There are a lot of changes that has taken place in the field of orthodontics. The dental braces have evolved from their traditional form to many newer forms. There are many myths concerning the various kinds of braces. It is extremely important to search the most suitable dentist for you in terms of cost and quality of work. There are certain facts that one must be aware of before going ahead with orthodontic treatment. This article will be helpful to you with regards to the facts about braces. Getting braces is a matter of excitement for kids and it can be matter of concern for adults who are diagnosed by their dentist for braces. Yes the parents of kids and asw well as adults have lots of questions associated with braces. These questions range from type of braces, which dentist is good, cost of treatment, whether insurance will reimburse, pain in braces and duration of treatment. For this sometime we are not able to ask everything for our dentist and something or other is left and for this info we have to then browse on various dental websites. This article is an attempt at providing all the required info at one place to answer all the common questions in one’s mind.

1.   What should be age for going for braces treatment?

Everybody regardless of age can go for braces treatment. However most of the people feel that orthodontic braces are meant mostly for teenagers. This is one of the many myths related to dental braces. As a matter of fact, adults are going for dental braces in almost the same number as teenagers. The most important criterion for undergoing orthodontic treatment is that the teeth, gums and the underlying bone must be strong and healthy. If your teeth and gums are not healthy, there is absolutely no use of you going for treatment. If your gums and underlying bone structure and form are in a sound condition, the treatment will be able to bring out positive results. If not, the gums ill undergo recession and there are chances of tremendous bone loss leading to the worsening of the dental condition.  During orthodontic treatment, the braces exert a lot of pressure on the teeth to bring about tooth movement. If the bone material is already deficient, they might not be able to take up the pressure and bone loss gets accelerated causing lack of support to teeth and finally loosening of teeth.

Why do people wear braces even after they become adults? One of the main reasons is the poor financial condition in which their families were. When they were children their families were not able to afford braces for them. Now that they have become adults and started earning for themselves, they can make their dream come true by getting braces. As adults, we are keener to enhance our smile and oral health as we feel that a good smile gives a better confidence. Some adults may have undergone orthodontic treatment n their teenage but may have not worn retainers resulting in the relapse of the dental condition or other side effects. Some adults may need a jaw surgery followed by dental braces to rectify few oro-dental defects.

 You may have a query regarding the cost of dental braces. The traditional dental braces take a time span of 2 years for the treatment to get over. On an average, conventional braces or metal braces come around in a range of $3000 to $6000. The cost mainly depends on the area where you live. Esthetic modifications like ceramic braces come for a higher charge. Invisalign braces have either a higher or same charge as the conventional braces.  Payment can be done by paying off the initial amount and then finishing off the whole amount by paying off in monthly installments.

2.   What should I go for? Whether Functionality of teeth or Esthetics?

Esthetics and functionality of your teeth are equally important. According to most of us, braces can only straighten our teeth. As a matter of fact, braces serve many more purposes including straightening. There are many things an orthodontist looks for during a session of consultation. Few of them are-

     a)   Are your teeth in proper alignment?
     b)   Are they coming in contact with each other properly while chewing?
     c)   Is your tongue protruding out from your front teeth?
     d)   Do you have any sort of jaw ache or clicking sound?
     e)   Is there a lot of crowding or spacing in between your teeth?
     f)   Have you lost all your milk teeth?
     g)   Are your teeth and gums in a good shape?
     h)   Do you have a problem in breathing or in speech?

For an orthodontist, restoration of function is equally important as restoration of esthetics. He will make sure that your teeth are aligned straight and you are able to chew and speak properly at the end of the treatment span. The teeth of upper and lower jaw must come in contact at proper positions while opening and closing of mouth. After all, nobody would like to have TMJ problems after getting dental braces done.

