• Why should I get my child checked out by an orthodontist by age 7?

The American Association of Orthodontists recommends that every child first visit an orthodontist by age seven, or earlier if a problem is detected by parents, the family dentist, or the child’s physician. Some orthodontic problems such as crossbites, large overbites, 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.

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• What does “Phase I” and “Phase II” treatment mean?

Phase I, also known as “early intervention,” refers to orthodontic treatment that occurs before all permanent teeth erupt.  Its purpose is to fix jaw and space problems that are most easily corrected at an early age when patients are growing making the Phase II treatment (braces) easier, if needed at all.

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

While in 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 “comprehensive treatment,” consists of full braces (fixed appliance). It’s designed to finish straightening the teeth and correcting the bite once all the permanent teeth have erupted.

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• My child’s friends already have braces, but the orthodontist says mine still isn’t ready. Why?

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 present. Early developers may have all of their permanent teeth (except wisdom teeth) by age 10, while late bloomers may not get them until age 14 or later.

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• I’m an adult – Can adults wear braces?

In fact, a large percentage of patients with braces are adults. Many adults decide to get braces because they never receive treatment when they were young or because their teeth have shifted with age worsening the crowding. Getting braces, even as an adult, can give you decades of more attractive straight teeth and correct serious jaw and bite problems. 

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• Are there any alternatives to braces?

Fortunately, there are many alternatives to the traditional metal braces including clear or tooth-colored brackets and wires, and lingual braces on the tongue-side of the teeth. Some patients are candidates for clear aligners instead of braces and there are also other types of removable appliances that can help align teeth.  

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• Will I still be able to talk when I have braces?

Yes, standard braces should not affect how you talk or the sound of your voice.  In certain cases, the orthodontist may need to use an appliance that could get in the way of your tongue. You could experience trouble talking clearly for a day or two, but then your tongue will adjust and you’ll be able to talk just fine.

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• Will braces cause sores in my mouth?

When you get braces, your mouth can be sore for a few days. Also, your mouth could be sore when the braces are adjusted. If you rinse the sores in warm salt water, they will heal quickly. If your mouth is sore during the first week, you can put wax on the braces to prevent the braces from rubbing and irritating your cheeks.

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• Can I still play football, soccer and other sports if I have braces?

Absolutely! You can play football, baseball, basketball, soccer. You can still go bowling. You can still do everything; just wear a mouthguard for your sports, and try to not get hit in the mouth.  The use of a mouthguard is suggested even for people who do not wear braces.  Avoid sports where you will get hit in the face (fighting, boxing, contact karate, snowball fights).

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• Will wearing braces affect my ability to play a musical instrument?

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 patients should be prepared for the fact that they will have to adjust their embouchure to find what works for them while wearing braces.  Be sure to mention your musical abilities (and your type of instrument) to your orthodontist.  You can buy lip protectors made specifically for musicians with braces.

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• My teeth feel loose – is this normal?

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 add new bone to 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.

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• When is pain considered normal, and when should I call the orthodontist?

Normal orthodontic appliance-related pain should go away with nonprescription painkillers such as acetaminophen. 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 our office immediately for an emergency, such as a broken orthodontic appliance that prevents you from opening or closing your mouth easily.

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• Why do some people wear rubber bands?

The rubber bands are used to move teeth forward, backward, and/or up and down. If rubber bands are recommended for you and you don’t wear them, it could lengthen your treatment time, and prevent correction of certain jaw problems.

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• Should I see my general dentist while I have braces?

Absolutely! You should continue to see your general dentist at least every six months for cleanings and dental checkups. In fact you may want to visit your dentist more frequently, every 3-4 months as braces make it more difficult to keep all tooth surface is clean and plaque accumulation can occur easily.

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• Will I need to wear a retainer?

Yes! Retainers keep your teeth straight after the braces come off. Teeth move throughout our lives. Without retainers your teeth will move and the treatment results could be jeopardized.

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• What are the consequences of not cleaning braces properly?

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.

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• What kind of toothbrush is best?

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.  Flossing, or other means of cleaning between the teeth/braces, can be important to removing trapped food. We also suggest, (available in our office), the use of a water flosser, to make it easier to remove food debris and plaque from difficult to reach places in your mouth.

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• I know I’m supposed to brush and floss after every meal, but I can’t always do this when I’m on the go. Is there an easier alternative?

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.

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• What happens if the braces come off?

Your orthodontist will attach them again. Just call us and make an appointment.  Usually, this is not a problem, although if it happens lots of times, your orthodontic treatment will take longer and the office will charge a broken appliance fee.

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• What do I do if a wire in my braces breaks?

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.

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• What if a bracket or band comes loose?

This is typically not an emergency that needs immediate care.  Don’t panic or try to remove any piece. 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 panic – unless it prevents you from breathing normally, it’s not a major problem.

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• What foods/food categories should I avoid with braces or other non-removable appliances?

  • Chewy foods, such as bagels or licorice.

  • Crunchy foods, like popcorn, chips or ice chips.

  • Sticky foods, such as caramel candies, taffy, Gummy candy or chewing gum.

  • Hard foods, like nuts or hard candy.

  • Foods that require biting into, such as corn on the cob, whole apples or raw carrots (unless sliced up first)

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• Which Food can I eat while using braces?

  • Dairy — soft cheese, pudding, milk-based drinks.

  • Breads — soft tortillas, pancakes, muffins (without nuts!)

  • Grains — pasta, soft cooked rice.

  • Meats/poultry — soft cooked chicken, meatballs, lunch meats. Slice all meat off the bone first and into smaller pieces.

  • Seafood — tuna, salmon, crab cakes.  Seafood is mainly softer, so enjoy!

  • Vegetables — mashed potatoes, steamed spinach, beans.

  • Fruits — applesauce, bananas, fruit juice.

  • Treats — ice cream without nuts, milkshakes, Jell-O, soft cake.

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• How do I clean my aligners and retainers?

"If you regularly wear your retainer, you know the importance of keeping it clean. Whether it’s the plastic-and-metal one you received after getting your braces off or a more modern-looking Invisalign tray, retainer cleanliness is crucial to mouth health."

Here is an article that cites our Dr. Cristina Teixeira and is a go-to guide on this topic: http://nymag.com/strategist/article/how-to-clean-your-retainer.html