frequently asked questions
Teeth respond to the gentle forces that are applied to them. "Braces" are a combination of "brackets" and "wires". Brackets are the part of the braces that attach to the teeth. Braces require a wire called an "archwire," which actually move the teeth, that connects the brackets and provides the forces to steer the teeth in the proper direction. In many cases, additional forces are needed to help balance the underlying jaw structure and to help the upper and lower teeth fit properly together to make the bite right.
It's normal to have discomfort for three to five days after braces or retainers are adjusted. Although temporary, it can make eating uncomfortable. Encourage soft foods. Have the patient rinse the mouth with warm salt water. Over-the-counter pain relievers, acetaminophen or ibuprofen, may be effective.
Extra time is needed with toothbrushing to make sure that all areas around the braces have been cleaned properly. Specialized brush tips are available to help get in between the braces and under the wires. Floss-threaders are helpful in passing floss under archwires to floss the teeth. The goal is to remove plaque from around the teeth and gums. It is the bacteria in plaque that is responsible for causing inflamed gum tissue, permanent scarring of enamel (decalcification), bad breath, as well as tooth decay. To prevent this, vigorously brush your teeth at least twice daily until they are spotlessly clean.
- Ice, pens, pencils, fingernails, nuts, popcorn kernels
- Hard crusts on bread
- Hard Candy-Starburst, Skittles, Jolly Ranchers, caramel
- Carrots and Apples (whole) - need to cut into bite-size pieces
- Regular gum - You can chew sugarless gum
- Minimize sugar intake: Soda pop or sport drinks, candy, cake
If any portion of the appliance breaks, let our office know so that arrangements can be made for repairs.
Yes. But wearing a protective mouth guard is advised while riding a bike, skating, or playing any contact sports. Avoid using mouth guards that require boiling. Our office can supply you with a mouth guard.
Playing wind or brass instruments will clearly require some adaptation to braces. With practice and a period of adjustment, braces typically do not interfere with the playing of musical instruments.
Good "patient cooperation" means that the patient not only follows Dr. Sekijima's instructions on wearing appliances as prescribed and tending to oral hygiene and diet, but is also an active partner in orthodontic treatment. Successful orthodontic treatment is a "two-way street" that requires a consistent, cooperative effort by both our office and patient. The teeth and jaws can only move toward their desired positions if the patient consistently wears the forces to the teeth, such as rubber bands. To keep teeth and gums healthy, regular visits to the family dentist must continue during orthodontic treatment.
Although every case is different, generally speaking, patients wear braces from one to three years. Treatment times vary with factors that include the severity of the problem, patient growth, gum and bone response to tooth moving forces and how well the patient follows Dr. Sekijima's instructions on dental hygiene, diet and appliance wear (patient cooperation). Patients who brush and floss thoroughly and regularly; avoid hard, sticky, and/or crunchy foods; wear their rubber bands and/or headgear as instructed; and keep their appointments usually finish treatment on time with good results. After the braces are removed, most patients wear a retainer for some time to keep or "retain" the teeth in their new positions.
Estimates of treatment time can only be that - estimates. Patients grow at different rates and will respond in their own ways to orthodontic treatment. Dr. Sekijima has specific treatment goals in mind, and will usually continue treatment until these goals are achieved. Patient cooperation, however, is the single best predictor of staying on time with treatment. Patients who cooperate by wearing rubber bands, headgear or other needed appliances as directed, while taking care not to damage appliances, will most often lead to on-time and excellent treatment results.
One of the problems commonly associated with jaw muscle and jaw joint discomfort is bruxing, that is, habitual grinding or clenching of the teeth, particularly at night. Bruxism is a muscle habit pattern that can cause severe wearing of the teeth, and overloading and trauma to the jaw joint structures. Chronically or acutely sore and painful jaw muscles may accompany the bruxing habit. Dr. Sekijima can help diagnose this problem. Your family dentist or Dr. Sekijima may place a bite splint or night guard appliance that can protect the teeth and help jaw muscles relax, substantially reducing the original pain symptoms. Sometimes structural damage can require joint surgery and/or restoration of damaged teeth. Referral to a TMJ specialist may be suggested for some of these problems.
My family dentist said I need to have some missing teeth replaced, but I need orthodontic treatment first - why?
Your dentist is probably recommending orthodontics so that he or she might treat you in the best manner possible to bring you to optimal dental health. Many complicated tooth restorations, such as crowns, bridges and implants, can be best accomplished when the remaining teeth are properly aligned and the bite is correct. When permanent teeth are lost, it is common for the remaining teeth to drift, tip or shift. This movement can create a poor bite and uneven spacing that cannot be restored properly unless the missing teeth are replaced. Tipped teeth usually need to be straightened so they can withstand normal biting pressures in the future.
After braces are removed, the teeth can shift out of position if they are not stabilized. Retainers are designed to hold teeth in their corrected, ideal positions until the bones and gums adapt to the treatment changes. For the first year your retainers should be worn all the time except when you are eating or brushing. After one year, you may wear your retainers at night only for the rest of your life.
Straight teeth help an individual to effectively bite, chew and speak. Straight teeth contribute to healthy teeth and gums. Properly aligned teeth and jaws may alleviate or prevent physical health problems. Teeth that work better also tend to look better. An attractive smile is a wonderful asset. It contributes to self-esteem, self-confidence and self-image; important qualities at every age. You may be surprised to learn that straight teeth are less prone to decay and injury. Untreated orthodontic problems may become worse. They may lead to tooth decay, gum disease, destruction of the bone that holds teeth in place, and chewing and digestive difficulties. Orthodontic problems can cause abnormal wear of tooth surfaces, inefficient chewing function, excessive stress on gum tissue and the bone that supports the teeth, or misalignment of the jaw joints, sometimes leading to chronic headaches or pain in the face or neck. Treatment by our office to correct a problem early may be less costly than the restorative dental care required to treat more serious problems that can develop in later years.
