Phase I, or early interceptive treatment, is limited orthodontic treatment before all of the permanent teeth have erupted. This treatment is sometimes recommended to make more space for developing teeth, correction of crossbites, overbites, and underbites, or harmful oral habits. Usually the treatment consists of limited braces and or appliances that are designed to help correct specific bite problems. This usually occurs between the ages of six and ten.
Phase II treatment is also called
comprehensive treatment because it involves full braces when all of the
permanent teeth have erupted. This usually occurs between the ages of
eleven and fourteen.
Braces use steady gentle pressure to gradually move teeth into their proper positions. The brackets that are placed on your teeth and the arch wire that connects them are the main components. When the arch wire is placed into the brackets, it tries to return to its original shape. As it does so, it applies pressure to move your teeth to their new, more ideal positions.
Treatment times vary on a case-by-case
basis, but the average time is two years. Actual treatment time can be
affected by rate of growth and severity of the correction necessary.
Treatment length is also dependent upon patient compliance. Maintaining
good oral hygiene and keeping regular appointments are important in
keeping treatment time on schedule.
The placement of bands and brackets on your teeth does not hurt. Once your braces are placed and connected with the arch wires you may feel some soreness of your teeth for one to four days. Your lips and cheeks may need one to two weeks to get used to the braces on your teeth.
No. It is recommended, however, that patients protect their smiles by wearing a mouth guard when participating in any sporting activity. Mouth guards are inexpensive, comfortable, and come in a variety of colors and patterns.
No. However, there may be an initial period of adjustment. In addition, brace covers can be provided to prevent discomfort.
Yes, you should continue to see your general
or pediatric dentist every six months for cleanings and dental checkups.
Wire / Brackets
Band & Loop (B&L)
Elastics (Rubber Bands)
The part of your braces which actually moves
the teeth. The arch wire is attached to the brackets by small elastic
donuts or ligature wires. Arch Wires are changed throughout the
treatment. Each change brings you closer to the ideal tooth position.
Brackets are the “Braces” or small attachments that are bonded directly to the tooth surface. The brackets are the part of your braces to which the dentist or assistant attaches the arch wire.
Occasionally, a bracket may come loose and
become an irritation to your mouth. You can remove the loose bracket and
save it in an envelope to bring to the office. Call the office as soon
as possible and make an appointment to re-glue the bracket.
A Band & Loop is routinely used to hold space for a missing primary (baby) posterior (back) tooth until the permanent tooth can grown in.
At some time during treatment, it will be
necessary to wear elastics to coordinate the upper and lower teeth and
perfect the bite. Once teeth begin to move in response to elastics, they
move rapidly and comfortably. If elastics (rubber bands) are worn
intermittently, they will continually "shock" the teeth and cause more
soreness. When elastics are worn one day and left off the next,
treatment slows to a standstill or stops. Sore teeth between
appointments usually indicate improper wear of headgear or elastics or
inadequate hygiene. Wear your elastics correctly, attaching them as you
were told. Wear elastics all the time, unless otherwise directed. Take
your elastics off while brushing. Change elastics as directed, usually
once or twice a day.
These are used to help modify the growth of
the jaws in children. The theory behind their action is that if you hold
a jaw in a specific position long enough, that it will grow into that
position. What you usually get is a combination of a little jaw growth
with a lot of tooth movement. These are not universally accepted, as
they do not always work.
Often called a “night brace”. The headgear
is used to correct a protrusion of the upper or lower jaw. It works by
inhibiting the upper jaw from growing forward, or the downward growth of
the upper jaw or even by encouraging teeth to move forward, if that is
Another appliance designed to encourage the lower jaw to grow forward and “catch up” to upper jaw growth.
A lower lingual arch is a space maintainer
for the lower teeth. It maintains the molars where they are, it does not
move them. This is fabricated by placing bands on the molars and
connecting them to a wire that fits up against the inside of the lower
teeth. It keeps the molars from migrating forward and prevents them from
blocking off the space of teeth that develop later. This is used when
you have the early loss of baby teeth or when you have lower teeth that
are slightly crowded in a growing child and you do not want to remove
any permanent teeth to correct the crowding.
Poor positioning of the teeth.
Types of Malocclusion:
The alignment and spacing of your upper and lower teeth when you bite down.
Types of Occlusion:
O rings, also called A-lastics, are little
rings used to attach the arch wire to the brackets. These rings come in
standard gray or clear, but also come in a wide variety of colors to
make braces more fun. A-lastics are changed at every appointment to
maintain good attachment of the arch wire to the bracket, enabling our
patients to enjoy many different color schemes throughout treatment.
