The first consultation

During this visit the patient is examined clinically. This enables the orthodontist to give advice on the treatment options available, when treatment should commence, the duration of treatment, and the approximate cost.

Records

Records include:

• Plaster models of the teeth.
• Photographs of the teeth and face.
• X-rays of the teeth and jaws.

Records allow the orthodontist to analyze each case accurately. They are also used to record the existing malocclusion for future reference.

Treatment Planning

At this visit the orthodontist discusses the treatment plan(s) which have been formulated using information obtained from the first consultation and records. Then, arrangements are made to commence treatment.

Extractions and other preliminary procedures

Sometimes it is necessary to remove teeth to gain sufficient space to align the remaining teeth. Any decayed teeth should be filled and the teeth sometimes need to be cleaned before orthodontic treatment is started.

Braces

Braces are the most efficient and accurate way of moving teeth. Braces (bands, brackets and wires) are usually made of stainless steel although clear brackets are available, usually at extra cost. The orthodontist attaches metal or tooth-colored brackets - small blocks - to the teeth and then runs a special wire over the brackets to pull the teeth into the right position.
When the brace is first fitted, it may feel strange and possibly uncomfortable. Because the brackets are raised, they may rub against the inside of your lips or cheeks. Your orthodontist will give you some special wax to prevent this rubbing which should make it more comfortable. You may also find that, for the first few days, your jaw aches because of the pressure of the brace. If this discomfort lasts longer than a few days, though, you may wish to go back to your orthodontist, who can then readjust the brace.
Although you'll still be able to eat most of the foods you were eating before, you will need to take care not to damage your brace. With other foods, like apples, you might need to cut them up, but you'll still be able to eat them.
Because your brace provides food with more places to hide, you'll need to be extra careful with your hygiene routine. Brushing your teeth twice a day with fluoride toothpaste is essential, and you may also find using a fluoride mouthwash last thing at night is helpful to protect your teeth while you sleep. If you don't look after your teeth while you're wearing your brace, they may become permanently stained.

Rubber Bands and Headgear

During treatment, patients may need to wear such items as rubber bands and/or headgear with their braces. These items provide important extra forces for the correction of the bite.

How Long?

Orthodontic treatment usually takes 18 - 24 months. Some cases may be finished earlier and others may take longer to complete. The total treatment time depends on the severity of the original malocclusion, the type of treatment carried out, and the co-operation of the patient.

Dental check-ups

Orthodontic patients should continue to attend their family dentist for regular check-ups during the course of orthodontic treatment.

Retention

At the completion of the active part of orthodontic treatment, the braces are removed and retaining appliances (retainers) are fitted to hold the teeth steady in their new position. These appliances may be removable plates or wires fitted behind the teeth.
The retaining appliances are usually worn:

• Full-time for up to one year.
• Just at night for a further year.
• Phased out altogether over one more years.

Brushing your teeth twice a day with a fluoride toothpaste and keeping your diet healthy is important whether you wear a retainer or not, but you should be especially aware of cutting down on sugary snacks and fizzy drinks, as these may cause more damage to your teeth while you are wearing your retainer. If you are using your toothbrush, though, do be careful not to damage the retainer.

How often should I clean my braces?

It is vital that you clean your braces every time you brush your teeth.  Braces can act as a "plaque trap", increasing the amount of plaque on your teeth, which in turn can lead to an increased risk of caries and gum disease.

How do I floss with fixed braces?

Flossing removes the plaque between your teeth and under your gum line - areas beyond the reach of your toothbrush.  In fact, if you don't floss, you're leaving up to 40% of your tooth surfaces untouched and uncleaned.