progress to periodontitis, which is why it is essential for a periodontist to monitor the gums. In addition, the hormonal changes that take place during pregnancy affect bone metabolism, which matters for how quickly teeth move. Because of these factors, teeth often move more slowly in pregnant women.

Question 6

Do I need to take time off after having braces fitted?

Accepted Answer

Having braces or aligners fitted is not a painful procedure. However, for the first few days afterwards you may feel some discomfort, ranging from mild irritation and tightness to pain when pressure is put on the teeth. In some cases there may be jaw pain or a headache. Braces can also cause sore spots on the inside of the cheeks and lips, which can add to the discomfort. Despite this, you can carry on going to school or work as normal.

Question 7

Can I play sport with braces or aligners?

Accepted Answer

Orthodontic treatment is no reason to stop playing sport. Aligners do not get in the way of physical activity, and it is not recommended to take them out while you train. If your sport carries a risk of a blow to the face, it is advisable to wear a sports mouthguard. A blow to braces can damage them, bend the archwire and put unwanted pressure on the teeth. If this does happen, it is important to see your orthodontist so that they can check everything and make any corrections needed.

Question 8

Can I wear a sports mouthguard over braces?

Accepted Answer

Sports mouthguards can be custom-made from an impression of your teeth or bought ready-made. Ready-made mouthguards are usually softened in warm water so that they can take on the shape of the teeth. If you wear braces, you can use this kind of mouthguard, as it will not damage them and will still be easy to take out after use.

Question 9

I have an important event coming up. Can my braces be taken off for a day and then put back on?

Accepted Answer

Fitting braces is a complex and precise procedure that determines how effective the treatment will be. If braces are removed, they cannot be reused and have to be replaced with new ones, which means extra cost. Removing braces also involves cleaning the adhesive off the teeth, which can cause sensitivity. Even taking braces off for a short time can significantly delay treatment, because when they are bonded again it is often necessary to go back to earlier stages of treatment. If there is a pressing reason to remove the braces temporarily, a better option is to switch to treatment with clear aligners.

Question 10

Can I smoke while wearing aligners?

Accepted Answer

Smoking ordinary or electronic cigarettes stains both your teeth and your aligners. If you smoke with your aligners in, they will quickly look dirty and you'll lose their aesthetic advantage. It has generally been found that smoking speeds up tooth movement, but before you get too pleased about this, I should point out that this is due to the harmful effect of nicotine, which increases bone resorption.

Question 11

I wear braces and I've noticed I can't whistle any more. Will I be able to again once they're off?

Accepted Answer

Braces get in the way of whistling. It's possible to learn to whistle with braces, but it takes practice. Once your braces come off, you'll get the skill back if you had it before, but you'll need to practise.

Question 12

If I'm pregnant, when should I tell my orthodontist?

Accepted Answer

Pregnancy changes the way an orthodontic patient is monitored. Special attention needs to be paid to the condition of the gums, and any discomfort caused by the appliance should be kept to a minimum where possible. It's best to let your orthodontist know about a pregnancy as soon as you find out. Of course, this means postponing any procedures that aren't urgent and require local anaesthetic.

Question 13

I need to have an MRI scan. Can I have it with braces?

Accepted Answer

Whether braces need to be removed for a magnetic resonance imaging (MRI) scan depends on the area being scanned. The main problems with having an MRI with braces are that metal parts in the mouth may heat up under the scanner's magnet, and that their presence may affect the quality of the scan (giving a blurred image). If an MRI of the head is needed, the following must be removed: metal braces, ceramic braces with a metal slot (the middle part of the bracket), metal tubes (the brackets on the back teeth), metal archwires – both steel and nickel-titanium – orthodontic mini-implants and bonded wire retainers. Braces made of ceramic, plastic, sapphire or composite, as well as aligners and their non-metal buttons, don't need to be removed. If the scan isn't of the head, there's no need to remove metal braces or anything else from the mouth.

Question 14

Can I have an X-ray while I'm wearing braces?

Accepted Answer

Braces and archwires show up on an X-ray as a strong shadow (white areas). They don't prevent the X-ray from being taken or affect its quality. However, they can hide decay located close to them, so that it goes unnoticed on the X-ray.

Question 15

Will my braces cause problems at airport security?

Accepted Answer

Braces (even metal ones) don't cause any difficulty when you go through airport security. They don't set off the detectors and aren't a reason for you to be given an additional check.

Question 16

Could my braces have anything to do with my frequent bouts of tonsillitis?

Accepted Answer

Frequently recurring upper respiratory infections can be caused by many factors that have nothing to do with orthodontic treatment or with having braces or aligners in the mouth. One possible link could be the so-called microbial count in the mouth. Having more bacteria in the mouth of a patient with braces can make the lining of the mouth and throat more susceptible to their effects. This applies to patients with braces or aligners and poor oral hygiene; it does not apply to all patients.

Question 17

How long after finishing treatment should I wait before whitening my teeth?

Accepted Answer

Studies suggest waiting 2 weeks after braces or aligners are removed before having your teeth whitened. My advice to patients is to wait until the sensitivity caused by removing the brace adhesive and the attachments has passed, and until the gums have settled if they are inflamed or swollen. Sometimes this can mean waiting 6 weeks or more.

Question 18

Do I have to whiten my teeth after orthodontic treatment?

Accepted Answer

Teeth whitening is a cosmetic procedure that is not suitable for every patient (it is not recommended for sensitive teeth or for front teeth that have crowns or composite build-ups). You don’t have to whiten your teeth after orthodontic treatment, but if it is possible in your case, whitening adds extra brightness and charm to your smile. I recommend the procedure, and I have had it done on my own smile too.

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