FAQ About Braces and Invisalign | Orthodontics at Don Mills in Toronto

What is Orthodontics?

Orthodontics is a special field of dentistry that concentrates on the diagnosis, prevention and treatment of dental and facial irregularities. The technical terms for these problems are “malocclusion”, which means “bad bite”. The practice of orthodontics requires professional skill in the design, application and control of corrective appliances, such as braces, to bring the lips and jaws into proper alignment, to achieve facial balance and create a beautiful smile.

What is an Orthodontist?

All orthodontists are dentists, but only 6% of dentists are orthodontists. An orthodontist is a specialist in the diagnosis, prevention and treatment of dental and facial irregularities. Orthodontists must first attend college, and then complete a four-year dental graduate program at a University or Dental School or other institution accredited by the American Dental Association. They must then successfully complete an additional 2-3 year residency program of advanced education in orthodontics. This residency program must also be accredited by the American Dental Association and American Association of Orthodontics. Through this extensive training, the orthodontist learns the skills required to manage overall care of the orthodontic patient. Only dentists, who have successfully completed this advanced specialty education, may call themselves orthodontists.

What causes Orthodontic problems?

Most orthodontic problems (malocclusions) are inherited and some are acquired. Inherited problems include a wide variety of irregularities involving the jaws, teeth and face such as crowding of teeth, spacing, extra or missing teeth and/or upper and lower jaw deficiencies. Acquired problems occur due to finger habits, airway obstruction by enlarged tonsils and adenoids, allergies, asthma, premature loss of baby and/or permanent teeth, and dental disease. Whether inherited or acquired, many of these factors affect the alignment of teeth as they erupt and the facial development throughout the growing years.

What is the Best Age for Treatment?

Each orthodontic problem determines its best starting time. However, the American Association of Orthodontics recommends that all children be evaluated by an Orthodontist by age 8, even earlier, if the problem is noted by either parent or the family dentist. Most orthodontic problems are inherited and therefore cannot be prevented. However, at this age, developmental problems relating to facial growth or eruption of teeth can be improved or corrected, if diagnosed early.
Orthodontics, for any age, is appropriate as long as there is healthy bone, teeth and gum tissue. The following signs may indicate that you or your child needs to be evaluated by an Orthodontic Specialist:

Thumb or finger sucking
Overlapping or crowding of erupting/erupted permanent teeth, broken or missing teeth
Difficulty chewing food
Mouth breathing due to allergies, enlarged tonsils and/or adenoids
Jaw joints that click, pop or experience discomfort
Developing underbite, overbite, crossbite or abnormal bite development
Teeth wearing unevenly or excessively
Spaces between the teeth
Lower jaw shifts from one side to the other when biting together

Why is Orthodontic treatment important?

Crowded and malaligned teeth are difficult to clean and maintain. This condition may cause tooth decay, eventual gum disease and/or tooth loss
Reduces or eliminates factors contributing to abnormal tooth wear
Improves inefficient chewing function that causes excessive stress on gum tissue and the bone that supports the teeth. This inefficiency may result in TMJ dysfunction of the jaw joints that may also cause headaches and joint discomfort.
Left untreated, many orthodontic problems become worse. Orthodontics is often less costly than the additional dental care required to treat more serious problems that may develop in later years.
A beautiful, healthy smile is a personal asset that will follow the young and remain with the old, throughout life. A great smile is vital to one’s self-confidence and improves one’s general attitude towards life.

How long is the initial exam?

This initial appointment takes approximately one hour. Our objective is to communicate proposed orthodontic treatment, if required, in a friendly, caring, and enjoyable atmosphere. The treatment coordinator will review the orthodontic treatment plan, as determined by the orthodontist, during the clinical exam. She will also discuss financial arrangements and answer questions regarding insurance, appointments, and treatment concerns, if indicated at that time.

Since we like to evaluate children by age 7, as recommended by the American Association of Orthodontics, many children are not ready to begin treatment until more permanent teeth erupt. After their new patient exam, they are placed on our Orthodontic Supervisory Program. This program enables Dr to monitor the eruptive pattern of the permanent teeth. Sometimes, poor erupted patterns may be eliminated with early removal of baby teeth and reduce the treatment time required for braces. We will notify your general dentist of any recommendations made during your visit. We normally see the patients every 6 months to observe their progress as they grow. There is no fee for this program. It enables the orthodontist to determine the optimum time to begin treatment and achieve the best possible result for your child.