By age 7, most children have a mix of baby (primary) and adult (permanent) teeth. Some common orthodontic problems seen in children can be traced to genetics. Children may experience dental crowding, too much space between teeth, protruding teeth, and extra or missing teeth and sometimes jaw growth problems. Other malocclusions (literally, "bad bite") are acquired. In other words, they develop over time. They can be caused by thumb or finger-sucking, mouth breathing, dental disease, abnormal swallowing, poor dental hygiene, the early or late loss of baby teeth, accidents or poor nutrition. Trauma and other medical conditions such as birth defects may contribute to orthodontic problems as well.
Dr. Sekijima is trained to spot subtle problems with jaw growth and emerging teeth while some baby teeth are still present. The advantage for patients of early detection of orthodontic problems is that some problems may be easier to correct if they are found and treated early. Waiting until all the permanent teeth have come in, or until facial growth is nearly complete, may make correction of some problems more difficult.
In some cases, Dr. Sekijima might find a problem that can benefit from early treatment. Early treatment may prevent more serious problems from developing and may make treatment at a later age shorter and less complicated. For those patients who have clear indications for early orthodontic intervention, early treatment gives Dr. Sekijima the chance to:
- Guide jaw growth
- Lower the risk of trauma to protruded front teeth
- Correct harmful oral habits
- Guide permanent teeth into a more favorable position
- Improve the way lips meet
Removing baby teeth may be necessary to allow severely crowded permanent teeth to come in at a normal time in a reasonably normal location. If the teeth are severely crowded, it may be that some unerupted permanent teeth will either remain impacted (teeth that should come in, but do not), or come into a highly undesirable position. To allow severely crowded teeth to move on their own into much more desirable positions, sequential removal of baby teeth and permanent teeth (usually first premolars) can dramatically improve a severe crowding problem.
Orthodontic treatment and a child's growth can complement each other. A common orthodontic problem to treat is protrusion of the upper front teeth. Quite often this problem is due in part to the lower jaw being shorter than the upper jaw. Upper teeth may also be the primary cause of the protrusion if they stick out too far. While the upper and lower jaws are growing, orthodontic appliances can be beneficial in reducing these discrepancies. A severe jaw growth discrepancy may require orthodontics and corrective surgery after jaw growth has been completed, although this is rare.
Most patients begin orthodontic treatment between ages 9 and 16, but this varies depending on each individual. Because teenagers are still growing, the teen years are often the optimal time to correct orthodontic problems and achieve excellent results. Most orthodontic problems are inherited. Other malocclusions (crooked teeth) are acquired. They can be caused by thumb-sucking or finger-sucking as a child, mouth breathing, dental disease, abnormal swallowing, poor dental hygiene, the early or late loss of baby (primary) teeth, accidents, poor nutrition or some medical problems. Then there's the emotional side of an unattractive smile. When you are not confident in the way you look, your self-esteem suffers. Teen-agers whose malocclusions are left untreated may go through life feeling self-conscious, hiding their smiles with their lips.
Todays braces are generally less noticeable than those of the past. The brackets are smaller and are bonded directly to the teeth, minimizing the "tin grin." Brackets can be metal or clear depending on the patient's preference. A good reason to keep teeth, gums and braces clean during orthodontic treatment is that clean, healthy teeth move more quickly! This will help keep treatment time as short as possible.
Today, orthodontic treatment is a viable option for almost any adult. It is well recognized that when left untreated, many orthodontic problems may become worse. You'll be pleased to learn that orthodontic treatment will fit in with your current lifestyle - you can sing, play a musical instrument, dine out, kiss, and even have your picture taken. One in five orthodontic patients is an adult. The rate of toothlessness has declined over recent decades. Our great-grandparents, for the most part, lost their teeth around age 40. Today's 25-year-old has the potential of another 75 years of keeping and using their teeth. This is a major change in dental health care. Teeth that do not fit well often wear down more quickly-another reason to make sure that your teeth are in good alignment and well maintained in your adult years.
Special treatment by the patient's dentist or a periodontist may be necessary before, during and/or after orthodontic treatment. Bone loss can also limit the amount and direction of tooth movement that is advisable.
It's never too late! Orthodontic treatment, when indicated, is a positive step-especially for adults who have endured a long-standing problem. Orthodontic treatment can restore good function. And teeth that work better usually look better, too. A healthy, beautiful smile can improve self-esteem, no matter the age.
Pregnancy brings on bodily changes that can affect the mouth. Soft tissues such as gums become much more susceptible to infection. The possible need for x-rays during the pregnancy is not advised. Discuss this question with your medical practitioner/physician and our office before you start orthodontic treatment.
My orthodontist wants to do something called enamel stripping to make my teeth smaller. I have never heard of this. Is this something new? Is it safe?
This procedure goes by many names: enamel stripping; interproximal reduction; slenderizing; reproximation and selective reduction. The goal is to remove some of the outer tooth surface (enamel) to acquire more space for your teeth. The procedure has been used in orthodontic treatment since the 1940s and has been shown to be safe and effective. Some studies among patients who have had this procedure show that it neither makes teeth more susceptible to tooth decay nor does it predispose patients to gum disease.