Orthodontics is best done in growing patients. The best time for an orthodontic assessment is age 10-11 years when your child is in 5th/6th class in primary school.
Gone are the days of filing down teeth and placing veneers or crowns on every tooth to create a hollywood smile. This can create an unnatural looking smile which lacks individuality. Getting the teeth into the correct position for the jaws and face and creating symmetry and balance is the best way to create a natural, full smile. Teeth can be moved and jaws developed with orthodontics. This is done at any age but has the best results in growing patients.
Every case is different. At Navan Orthodontics we recommend the best time to see your orthodontist is at age 10 or 11. This is a great time to start treatment as children are just about to start entering their growth spurt which is when orthodontics works best. Having some baby teeth remaining is also great as they tend to be bigger than the developing adult tooth underneath so this extra space can be kept and used to relieve crowding. Adult canines are the last to erupt into the mouth which often leads to them being crowded out. Removal of some baby teeth eg baby canines can help adult canines erupt in to a better position.
Treatment might involve a removable brace or a brace to wear at night time. At this age, you would be surprised how quickly children adapt to new braces! They also have less social pressure as they have their current group of friends and only one teacher to deal with at primary school.
Every case is different, so it really is best to come in for an assessment and your orthodontist will let you know when is the right time to start for your child.
Orthodontics can be done later in life too. It may need to be supplemented with enamel bonding if there has been wear to the structure of the teeth from a previous traumatic bite.
Orthodontic treatment can correct a lot of problems associated with the imperfect position of teeth. These problems can be aesthetic but can also have an effect on how the teeth are developing, how they meet on chewing, how easy they are to keep clean, risk of trauma to teeth or gums. Aesthetic considerations should not be under-estimated. Certain orthodontic problems can have a profound impact on your quality of life.
Crowding is due to a disproportion between the number/size of the teeth and the size of the jaws. It is a very common orthodontic problem. It can be corrected by maintaining space of baby teeth, regaining space that has been previously lost or by removal of some permanent teeth. Your orthodontist will do a detailed orthodontic assessment taking into consideration the shape of your jaws, your facial profile or side view, growth potential, your smile, teeth present and their position of teeth and amount of crowding. They can then discuss the options with you and come up with a treatment plan to suit you or your child.
Overbite is the vertical overlap of the top incisors over the lower incisors. An increased overbite (or deep bite) can sometimes lead to trauma to the enamel of the incisors or the supporting gums. The top teeth trap the lower teeth, this in turn can restrict the growth of the lower jaw. Overbites are best corrected at a younger age and preferable during growth spurts (age 10-14, younger for girls, slightly older for boys). Overbites can be corrected in adults but involve more tricky orthodontic mechanics.
Overjet is the horizontal overlap of the top incisors relative to the lower incisors. Increased overjets are associated with an increased risk of trauma to the upper incisors. Although this is definitely not the case, increased overjets (protruding teeth) are also associated with public perception of being less intelligent (? Rephrase). Often the top incisors are thought to be protruding, however normally the top incisors are in the correct position to the face and the lower jaw/teeth are set back in the face. Increased overjets may be associated with a narrow upper jaw or thumb sucking habit. Narrow upper jaws and relatively small lower jaws are best corrected again during growth spurts (age 10-14, younger for girls, slightly older for boys). Increased overjets can be corrected in adults but involve more tricky orthodontic mechanics as there is no growth potential.
Spacing or gaps between the teeth are either due to small teeth, large jaws, or missing teeth (hypodontia). Your orthodontist will do a full assessment to determine the cause of the gaps and then make a patient specific plan for you.
Missing teeth affects 5% of the population. The most common missing teeth are 2nd premolars and upper lateral incisors. Orthodontic treatment options for missing teeth are either to open the space for replacement teeth (bridges, implants or dentures) or close the space. For missing upper lateral incisors, if spaces are closed, you may need some small fillings and reshaping of the canines to camouflage them as lateral incisors.
The treatment plan will depend on a number of factors: crowding, remaining baby teeth, position and shape of the jaws, face, smile aesthetics. Your orthodontist will help create a treatment plan for you taking into consideration all of the above and your personal preference of long term maintenance of the spaces. Often, we need to involve your general dentist or specialist prosthodontist with the treatment plan as they would be involved with replacing the teeth or reshaping them as needed after the braces are removed.
Impacted upper adult canines or canines that are developing in the incorrect position affect 2% of the population. Assessment for impacted canines should be done at age 10 by your dentist. If the canines cannot be felt under the gum at this age, an orthodontic referral is necessary to see where the canines are. Simple orthodontics can be done at this age to improve the position of the adult canine. This might involve extraction of the baby canines or widening of the top jaw to make more room for the developing canines. If the canines do not erupt by themselves, a small surgical procedure might be needed to expose the developing canine and then an orthodontic brace fitted to help move it into the correct position. This is done routinely but is a complex orthodontic procedure and can take a long time. Early intervention is best. If you are worried about impacted canines, book in with your orthodontist at age 10 for an assessment.