3. Whom should I opt for my braces treatment? Whether my General Dentist or an Orthodontist?

You may always find your family dentist to be more comfortable to be with. He may have offered you a lower rate for getting braces done from him. In such a case, one may not be able to guarantee you success. There are many instances when people approached and had undergone orthodontic treatment from a dentist and were referred to orthodontist when the whole treatment went for a failure. An orthodontist is trained to deal with a variety of cases dealing with dental and skeletal problems. He has a better understanding about braces as he is better trained to deal with even complicated cases. It is always a safer option to go for a specialist instead of a general practitioner.  Failure in treating the case effectively leads to loss of time and money.  Orthodontists are trained to deal with issues related to tooth movement and functionality of the jaw; general dental practitioners are not. Nowadays, there are some new courses that have come up recently which teach and train dentists on topics like Invisalign. These are short term courses which cannot be equivalent to a specialist degree. It is similar to a case like heart surgery wherein a cardiologist is preferred over a general physician. To become an orthodontist, first a person completes his degree in a dental school and becomes a dentist. Then he attends another course on Orthodontics which takes a couple of years to complete successfully. In this course, the narrowing up of studies take place and the whole focus falls onto issues about tooth movement, functioning of the jaw, and restoration of facial aesthetics. After course completion, he has to appear for a particular exam to become Board Certified. When you select an orthodontist, see to it that he/she is Board Certified. This gives you an assurance that they have been trained totally and that they are professionally sound enough to take up your case and present high quality in their work.

Does this mean that a general dental practitioner is not efficient enough to do braces?

No,  if the patients have problems that can be corrected by simple tooth movement, general dental practitioners take up the case and have treated them successfully. Experience is what actually matters. You can just enquire from your dentist about the number of patients that have been taken up by him for braces. You must also enquire about how complex your case is. Only if you are completely satisfied with your dentist, should you proceed with the treatment. Getting braces is not a simple treatment. It needs your time and money. If the dentist is not able to rectify your problem, you will be referred to an orthodontist who will take your time and money again.

4. What is consultation fee of dentists for braces treatment?

Most of the people land up to an orthodontist when they are referred from their dentist, or from a friend or acquaintance. Generally there is no charge for a consultation. Consultations are normally free of cost! If you are not satisfied with one orthodontist, or want to get a second opinion, you can always feel free to do so. There is no harm in taking more than two opinions before selecting the one that you wish to continue with. Generally, people go for a second opinion when an orthodontist suggests that their teeth need to be removed or if the case is complex. Every orthodontist has his/her own way of treating a patient or dealing a case. You are always the best person to choose the orthodontist depending on the method of treatment and the amount charged for treatment.

During a session of consultation, an orthodontist will come to know about you by recording a proper case history and a thorough examination of your teeth and oral cavity. Towards the end of the session, almost every important detail is mentioned to you in an almost accurate manner, like-

     a)   The type of braces that will suit you
     b)   If there is any need for teeth to be pulled out
     c)   What is the span of the treatment?
     d)   How much will be the cost of the treatment?

Once you have confirmed your orthodontist, you will be asked to get the impression of your mouth done. Panoramic x-rays and, at times, photographs of your face from different aspects is taken. These records help the orthodontist develop a treatment plan that is suitable for you. Before developing a proper treatment plan, an orthodontist can provide you with answers that are mere guesses. Once he has prepared a treatment plan, he will be in a better state to explain exactly what is required to be done. At that time, you can get answers to all your queries in a detailed manner. So Don’t hesitate to go for a consultation because consultations are generally not chargeable or the charges are lower than routine consultation and say $25 or so.

5. What Type of brackets / braces I should opt for?

Choosing right type of braces is very important for successful braces treatment. Everybody can not fitted with any kind of braces. It depends / varies case to case. Invisalign or other "invisible braces" are not suitable for anyone and everyone. They cannot be termed as universal braces. There are certain specificities which decide who is going to be the candidate for Invisalign. Most adults opt for orthodontic treatment with a hope of getting Invisalign, but only a few of them are actually good candidates for the invisible aligners. The reason is that some defects cannot be rectified with Invisalign. Only conventional braces can deal with such cases. There are many modifications in traditional braces as well. Apart from the metal braces, there are other options like ceramic braces which are esthetic alternatives to the usual metal braces. You need to have faith in your orthodontist when he tells you that you are not a candidate for Invisalign or other type of braces other than traditional braces. It is always a good idea to ask the orthodontist the reason for not choosing you as a suitable candidate for Invisalign. Enquiries of such kind are not going to offend anyone and they can also give you a clear picture of the type of treatment that you will have to undergo.

Another important point to be considered is that orthodontists require particular training to apply some kinds of brackets. For example, the company that produces Damon brackets provides special training to an orthodontist so that he has better understanding for using them on his patients. Lingual (behind the teeth) braces are another example apart from Damon brackets. If your orthodontist has not attended the extra training sessions for these specific brackets, he will not mention about them to you.

It is the age of advertising and publicity. The companies producing orthodontic brackets and appliances are also spending extravagantly to make their position stable in the industry of dental materials. Only a good orthodontist can make you realize the fact that the technique and skills employed by an orthodontist decides the outcome of the treatment and not the brand of the brackets. Though, there are few newer versions of brackets available that have benefits because they are smaller in size so less conspicuous or don't need elastic "o-ring" ligatures. But that doesn't give them an upper hand on other types of brackets.

