Faq FAQS: Considering/Planning for Braces
Some orthodontic problems such as underbites, large over bites, severe crowding, severely protruded front teeth, and narrow jaws are much easier to correct at a younger age.These corrections usually work best between ages 7 and 10, while the jaw is still growing, and are sometimes referred to as “early intervention” or “Phase I” treatment. Even if you think your child won’t need this sort of treatment, it’s good to have the orthodontist check out the way that your child’s teeth and jaws are developing – not all problems are easily visible to the casual observer. Finally, knowing whether or not future orthodontic treatment or braces will be likely can help families budget for the future.
Unfortunately, there aren’t many alternatives to braces, but there are alternatives to the metal braces that many people immediately picture. You can get clear or tooth-colored brackets and wires , which make braces much less noticeable. Some patients are also eligible for Invisalign clear aligners instead of traditional braces. There are also other types of removable appliance that can help align teeth.

Some adults do choose to get veneers instead of braces to serve as a purely cosmetic fix. However, these are quite expensive, may need to be replaced at some point in life, and do not actually correct any bite issues.

There’s no set “best” age to get braces. For most kids, the best time for braces is generally between ages 10 and 14, when a child’s mouth and head are still growing and the permanent teeth are erupting. The exact time depends on growth and on how quickly a child’s adult teeth come in. However, braces can still be effective in older teenagers and adults.
Phase I, also known as “early intervention,” refers to orthodontic treatment that occurs before a child has all of their permanent teeth. This usually happens between ages 7 and 10. Phase I treatment hardly ever functions as a complete replacement for braces – its purpose is to fix problems that are most easily corrected at an early age and to make the Phase II treatment (braces) easier. To put it simply, Phase I takes care of the initial structural (skeletal) corrections so that braces can make more refined (dental) corrections and finish the job.

Some orthodontic problems like underbites/crossbites, large over bites, severe crowding, severely protruded front teeth, and narrow jaws are easier to correct at a younger age. Early correction often leads to easier and more predictable treatment after all of the permanent teeth have erupted. Early intervention can also decrease the need to extract permanent teeth in the future, correct harmful habits like thumb-sucking, tongue-thrusting, and speech problems, reduce the risk of tooth trauma to protruded front teeth, eliminate the need for later corrective surgery, and reduce bullying caused by abnormally crooked teeth.

Between Phase I and II, kids may wear a retainer or space maintainer to maintain their progress, and should continue visiting their orthodontist so he or she can check on jaw and tooth development.

Phase II, sometimes just called “active treatment,” consists of full braces. It’s designed to finish straightening the teeth and correcting the bite once all the permanent teeth have come in.

