Frequently Asked Questions About Orthodontics

Orthodontics is the correction of problems involving the alignment of the teeth, bite and jaws. The technical term for these problems is "malocclusion”. Dentists who become orthodontists must complete a two-to-three-year orthodontic residency beyond dental school. This additional education makes the dentist a specialist in moving teeth and aligning jaws.¹

Many malocclusions are inherited, which means genetics plays a key role in their appearance. Inherited problems include crowding of teeth, too much space between teeth, extra or missing teeth or the improper alignment of the teeth to each other.² Another way orthodontic problems occur could be a result of trauma (accidents); thumb, finger or pacifier sucking, dental disease, early or late loss of baby teeth and other causes.²

Orthodontic treatment helps teeth fit better (alignment and occlusion) - crooked and crowded teeth are hard to clean. These issues may contribute to future dental disease, like decay or periodontal disease. Orthodontic problems can also contribute to abnormal wear of tooth surfaces, inefficient chewing or misalignment of the jaw joints. If left untreated, many orthodontic problems may become worse.²

Children and adults can benefit from orthodontics, healthy teeth can be moved at any age.² Because monitoring growth and development is crucial to managing some orthodontic problems, the American Association of Orthodontics recommends that all children have an orthodontic screening no later than age 7.² Some problems may be easier to correct if treated early. Waiting until all the permanent teeth have come in, does not allow the orthodontist to recommend appropriate treatment at the appropriate time, using natural growth to help in aligning in the teeth.² An orthodontic evaluation at any age is advisable if a patient/parent, family dentist or the patient's physician has noted a problem.

The orthodontist will recommend the best option, depending on the problem and patients’ preferences.³ Treatment usually consists of custom-made removable or fixed appliances that use gentle pressure to move teeth into proper position, correcting bite (occlusion) and tooth alignment.³ Traditional braces (fixed appliances), usually consist of small brackets cemented to teeth, connected by a wire, which is periodically tightened by the dental team.³ Braces may be metal, or tooth colored or even clear. Other orthodontic appliances (like retainers) use carefully directed forces to guide corrections.³

Many people have some discomfort after their braces are first put on their teeth or when adjustments are made during treatment; a patient’s cheeks, lips and tongue may also become irritated. The orthodontist may recommend over the counter pain relievers (like acetaminophen, ibuprofen or naproxen).⁴ Overall, orthodontic discomfort is short-lived and easily managed.

The orthodontist and dental team will teach the patient how to best care for teeth, gums and braces during treatment. Instructions on how to brush and floss may be given, as well as tips on how to eat certain foods (like cut up an apple – don’t bite into it). Keeping the teeth and the braces clean requires more precision and time than normal cleaning, maintaining excellent oral health during treatment is important. Patients with braces must be careful to avoid hard and sticky foods, and not chew on pens, pencils or fingernails because chewing on hard things can damage the braces. If playing in contact sports your orthodontist may recommend a special mouth guard to protect the braces and your lips, tongue and teeth.

Orthodontic treatment can typically range from one to three years, averaging just under two years. When “active” treatment ends, most patients must wear retainers to keep teeth in their new positions.³