A crossbite most commonly involves the upper teeth biting inside the bottom teeth (normally the upper teeth bite outside of the bottom teeth). If left uncorrected, it can lead to wear on the enamel surfaces of the teeth. Crossbites can be due to crowding, a small upper jaw, large lower jaw or asymmetric growth of the jaws. If this affects the incisors, it is one of the orthodontic problems that can be corrected early (interceptive treatment, age 7-10) to limit or reduce the need for orthodontic treatment later. This might be done with a short course of fixed braces, a removable brace or a fixed expander brace. Speak to your orthodontist to discuss the options.
Open bite is the increased vertical distance between the upper and lower incisors. It can be due to a habit like thumb sucking, a prominent resting position of the tongue or vertical growth patterns of the jaws. Your orthodontist will do a full clinical examination to assess the underlying factors and then create a treatment plan for you.
A softer diet is recommended when you have braces are on your teeth (soups, scrambled eggs, minced meat, chicken, pasta, rice, noodles, salads, softer fruits). You can generally eat most foods, you may just need to cut them up smaller, take your time and eat gently on your back teeth (eg apples, carrots). Opt for softer breads rather than hard baguettes. Avoid chewing gums, hard sweets, sucky sweets.
When the braces are in place, you are more at risk of dental decay especially on the front teeth. To reduce the risk, you should brush your teeth for 3 minutes 3 times per day with a Fluoride toothpaste (containing 1450ppm Flouride) and you should rinse with a high strength Fluoride mouthwash for 1 minute once a day (Flourigard, made by Colgate) at a different time to when you are brushing your teeth.
You also need to actively cut down on sugary food and drinks especially. Drink water, milk or tea with no sugar routinely. Do not drink fizzy drinks, fruit juices, mix cordials with water (even the no added sugar ones) or sports drinks regularly. One fruit juice or smoothie is allowed with breakfast. Special occasions are ok as a treat. Dr Sinead and Dr Christine will keep a close eye on your brushing and diet and will let you know how you are doing or if you needed to tweek your techniques/dietary habits a little. We also recommend that you see your general dentist every 6 months even though you are seeing us every 6 weeks or so.
Braces tend to be sore after they are initially fitted. This can be managed with pain killers such as paracetamol and ibuprofen. It is normally a pressure pain rather than a toothache pain. The braces may rub on the cheeks or lips and cause ulcers. Ulcers tend to heal within 7-10 days as the skin in the mouth hardens up and gets used to the braces. Much like wearing in a new pair of shoes. We will provide you with special orthodontic wax to cover the brace for when you do get some ulcers. Ulcers occur more at the start and less so throughout the treatment. Teenager take about 2 weeks to adjust fully to the brace and adults take about 2 months.
Braces are stuck to the teeth with a small amount of dental glue or composite but they are not unbreakable. The wires we use can bend or break if put under too much pressure. Removable braces will break if constantly being clicked in and out and not kept in their retainer box when out of the mouth.
You need to be careful with your brace. This means eating gently and taking your time, avoid hard, chewy foods or biting pens or nails. Breakages mean teeth don’t move as smoothly as they are supposed to and ultimately leads to longer time in treatment for you.
If you are worried about your brace being broken, just give us a call and we will guide you through what best to do. If it is a loose bracket, and it is not causing any pain, it can sometimes be left until your next appointment. If a wire is long and hurting the gum, then you might need to pop in the practice where we can fix this for you.
Because we are a specialist orthodontic practice, there is an orthodontist there every day to help you and are staff are trained to manage orthodontic emergencies. You are generally seen on the same day as you have a problem. There is no waiting around if you are in trouble!
When taking part in contact sports, your teeth and jaws are at a greater risk of trauma. Mouthguards reduce the risk of trauma to the teeth and act as a cushion to reduce the risk of concussion if you get a bang to the jaws. A good fitting mouthgard is very important. When you have braces on, your teeth are constantly moving so getting a perfectly fitting mothgaurd is difficult. At Navan Orthodontics, we sell special orthodontic mouthguards that fit over the braces. If you play lots of contact sports, it may be an option to get a custom made mouthgaurd a few months into your treatment after the larger tooth movements have taken place. After your braces have been removed, we recommend getting a custom made mouthguard fitted specifically for your mouth. These will protect your new teeth and smile but also has the huge benefit of fitting better so they are more comfortable to wear and easier to breath and communicate with them in.