Not necessarily. Many problems, including severe crowding, tooth eruption problems, open bite, crossbite, large over bite, underbite, narrow jaws, harmful habits, and severely protruded front teeth are much easier to correct at an early age. Delaying treatment for some orthodontic problems can lead to increased difficulty in correcting the problem, less stable results, abnormal jaw growth, abnormal tooth wear, or increased risk of chipping a tooth. Early intervention can also help permanent teeth come in properly (and is sometimes needed to give them room to come in at all). Finally, while early intervention does not eliminate the need for braces, it can reduce the patient’s time in braces when they’re older.
On average, most kids wear braces for 1 to 3 years, but this can vary greatly for each person based on growth and the severity of the problem. It also depends on the cooperation of the patient, including maintaining good oral hygiene, wearing auxiliaries such as rubber bands as directed, avoiding damaging food, and keeping all of their follow-up appointments.
This is a subjective choice, but braces can still be quite effective for adults and modern styles are much less noticeable than the braces that many adults remember. In fact, about 20% of patients with braces are over 18. Many adults decide to get braces because they couldn’t afford them as a kid and now can, or because their teeth have shifted with age. Getting braces, even as an adult, can give you decades of more attractive straight teeth and correct serious structural problems, so many people see them as a worthwhile investment.
Tag: adults
A common reason for needing braces is genetics. For many kids, their mouth is simply too small for their teeth, causing the teeth to crowd together. Crooked teeth and poor jaw growth can also be caused by harmful habits like thumb-sucking, oral posture (mouth breathing, lip-apart posture, “hanging” the mouth open), or early loss of teeth from tooth decay or injury.
Possibly, but not necessarily. The mixed dentition stage where adult teeth are first starting to come in is known as the “ugly duckling” stage for teeth, so some crookedness can be normal. However, if you notice significant crowding, the chances that your kid will need braces are higher. Only an orthodontist can tell you for sure.
Just as children mature at different ages, their teeth and jaws mature at different ages. To be ready for full braces (sometimes known as Phase II treatment), kids generally need to have all of their permanent teeth. Early developers may have all of their permanent teeth (except wisdom teeth) by age 9, while late bloomers may not get them until age 14 or later. On average, girls’ mouths also develop slightly earlier than boys, and they tend to be ready for braces about 6-12 months sooner.
Many communities have informative and active parenting listservs and forums online. Some have membership fees, but many are free. Search for one in your community – you’ll be sure to find other parents who are also dealing with braces.
Some people may get braces for mostly cosmetic reasons but there are also a number of health benefits to straighter teeth. Straight teeth are easier to clean well, which reduces tooth decay and gingivitis. Correcting the bite also fixes many structural problems, which can reduce jaw pain and make chewing less painful.
No. They may not be exactly enjoyable, but they’re less noticeable, less painful, and more efficient than you remember. You can now get clear brackets or Invisalign for a less noticeable look, and even “traditional” metal brackets are much smaller than in the past. New heat-activated wires move teeth with constant, more gradual pressure, so each adjustment hurts less and teeth realign more quickly. Computer technology in orthodontics has also improved greatly, giving us “smart” wires and brackets that move teeth faster and more efficiently.
No. Braces can be uncomfortable or even painful at first, and may hurt for a couple days after each monthly adjustment. But after a few months, patients hardly notice their braces at all.
Remind them that braces will only last a couple of years, but their straighter teeth will last the rest of their life. You could also show them that even a number of celebrities have worn braces – for a few examples, check out this slideshow: http://www.drfrangella.com/celebrities-in-braces/ . If possible, it also helps to start visiting the orthodontist before they’re teenagers – most kids are much more comfortable wearing braces in middle school, when many of their friends will have them at the same time, than in high school.
During your first consultation, it’s important to thoroughly interview the orthodontist to determine whether he or she is a good fit, and to know what to expect during the process.

A few questions you should be sure to ask are:

  • What’s the scope of the plan? When is the best time in my child’s life for treatment? What exactly needs to be done? How frequent will the visits be? What are my options? How long will the entire process take?
  • What are your office hours? (Many orthodontists keep bankers’ hours, which means that working parents have to skip work and kids have to be taken out of school.)
  • How does the office work to emphasize good oral care at home?
  • How long have you been in practice?
  • How much will this cost? How is my treatment cost determined? Does your quote include all costs from beginning to end? Are there additional fees during the treatment? What follow-up care, such as retainers, is included after the braces are removed? What insurance plans do you accept?
  • Do you provide references from past patients?

  • To download a list of these questions to take with you, click here.
    Help! Something’s Wrong with my Braces.
    First of all, don’t panic – broken wires are common. Don’t try to bend or cut the wire – there’s a good chance you will end up making things worse. If the wire is poking you, cover the end with orthodontic wax or wet cotton. Then be sure to call your orthodontist as soon as possible. A broken wire can delay progress, increasing the amount of time that you have to wear your braces.
    Don’t panic or try to yank any piece off quickly. Broken or loose braces should be repaired by the orthodontist, but you can prevent the bracket from wiggling by using a bit of wax to cover it. You should carefully remove any loose bands, as they can cause buildups of saliva and germs. If the wire is poking into your cheek, you can ask your orthodontist to fix the problem and use a ball of wax on the tip of the wire to prevent it from poking until your appointment. If you accidentally swallow any part of your braces, don’t freak out – unless it prevents you from breathing normally, it’s not a major problem.
    Yes. For braces to work, pressure from the wire has to loosen teeth so they can be pushed or pulled to a new location. As teeth shift, some cells have to break down so new bone cells can grow in their place to support the teeth in their new positions. This process can take several weeks. While you’re waiting for this bone regeneration to occur, it’s totally normal for teeth to feel loose. Although this can feel very disconcerting, don’t worry – your teeth are not going to fall out.
    Normal orthodontic appliance-related pain should go away with nonprescription painkillers such as acetaminophen or ibuprofen. If these don’t help your mouth pain at all, call your orthodontist for an appointment. You should also call your orthodontist for an appointment if the pain is being caused by any loose brackets or bands, distorted wires, or wires that are too long and poking the inside of your cheeks.