So don't get stuck to one kind of bracket or a single type of treatment. You need to have faith on your orthodontist. If you don't feel comfortable with his technique of treatment that has been previously explained to you, you can always go for a second opinion from another orthodontist, or go to one who offers the type of brackets of your choice.

6.   What is Usual Cost and duration of braces treatment

Cost of braces vary from place to place. Braces are one of the most expensive dental treatments. If your dental plan covers even a percentage of the charge of installation of braces, it would be of a great relief. The average cost of dental braces falls in the range of $3,000 and $6,000. The cost largely depends on where you live and what are the requirements of your case. The cost of Invisalign is usually quite similar to that of conventional braces, and at times even more. The treatment is more expensive in major cities than in rural or suburban areas. As the charge is high you will be asked to pay the bill off in installments. They charge you separately for impressions and panoramic x-rays. In the first visit of your treatment, you will have to pay an initial payment of about $1,000. If there is any balance amount, it is usually carried over to the next month where you pay the next installment.

If you pay off the full amount upfront in the first appointment or advance then you are eligible for some % of discount on your cost for all your treatment. Even though it sounds good, it is not a good idea. This is because you cannot predict the future. Some of the unlucky patients have bad experiences like their dental offices got closed due to heavy losses. Generally, there should be nothing to worry about as almost all orthodontists have financially stable dental offices. To have a payment plan is the most appropriate way to proceed with.

How long will the treatment with braces last? The duration depends on every single case as no two cases are alike. The average duration of treatment is two years (24 months). There are techniques for speeding up the tooth movement, but you need to research about them properly so as to get a clear picture about what exactly the treatment procedure comprises of.  There is one technique that takes only six months to accomplish the desired tooth position. During this technique one needs to undergo moderately painful jaw surgery. You should not jump into conclusions. Only after thorough research should you decide about your treatment technique. To cut short the duration of two years in braces, you may resort to some shortcuts which is not required actually as time flies. So it is advisable to go for better and safer option even if takes a little longer.

7. Reading all the terms and conditions of your braces contract is important?

Before starting off with your orthodontic treatment, your orthodontist will prepare a treatment plan, explain it to you and will ask you to sign a contract. Make sure that you have gone through the contract thoroughly. The contract has almost all the significant details, which includes terms of payment, what is the consequence of missing a payment, and your treatment charge covers the charge of retainers as well. If anything goes wrong during your treatment, your contract is an obligatory legal file and a great proof.  Even if you are not able to make payments in one or two months, your orthodontist is not going to discard you. If you get stuck in some deep financial trouble, discuss it with your orthodontist or his office manager. You can reach to some or the other solution for sure.

8. Do I need to stick with my Orthodontist for entire treatment period?

All of us, would like to stick to one orthodontist and continue with the treatment for the required time period till the treatment comes to an end. You get this feeling because of the contract signed by you that states the payment and the duration part of the treatment. But it is not necessary that everything happens the way we plan and there arrives such situations when we are bound to leave our place and move onto the next. You must have some facts clear regarding movement during treatment.

Firstly, you may be allowed to get a partial reimbursement for your treatment if it has not been totally paid off. That depends on the terms and conditions of your contract.

Secondly, once you reach a new city, you will have to find a new orthodontist and start off with the treatment. There is usually no discount for such patients and the treatment has to be started afresh. As a matter of fact, it can become a tough job for a new orthodontist to finish your treatment as different orthodontists have different techniques and principles yo deal with a given case. Ensure that you carry along the old records from your previous orthodontist so that the new orthodontist can understand the extent of progress of your treatment and start off from the point where the previous one has stopped. For some patients, the treatment charge may come less with a new orthodontist. Make up your mind and your account balance as you may need many more dollars to finish your treatment.

9. How important is Oral Hygiene with Braces? I am afraid of sticking food with braces.

When you are spending thousands of dollars and your precious time on your teeth then you should take good care of your teeth. There should be no compromise on the hygiene part. You must brush almost after every meal to keep your teeth clean while having braces. Even though it sounds quite monotonous and time taking, one gets used to it when it becomes a part of the routine. You are asked to brush your teeth quite often, because food debris get trapped between your brackets, which can be good breeding sites for cavity-causing bacteria and also cause bad breath. If you do not get time to brush after every meal, you can rinse your mouth thoroughly with water after eating.

