Q.1 What is the best age to start Orthodontic treatment?
By age 7 years when the permanent incisors begin to erupt would be a good time to spot any developing malocclusion. Also at this stage, space deficiency for the permanent teeth due to erupt could be detected and the extra space needed could be created by a process of expansion thereby preventing extractions at a later stage. Certain habits such as thumb sucking, mouth breathing, tongue thrusting which could cause debilitating malocclusions could be detected early and stopped.
Q.2 Is it too late to correct the problem if the child has crossed 7 years of age?
No it is never too late to start orthodontic treatment if the bone and surrounding gum tissues are healthy. The only difference would be the treatment plan would vary. In some situations involving a malrelation of the upper and lower jaw bones treatment started early could correct the malrelation of the jaws and prevent surgery of the jaws at a later stage once growth is complete.
Q.3 What is malrelation of the jaws and how can they be corrected?
As discussed previously certain habits could cause the upper and lower jaws to fall out of line. For example the upper jaw may be significantly protruded and the lower jaw retruded (placed behind) increasing the overjet (horizontal overlap) between upper and lower teeth. Correcting the position of the jaws would be sufficient to decrease the overjet and significantly improve profile. This correction could be accomplished up till age 16 in males and 14 in females as growth is still present. After 17 years growth is more or less complete and the jaw bones are mature and the only way to correct this is by repositioning the jaw bones through a surgical procedure.
Q.4 How is the malrelation of the jaw bones corrected at a younger age?
By detecting the aberrant and perverted forces (habits) which are causing growth of the jaw bones in the wrong direction and redirecting the forces back into the right direction, normal growth is reestablished. This is accomplished by a series of Removable and fixed appliances.
Q.5 Would the child need Braces after the correction of the jaws?
Yes the patient may need a short period of Braces to line up the upper and lower teeth after the jaws have lined up.
Q.6 What are Lingual Braces?
Braces placed on the inside/behind of the upper and lower teeth are termed as Lingual Braces.
Q.7 Do Braces on the inside /behind (Lingual braces) teeth hurt?
The most common type of Lingual Braces used currently is the Incognito Braces which is custom made for each individual patient. Once you have decided to get treated a mold is taken of the upper and lower teeth and the mold is sent to the Incognito lab in Germany where the Braces are custom made to fit your teeth, because of this good fit of the Braces the amount of discomfort you encounter is less when compared to other Lingual Braces. However, initially for the first few days you would encounter some discomfort especially to the tongue as it comes in contact with the Braces during speech.
Q.8 Is the treatment longer with Lingual Braces?
The treatment is not longer with Lingual Braces and would last for anywhere between 18-24 months but at each appointment the amount of time the Orthodontics spends adjusting/tightening the Braces would be a little longer; approximately half hour appointments for wire changes would be required.
Q.9 Is the treatment longer with Clear Braces?
Yes, the treatment would take a few months more with Clear Braces as the material the clear Braces is made up of is ceramic, which offers more friction during tooth movement than Metal Braces.
Q.10 How long does the treatment with Braces usually last?
Treatment lasts for anywhere between 18-24 months but the treatment time for each individual case varies and can be determined after the Orthodontics does an initial assessment.
Q.11 What is the interval between visits once the Braces is placed?
Usually on placement of the Braces the patient would have to be seen once in 4-6 weeks which would entail activation (adjusting/tightening) of the appliance which would be accomplished mainly by wire changes.
Q.12 Do Braces hurt?
Initially when they are first placed the patient would encounter some soreness on the inside of their cheeks and lips, this would last for a week. Wax would be provided to place on top of the Braces to decrease the soreness of the soft tissues.
Q. 13 Does one have to wear elastics during treatment?
Yes the Orthodontics may prescribe some elastics during the treatment and the pattern of elastic wear depends upon the malrelation of the teeth.
Q. 14 Once the treatment is complete would we have to wear retainers?
Yes it is very important to wear retainers after the Braces are removed. Usually in the lower teeth a retainer is stuck behind the lower teeth and for the uppers a removable retainer is provided which would have to be worn the whole day for the first 6 months and only at night after that.
Q.15 How long do we wear the retainers?
They are called permanent retainers and should be worn basically for the rest of your life if the teeth have to be maintained in the same position. However after the first six months of full time wear (except while eating), they need to be worn only when you sleep.