    Call your dentist or orthodontist immediately for a dental emergency, such as the loss of a tooth, or a broken orthodontic appliance that prevents you from opening or closing your mouth or breathing easily.

    This is normal – many patients find themselves drooling more than normal during the first few weeks of having braces or other orthodontic appliances. Anything you place in your mouth sets off receptors that normally tell your brain to prepare the body to digest food. So when these receptors encounter an unfamiliar object in the mouth, such as braces, the brain doesn't initially realize it isn’t food. Just give these receptors a little time to adapt and the drooling will stop. Braces can also cause drooling because they simply feel unfamiliar. Your lips don't come together quite like they used to, and you have a bunch of stuff in your mouth getting in the way - it's just harder to swallow all your excess saliva. Once your mouth gets used to your braces, the drooling problem should get better.
    Cleaning your Braces
    Not cleaning your braces properly can lead to tooth decay, gum disease, and other serious health problems, not to mention unattractive tartar, stains, and bad breath. Plus, taking poor care of your braces can increase your treatment time with them. If the situation is bad enough, the orthodontist may even have to stop treatment, take off the braces, and wait until teeth and gums are healthier before putting them back on.
    Most people find it easier to clean their braces thoroughly with an electric toothbrush that can fit between all the small spaces in the brackets and wires. However, the best brush is the one that encourages you to brush carefully for the full recommended length of time. If this is a manual brush for you, you should choose one with a small head and soft bristles.
    Brushing after every meal is important, and you should carry a travel-sized toothbrush or interdental toothbrush with you at all times. However, if you absolutely can’t brush, you should at least make sure to vigorously swish water or mouthwash around your mouth a few times to try to rinse all the food you can from your brackets.
    Tag: cleaning
    Other Questions about Life with Braces
    No. This situation is not uncommon - it’s impossible to predict exactly how fast teeth will move, and for some kids this happens much slower than predicted. The time needed for braces to work depends on growth, the severity of the problem, and how well the patient cooperates, including maintaining good oral hygiene, wearing auxiliaries such as rubber bands as directed, avoiding damaging food, and keeping all of their follow-up appointments.
    It’s perfectly safe to participate in sports, but it’s recommended that patients wear a mouth guard for contact sports. (This is also now recommended even for people without braces).
    Tag: activities
    Playing an instrument that uses the mouth (such as the trumpet or clarinet) can be difficult at first, but shouldn’t be a major problem. However, the student should be prepared for the fact that they will have to adjust their embouchure to find what works for them while wearing braces. You can also buy lip protectors made specifically for musicians with braces.
    Tag: activities
    Changing orthodontists can be tricky, because different doctors may use different brackets, wires, and appliances. Before you move, make sure to get a copy of your treatment chart and initial records. Have your orthodontist fill out an American Association of Orthodontists transfer form – they should know what this is, but you can also download it here. If you can’t get access to this form, have them write down the answers to the following questions, so you can give this to your new orthodontist:

    1. What is the Treatment Plan?
    2. What stage of treatment are you in?
    3. What are the recommendations for continuing treatment?
    4. What are the type of brackets and prescription used?
    5. What is the slot size of the brackets?
    6. What are the sizes and types of archwires currently in your mouth?
    7. What is the type of cement or bonding agent used?

    Next, research orthodontists in your new city – for tips, see our section on Choosing an Orthodontist. Be sure to ask if they accept transfer patients. Then schedule a consultation to see if potential new orthodontists will be able to work with your existing braces (many will be able to do this even if their office uses different brackets).

    Finally, every office structures their payment plan differently, so be prepared for the possibility that you may need to pay extra money to settle your account with your old orthodontist before leaving.

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