Orthodontic FAQ

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Orthodontic And You

Orthodontics and You This web page is designed to help you - the parent, or the patient, to have a better understanding of orthopedic and orthodontic therapy. It covers such items as diagnostics, treatment time, and cost, and provides many helpful suggestions.

Orthopedics To the lay person the name maxillo-facial orthopedics can be very confusing. In simple terms it means changing the size, shape, and relationship of the bones of the face and jaws. In most cases this correction can be accomplished with functional removable orthopedic appliances as opposed to surgery. Lost or destroyed appliances will result in an additional laboratory charge. Orthodontics Most of us understand that the term orthodontics means the movement and correct alignment of the teeth. This change in tooth position is usually best accomplished with fixed or permanent braces. Unfortunately, removable orthopedic appliances can make remarkable corrections in the patient's bony problems, but they do not align the teeth well. Conversely, fixed conventional braces can align the teeth quite nicely, but they have difficulty correcting bony problems. It is for these reasons that your dentist may use a combination of both of these techniques to properly solve a problem. New invisible porcelain braces are available to make the orthodontic portion of the treatment less obvious. There is, however, an additional cost for this type of orthodontic appliance.
Diagnosis The first step in treating your child is to fully understand the nature of the problem. In order to arrive at a proper diagnosis the dentist will take a series of records. These include study casts of your child's teeth, photographs of the face, x-rays of the teeth and jaws, and a single x-ray of the skull called a cephalometric radiograph.
	Once the doctor has all of this information, he or she can diagnose the exact cause of your child's problem. It is important for you, the parent, to understand that the improper alignment of dental units is usually more complex than just "crooked teeth." The dentist must not only straighten the teeth, but must also establish balance and harmony within the jaws, face and the temporomandibular joint.
Treatment The exact type of treatment that will be required to correct your child's problem will obviously depend upon the information that was gained from the diagnosis. However, we can divide therapy into four categories. They are functional orthopedic therapy, extraction therapy, surgical therapy, and fixed appliance therapy. In order to eliminate confusion, let's briefly define these four concepts of treatment. Functional Orthopedic Therapy: When a removable orthopedic appliance is used to correct jaws that are growing improperly. A different form of appliance may be required to treat different growth problems. Extraction Therapy: When the removal of permanent teeth is required in order to correct an orthodontic problem. This technique is used very selectively as it is usually in the patient's best interest to maintain all of the permanent teeth if possible. Surgical Therapy: Just as the name implies, this procedure is reserved for those patients whose bony imbalance has progressed to the point that only surgical intervention can correct the problem. Fixed Appliance Therapy: This is the conventional appliance technique using fixed braces. The appliance is attached to each individual tooth for precise positioning of the teeth. It should be noted that quite frequently two or more of these techniques are combined in order to achieve the desired results. Your dentist will explain to you the type of treatment that can best correct the patient's problem.
Who is Responsible? The treatment of your child is a cooperative effort. It is very important that everyone involved understands his or her responsibilities in order for the treatment to be successful. Also the overall cost of the therapy is directly related to the child's compliance.
The Dentist - The role of the dentist is to recognize the patient's problem and to select and apply the appropriate therapy. The Patient - It is the patient's job to faithfully wear the appliance and to follow the instructions of the doctor. The Parent - It is the responsibility of the parent to see that the child is wearing the appliance and following the appropriate instructions of the doctor.
This relationship is called the "triangle of success." When everyone does their job correctly, the results will be astounding.
Let's Get Under Way!	Now that we have a basic understanding of the problem and the treatment, let's get down to the "nuts and bolts" of every day therapy. Most cases require between two and three years of active treatment to correct. This means that discipline is important. All appointments must be kept. If you fail to keep appointments, then the treatment will be longer and more expensive for the patient. No one is a winner. If appointments and instructions are honored then the treatment goal is obtained quicker, easier, and cheaper. Everyone benefits. Don't forget the triangle for success!!!!!
Removable Orthopedic Appliances We have already stressed the need for cooperation. Beyond this there are some pointers that can be very helpful. Cleaning: Both the appliance and the teeth must be cleaned regularly. Any of the commercial denture cleaners work quite well when used on a daily basis to clean the appliances. However, some patients will build up a white coating on the appliance that is difficult to remove by soaking. "Lava" soap and an old toothbrush will easily remove this deposit. Be Careful!! Do not bend any of the wires while brushing the appliance.