How long is orthodontic treatment?

Treatment time typically ranges from one to two years, depending on age, the growth of the patient’s mouth and face and the severity of the problem. Patients will respond differently to orthodontic treatment, so the time to case completion may change from the original estimate. The patient’s diligent use of any prescribed rubber bands, proper oral hygiene, following the recommended diet to avoid emergencies and keeping scheduled appointments are important factors in achieving your beautiful smile in a timely manner. Interceptive, or early treatment procedures, may take as few as six months, depending upon the problem.

What is Phase I and Phase II treatment?

Phase I (early interceptive) treatment, is limited orthodontic treatment (ex: expander or partial braces) before all the permanent teeth erupt. Such treatment can occur before the permanent teeth erupt. This treatment may be recommended to make more space for developing teeth, to correct crossbites, overbites, underbites, or harmful oral habits.

Phase II treatment is also called comprehensive treatment, because it involves full braces when all the permanent teeth erupt, usually between the ages of eleven and thirteen. The female patient’s permanent teeth normally erupt one year earlier than the male patient’s permanent teeth. Consequently, the gender timeline varies. Hereditary factors also play a part in early or later eruption of permanent teeth and may affect when Phase II treatment begins.

How does orthodontic treatment work?

Orthodontic appliances can be made of metal, ceramic or plastic. They may be removable or they may be brackets bonded to the teeth. By placing a constant, gentle force in a carefully controlled direction, braces or Invisalign aligners slowly move teeth to a corrected position. This is a great time to wear braces! Gone are the days when a metal band with a bracket was placed around each tooth. You can choose brackets that are clear or metallic color. You can choose the color of the ties that hold the wire into the brackets. Wires are also less noticeable than they used to be and the latest titanium heat reactive wires move teeth faster, with less discomfort to patients and with fewer appointments. Patients are normally seen for adjustments every 8 weeks. This helps us accommodate busy school and work schedules.

Standard metal brackets. Colored elastics are available
Ceramic brackets
Invisible Aligners for both teens and adults. The “braceless” alternative to straighten teeth

Do braces hurt?

The placement of bands and brackets or Invisalign on your teeth does not hurt. Once your braces are placed and connected with the archwires or your Invisalign aligners are inserted, your teeth begin to move. You may feel some soreness of your teeth for one to four days. Tylenol or Advil works well to alleviate discomfort during this time. Your lips and cheeks may need one to two weeks to get used to the braces on your teeth. Your orthodontic hygienist will provide you with all the information necessary to make this transition as easy as possible after the appliances are placed.

How do we take braces off?

We use a special plier to squeeze the curve on the back of the bracket to break the bond to the plastic adhesive. The plastic bonding material is simply fractured gently off the back of each bracket. The brackets remain attached to the wire and everything is removed, at once, in less than a few minutes with little discomfort. If any bonding material remains on the tooth, it is smoothed off with a polishing disk. When the braces are removed, your teeth feel very smooth and strange. It has been a long time since you felt the real thing!

Will braces interfere with playing sports?

No. However, we recommended that patients protect their smiles by wearing a mouth guard when participating in any sporting activity. We supply our patients with special orthodontic mouth guards that come in a variety of styles and colors. Please let us know if you require a mouth guard when treatment begins.

Will braces interfere with playing a musical instrument?

No. However, there may be an initial period of adjustment. Brace covers or wax is provided to prevent discomfort while the lips and cheeks callous. Your orthodontic hygienist will instruct you on what to apply when the braces are placed. Please let us know if you play a musical instrument.

How long do I wear my retainers?

Upon completion of orthodontic treatment, we recommend that all patients wear retainers full time, as instructed by Dr. Noble. Once the bite has stabilized, the retainers are worn part-time, indefinitely. This is your insurance policy that the teeth will remain in position for a prolonged period of time. Teeth move throughout life. It is a normal consequence of the aging process. If retainers are worn indefinitely, change will be minimal over a lifetime.