Braces can be fitted at any age once the baby teeth have been replaced by permanent teeth. Braces can solve aesthetic problems (straightening teeth) and functional problems (correcting the bite, improving breathing through the nose, treating sleep apnoea), and they can also be part of a comprehensive treatment plan that addresses other dental problems, more often in older people. A large proportion of our patients with braces are between 30 and 40 years old.
Orthodontic treatment is a very long commitment. It starts with fitting braces or an appliance in the patient's mouth, but it does not end when they are removed. Active treatment is followed by a period of keeping the result, called retention. It lasts at least twice as long as the treatment and involves wearing appliances called retainers. Retainers can be removable (the patient takes them out and puts them in) or fixed (bonded) permanently in the mouth. With the first type, the patient is responsible for wearing the retainer regularly. If it is not worn as instructed, some of the result may be lost.
Fitting braces takes about an hour and a half. During this time, the patient keeps their mouth open and helps when needed. The teeth are cleaned and dried, and the brackets are placed on the teeth one by one. Positioning them correctly takes time and patience. You do not feel any pain or discomfort during this time. Once the brackets are fixed (bonded), an archwire is placed, which applies force to each tooth to move it in the desired direction. When the archwire is placed, you feel tightness for about a minute. A few hours after the braces are fitted, a process begins around each tooth that is linked to its movement. You feel pain when pressure is applied – discomfort when eating. Patients decide for themselves which foods to eat and often stick to soft foods. How long this period lasts depends on the patient's individual sensitivity to pain – from 2-3 days to a week. Once it passes, the sensations in the teeth become much weaker. Visits to activate the braces are usually once a month. After an activation, there are a few days of discomfort and pain on pressure again, but these are much milder than at the start. Extra visits are needed if a bracket or band comes off, or if the archwire breaks or moves out of place. There is no urgent need to fix these problems unless one of them is causing pain.
The lining of the mouth adapts to the braces, and there may be some irritation. Sometimes sores form, and they heal much more easily if you use orthodontic wax. The wax is clear and soft: take the amount you need with your fingers, squash it and roll it into a ball, then press it onto the bracket that is causing the sore. Shape it so that it gives the bracket a smooth, soft surface. This allows the sore to heal within a few days. Sores do not always form, and they do not necessarily appear straight after the braces are fitted. As the teeth move during treatment, small sores can appear again, so keep your wax!
Wearing braces comes with certain restrictions. Biting with your front teeth, eating hard foods and chewing gum are not allowed. Cut your food into pieces and bring it to your back teeth. After eating, rinse your mouth with water so that not too much plaque is left on your teeth. Take extra care during sport to avoid injuries. Cleaning teeth with braces is more difficult. Brushing takes longer, interdental brushes are used, and flossing is difficult but essential. Insufficient or careless cleaning leads to tooth decay or white spots on the front surface of the teeth, which can only be treated by removing them and replacing them with composite. Responsibility for keeping the teeth healthy during treatment lies entirely with the patient – and with their parents if the patient is a child.
The most visible changes in the alignment of the teeth happen in the first few months. For the rest of the treatment, fine movements are made that are important for the stability of the result, so be patient. Each problem is corrected at a specific stage of treatment, and it is important to follow this sequence. We reach a stage when the patient can give their opinion and say how they would like individual teeth to be moved – that is when you can raise all your questions and wishes.
Removing braces takes about an hour and involves taking the brackets off, removing the adhesive from the teeth and polishing. After that, a retainer is fitted if it is fixed, or made if it is removable. Everything is done on the same day. We recommend using a paste that remineralises the enamel, such as Tooth Mousse or MI Paste. Patients often need or want the shape of worn or chipped teeth corrected, as well as teeth whitening. It is best to whiten the teeth a month later, then wait about a month after whitening for the colour to settle before planning any build-ups.
You can find more information about orthodontic treatment at iSmile Dental Clinic here – https://ismile.bg/en/orthodontics/
This article is for information only and does not replace an examination by a dentist.