Special toothbrushes like an orthodontic toothbrush can be used or a regular soft toothbrush can be used. Along with brushing you should floss at least once daily. It isn't easy, so products like floss threaders are available in the market that makes it easier. Your orthodontist can demonstrate you the correct method to brush and floss properly. While brushing, you should not use whitening toothpaste. Once you remove the brackets, the teeth will have two shades of white.

New devices like Waterpik act as a gum stimulator and dislodging trapped food particles. These devices cannot be a substitute for flossing. Read more on Oral Hygiene

10. Whether fixing of Braces will cause pain?

Initially wearing braces might hurt you. On the day of fixing the braces on your teeth, it won’t hurt; the pain and pressure is experienced only after a day or two. The pain in your teeth is due to the tooth movement. The brackets will poke the inner side of your gums and lips which will lead to mouth ulcers. This phase of pain lasts for only a couple of weeks. The best treatment for mouth sores is a thorough rinse of your mouth with warm salt water several times in a day. You can use a mouth rinse like Rincinol PRN which is easily available in the market. Take moderate painkillers like Tylenol or Motrin to get relief from the pain. Apply dental wax or a lip protector on braces. You will have diet restrictions like eating only soft foods and chewing very slowly and carefully. Read more on Braces Pian

11. Should I be cautious of allergies?

People have allergies of different kinds. Some are allergic to nickel which is present in some brackets and wires. Some people are allergic to latex that is present in o-ring ligatures, elastics, and examination gloves. Some other people are allergic to materials present in the plastic aligner trays and plastic retainers. If you are allergic or sensitive to any of such materials, inform your orthodontist or dentist. They will be able to arrange other substitutes which won't create problems for you. Allergies can develop all of a sudden to things that you are exposed to almost every day. If you find that your mouth sores caused by braces or retainers are not healing off and aggravating instead, or if you start experiencing upper respiratory symptoms or swelling, inform your orthodontist immediately. If you feel that your throat is swelling up, never take it lightly as this can be a life-threatening situation. Rush to your nearest Emergency Room. If you find yourself unable to breathe, call 911.

12. Do I have to wear retainers after braces treatment is over?

After the removal of your braces, your orthodontist will record an impression of your mouth and fabricate a pair of retainers. The type of retainer varies from case to case. Sometimes, orthodontists suggest a bonded type of retainer that will keep your teeth in the desired position permanently.

Apart from the permanent bonded retainer, the other two types that are easily available are-

A Hawley Retainer is made out of acrylic and metal. The acrylic forms the base and covers the back portion of your teeth and your upper palate; the metal wire runs along the front of your teeth restricting the tooth movement. This is the most commonly used and one of the most reliable kinds of retainer. Your orthodontist can "twist" the metal wire to make any minor adjustments to your teeth.

An Essix Retainer is made out of a clear plastic material and almost resembles an Invisalign aligner tray. This type of retainer has grown in popular demand, but it has its own drawbacks. Many orthodontists are of the opinion that since it covers the chewing surface of your teeth, they do not "settle" in an appropriate manner after treatment. For this reason, some orthodontists use a combination approach by giving a patient both the types of retainers: an Essix Retainer, which is to be worn during the day when they are facing other people, and a Hawley Retainer to wear at night while sleeping.

Whatever be the type of retainer, the most important fact is to wear it in the exact way as directed by the orthodontist. For most people, retainers are to be worn day and night for at least a period of 6 months, after which they are asked to wear it only at nights while sleeping.

For how long should you wear your retainer? The answer is forever. Your retainer is to inhibit your teeth from moving back into their old positions. If you stop wearing retainers there are high chances of relapse and the result is failure of previous treatment.

Take good care of your retainer. Keep them in a retainer case. Don't cover them in a tissue. This is the most frequent way by which retainers get discarded. A new retainer will come for about $250, so become responsible people and take care of them!

It is extremely important to keep your retainers clean. As your teeth get covered with deposits and plaque, your retainers will also undergo the same. You can use cleansing solutions like Retainer Brite, SonicBrite, or DentaSoak to keep your retainers clean. These products are not available in local shops. Brushing your retainers with a toothbrush and toothpaste can keep them clean to some extent. Read more on Wear Retainers after Braces Treatment

"So donot worry, braces is very common treatment and lot of kids as well as adults go for them. It is non surgical procedure and after completion of your treatment, your smile will be worth it. So go for them without worries…"

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