An appliance which is placed in the roof of the mouth to widen the upper dental arch. The maxilla, or upper dental arch, is joined in the center by a joint, which allows it to be painlessly separated and spread. Temporarily you may see a space develop between the upper two front teeth. This will slowly go away in a few days. Once this has occurred, the two halves knit back together and new bone fills in the space.
Care of appliance: Brush as usual. Brush the
appliance and roof of the mouth thoroughly. Rinse often to clean any
food lodged between the arch and appliance.
A plastic or rubber donut piece which the
dentist uses to create space between your teeth for bands.
You will be shown the proper care of your braces when your orthodontic treatment begins. Proper cleansing of your mouth is necessary every time you eat. Teeth with braces are harder to clean, and trap food very easily. If food is left lodged on the brackets and wires, it can cause unsightly etching of the enamel on your teeth. Your most important job is to keep your mouth clean. If food is allowed to collect, the symptoms of gum disease will show in your mouth. The gums will swell and bleed and the pressure from the disease will slow down tooth movement.
BRUSHING: You should brush your teeth 4-5 times per day.
Look in a mirror to see if you have missed any places. Your teeth, brackets and wires should be free of any food particles and plaque.
Note: If your gums bleed when brushing, do not avoid brushing, but rather continue stimulating the area with the bristles. Be sure to angle your toothbrush so that the area under your gum line is cleaned. After 3 or 4 days of proper brushing, the bleeding should stop and your gums should be healthy again.
FLOSSING: Use a special floss threader to floss with your braces on. Be sure to floss at least once per day.
FLUORIDE RINSE OR GEL: May be
recommended for preventive measures.
Clean the retainer by brushing with
toothpaste. If you are wearing a lower fixed retainer be extra careful
to brush the wire and the inside of the lower teeth. Always bring your
retainer to each appointment. Avoid flipping the retainer with your
tongue, this can cause damage to your teeth. Place the retainer in the
plastic case when it is re-moved from your mouth. Never wrap the
retainer in a paper napkin or tissue, someone may throw it away. Don't
put it in your pocket or you may break or lose it. Excessive heat will
warp and ruin the retainer.
If elastics (rubber bands) are worn
intermittently, they will continually "shock" the teeth and cause more
soreness. Sore teeth between appointments usually indicate improper wear
of headgear or elastics or inadequate hygiene. Wear your elastics
correctly, attaching them as you were told. Wear elastics all the time,
unless otherwise directed. Take your elastics off while brushing. Change
elastics as directed, usually once or twice a day.
Please feel free to contact the office if
you are experiencing any discomfort or if you have any questions. Below
are a few simple steps that might help if you are unable to contact us
or if you need a “quick fix”.
Occasionally, a glued bracket may come
loose. You can remove the loose bracket and save it in an envelope to
bring to the office or leave it where it is, if it is not causing any
irritation. Call the office as soon as possible in order for us to allow
time to re-glue the bracket.
If a wire is poking your gums or cheek there
are several things you can try until you can get to the office for an
appointment. First try a ball of wax on the wire that is causing the
irritation. You may also try using a nail clipper or cuticle cutter to
cut the extra piece of wire that is sticking out. Sometimes, a poking
wire can be safely turned down so that it no longer causes discomfort.
To do this you may use a pencil eraser, or some other smooth object, and
tuck the offending wire back out of the way.
Please be careful to avoid hard or sticky
foods that may bend the wire or cause it to come out of the back brace.
If this does happen, you may use needle nose pliers or tweezers to put
the wire back into the hole in the back brace. If you are unable to do
this, you may clip the wire to ease the discomfort. Please call the
office as soon as possible to schedule an appointment to replace the
Some brackets have small hooks on them for
elastic wear. These hooks can occasionally become irritating to the lips
or cheeks. If this happens, you may either use a pencil eraser to
carefully push the hook in, or you can place a ball of wax on the
hook to make the area feel smooth.
You may be experiencing some discomfort after beginning treatment or at the change of wires or adjusting of appliances. This is normal and should diminish within 24-72 hours. A few suggestions to help with the discomfort:
Cypress TX Pediatric Dentist Dr. Michelle Lin & Orthodontist Dr. Daniel Le. Serving patients in the surrounding cities and suburbs of Cypress, Texas.
Copyright © 2008 Michelle Lin, D.D.S. and Daniel Le, D.M.D. All Rights Reserved.
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