	Lost Appliances: Most removable appliances are lost as a result of the patient removing them for eating. An appliance box with the name and address of the patient is furnished by the doctor. If, however, the appliance are not placed into the box, they can easily be lost. The patient or parent should never wrap the appliance in a tissue or napkin. If this occurs they are easily discarded as trash and lost forever. Appliances are no different than eye glasses. They must be properly cared for!!! A second major cause of loss is the household dog. Dogs love the smell and taste of an appliance after it has been in a patient's mouth. They will chew on it or even bury it much like they would a bone. Keep the appliance and the box well out of reach of the family pet!!! If an appliance is lost or destroyed the doctor must pass the expense of replacement on to the patient or parent. Appliance therapy is not extremely expensive if patients and parents are responsible.
Fixed Appliances The most important fact to remember about fixed appliance therapy is hygiene. If the patient does not keep the appliances clean, either decay or a change in tooth color will result around the braces. The patient must brush after every meal being careful to clean around each individual tooth. In addition, an irrigation cleaning with fluoride should be performed after breakfast and just prior to bed. The standard plaque controlling fluoride mouth wash can be added to the water reservoir or used after irrigation. If these rules are observed, no damage will occur to the teeth or gums as a result to orthodontic therapy. A second major factor in appliance care is diet. Orthodontic appliances are very delicate instruments and can be easily damaged by improper diet.	Sticky foods such as gum and candy must be avoided. In addition, hard items such as ice, nuts, or chips can break the appliance away form the tooth. Common sense dictates that careful attention to eating habits can speed treatment and reduce the cost of orthodontic therapy. If elastics are required as part of the therapy, they should be worn exactly as requested by the dentist. All rubber bands should be exchanged for new ones every twelve hours. If the rubber band supply becomes low, please contact the dental office for an additional supply.
Watch Your Diet!	Avoid Sticky Foods Candy Gum Avoid Hard Foods Ice Nuts Chips
Retainers There are a number of different kinds of retainers. The doctor will select the particular type of retainer that is best suited for each patient. No matter what type of retainer that is used, it is extremely important that it be worn according to the doctor's recommendations. Everyone has too much invested to let a few careless months spoil the results. Don't Forget that triangle for success!!!
Common Questions As with anything that is new and unfamiliar, many questions always arise. The following are the most common. If you do not find an answer to your question be sure to ask the dentist. The more that you understand about the treatment, the better it will progress. Q What causes the problem in the first place? A No one knows the exact cause of every orthodontic problem. Some causes are very evident, such as thumb sucking. Most are much more complex . However, the old cliche' that the patient inherited daddy's teeth and mother's jaw is simply not correct. Q Why do my child's teeth look so large? A The teeth do not change in size once they are formed. In a normal relationship the face and jaws grow fast enough to accommodate the erupting permanent teeth. It is when this balance becomes disrupted that orthodontic problems start to occur. Q Are teeth ever actually too large for the patient's mouth? A Yes. However, this is not a common occurrence. Incidentally the teeth can also be too small for the patient's face and jaws as well. Q Is early treatment always best? A Not necessarily. If the patient's problem is growth related then it certainly is wise to begin therapy early. The majority of problems fall into this category. However, if the problem is simply "crooked teeth", the dentist may advise you to delay treatment until all of the permanent teeth have developed into the mouth. Q Can my child be treated with only removable appliances? A Not usually. Sometimes all of the permanent teeth will correctly align themselves following orthopedic therapy. Everyone should be prepared to complete the second phase of treatment which is orthodontic therapy with fixed braces. Q What will the treatment cost? A In most situations the doctor can provide you with a reasonable estimate of the expenses involved. If you have any questions regarding the fee by all means ask the doctor. Q Will my insurance cover the cost of braces? A As with all insurance the amount of coverage will vary from policy to policy. Most policies have a maximum age limit as well as a maximum "life time" total. The average insurance policy will usually pay about 40% of the total amount with the patient being responsible for the remainder. Be sure and consult the information booklet that came with your insurance policy for specific details. Q Do children "talk funny" with appliances in their mouth? A Only for a short period of time. The speech pattern will quickly adapt to the appliance when they are worn full time. Q When can my child take the appliances out? A Only when eating and brushing. There are certain exceptions such as singing in a choir, but these should be discussed with the dentist. There are also certain malocclusions that it's best to eat in the appliances.
It's the goal of everyone concerned to create beautiful smiles, beautiful faces,and teeth that will last a lifetime. The time and expense that is required to attain this goal is a nominal investment compared to a lifetime of rewards.