All About Braces

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What is Orthodontics?

Orthodontics is a specialty in dentistry which focuses on the alignment of teeth and the way teeth bite together, within the framework of the jaws and face.

Why do I need braces?

People have their teeth straightened for a variety of reasons - dental health, appearance, speech and chewing. Among these, dental health is most important. In certain patients, functioning with a traumatic bite over a prolonged period can cause irreversible damage to the teeth and/or gums. Crooked teeth are also usually more difficult to keep clean and this may give rise to tooth decay and gum disease.

When should I bring my child to see an orthodontist?

The American Association of Orthodontists (AAO) recommends a check-up with an orthodontic specialist no later than age 7.

When is the best time to start treatment?

This depends on the type of orthodontic problem.

For jaw-related issues, treatment generally starts while the child is still growing, often between the ages of 9 to 11 years.

For mal-aligned teeth not related to jaw problems, treatment can generally be delayed until all the baby teeth have changed to permanent ones. However, in some instances, treatment is best delayed until growth has ceased, especially if jaw surgery is indicated as part of the overall treatment.

There is no age limit for orthodontic treatment. Adults can also benefit from orthodontic treatment.

What are the different types of braces available?
Different types of braces are designed for different types of problems. The most ideal type(s) for you will be advised by the orthodontist, depending on your teeth and personal needs.

Fixed braces involve the use of small attachments (brackets) that are attached to the front of each tooth and connected by wires. These brackets can be made of metal or tooth-coloured ceramic. The brackets are secured with rubber bands – many patients look forward to customising their braces with the multitude of available colours!

Patient with metal brackets

Patient with ceramic brackets

Alternatively, there are self-ligating brackets which do not require rubber bands. Instead, these brackets utilise a "sliding door" mechanism to secure the wires.

Clear aligner therapy uses a series of removable clear plastic trays (aligners) to straighten the teeth. Each successive tray is designed to move the teeth gently towards the final position, provided the patient wears them all the time. The aligners are hardly noticeable when worn, and hence are the go-to option for those concerned with aesthetics.

Patient with clear aligners

Removable or fixed braces can also be used for simple problems in younger patients (usually under age 12). This is called interceptive treatment and aims to correct poor bite or jaw growth disharmony, facilitate the eruption of teeth that are stuck or eradicate bad habits such as thumb sucking.

Patient with a type of interceptive braces appliance

How long does treatment take?
Orthodontic treatment is a gradual process as we must ensure teeth are moved safely. With fixed braces, treatment duration generally takes 2 to 3 years. You will need to make time every 4 to 8 weeks to visit your orthodontist if you wish to finish your treatment well and on time.

How will braces affect my daily life?

Brushing with braces: For treatment to progress smoothly, you must maintain good oral hygiene. With braces on, your teeth are more difficult to clean. You should brush your teeth for 5 minutes every morning and night. You also need to brush properly after every meal and snack. Do not leave food on your braces. Otherwise, you will have a higher risk of decay and gum disease.

Have your toothbrush available to brush after meals as well as at your orthodontic visits.

Eating and diet restrictions: Eating hard food or biting on large pieces of food may dislodge the components of your braces and damage the wires. Avoid eating nuts and biting on fingernails or pencils. Do cut up your food into small pieces before eating.

Sweet and sticky food and drinks are harder to brush away and increase your risk of developing decay. It would be a good idea to avoid these while you are on braces.

Speech: With regular fixed braces, speech is normally not affected. However, if your condition requires any appliance to be fitted at the roof of your mouth, this may interfere with your speech.

Pain and discomfort: You may take around one week to get accustomed to your braces. Initially, you may get ulcers on your lips, cheeks and tongue due to irritation from the braces. As your teeth is starting to move, soreness is also expected.

During your subsequent visits for adjustment of the braces, you will also feel some discomfort for a day or two.

Playing musical instruments: If you play a musical instrument with a mouthpiece, it may take you one to two weeks before you adapt to playing it proficiently again.

What can influence the treatment result?

Poor oral hygiene: Inadequate brushing and flossing of your teeth increases the risk of tooth decay and gum disease.

Failing to comply with the use of braces and accessories is the most common cause of inferior results and increased treatment time.

Missed appointments result in unnecessary lengthening of treatment time. The quality of the treatment outcome may be affected.

What are the limitations and potential risks associated with braces treatment?

Like all medical and dental treatment, orthodontic treatment has certain limitations and potential risks that you should be aware of. Do ask questions at the consultation, before treatment starts.

Discoloured teeth, tooth decay, and gum disease: These are brought about by the lack of good oral hygiene during your braces journey. Initial decay can appear as white discolouration spots on the teeth. Your gums may also become swollen and inflamed if bacteria plaque is not removed daily.

Apart from good brushing habits, you should also visit your general dentist once every 4 to 6 months while on braces to have your teeth checked and cleaned.

Damage to the nerve of the tooth: Teeth that have been knocked before, or have larger fillings near to the nerve of the teeth, are at increased risk of needing root canal treatment. Orthodontic treatment on its own sometimes (but rarely) disrupts the nerve and blood supply of the teeth, such that root canal treatment may be warranted.

Root shortening: In most patients, the roots of the teeth will be shortened minimally during a normal course of treatment, and this is of no practical consequence. However, if the root shortening is rapid or extensive, it may become a threat to the longevity of the tooth, and orthodontic treatment may have to be stopped.

Relapse: Teeth always have a tendency to return to their original positions regardless of the duration of your orthodontic treatment - this is called relapse. The use of retainers helps to minimise this.

Abnormal growth and development: Growth disharmony and unusual tooth development are beyond the control of any dentist. If there is significant jaw discrepancy, surgical correction may sometimes be indicated as part of your overall orthodontic treatment.

Estimated charges and waiting time

  
Do note that these rates vary with seniority of orthodontist.