Braces do more than create a perfect smile, though braces do that very well. Most people elect to get braces to straighten crowded teeth, and make themselves feel more confident. But there’s more to it than that.
I’ll list below a few conditions that braces corrects:
Overbite: upper teeth are far ahead of lower teeth
When this is excessive, braces can do much to improve someone’s appearance and function.
Underbite: lower teeth are in front of upper teeth
Correcting this greatly improves individuals’ appearance and improves the bite or how the teeth fit together.
Open bite: top and bottom teeth don’t overlap
Correcting this allows teeth to overlap properly and to bite into food in the front part of the mouth.
I hope these 3 conditions posted above help you understand that braces do more than straighten. Yes, braces allow ideal biting in the front and back of the mouth. So, you get a lovely smile — what most people originally seek — and a well-fitting bite — something that will give you life-long benefit.
Extracting teeth for braces isn’t nearly as common as 30 years ago. But, in certain cases, we still need to remove teeth.
The two main reasons to remove teeth are: 1) severe crowding, as in image above, and 2) very full profile (can’t close lips well). Every orthodontist is different, and each provider practices with at least a slightly unique philosophy — even relating to extractions. However, most orthodontists still remove teeth when they feel space must be created.
Before brackets were glued on teeth — an innovation adopted by most in the 1980s — orthodontists used to place bands on all the teeth (see image above with a real “metal mouth”).
These days, if any bands are used at all, bands are placed only around the very back teeth or molars (see image above with metal ring or band around back molar and regular braces on other teeth more in front). Placing bands took up lots of space, requiring orthodontists to remove teeth to create room for bands. This, along with a higher awareness of preserving (popular) full profiles, has driving down extraction rates.
So, yes, we still remove teeth. But not at the rate of orthodontists from the more-distant past. We will happily review other aspects of this question at a free consultation.
The short answer is it depends. When to bring your child to our office depends on a lot. Here are a few things the decision depends on: 1) What does your child think? Is he/she embarrassed or teased at school, for example? 2) Do you, the parent(s), feel the condition is serious? 3) How many permanent teeth are in? 4) How old is the child? I could list several other factors.
Early treatment — often referred to as phase I — isn’t recommended for every child. However, depending on the child’s situation, early or interceptive treatment can be very helpful, even if all baby teeth haven’t fallen out yet.
Usually, it’s best to bring your child to the orthodontist for treatment when all the permanent teeth are in (around 12 years of age). However, if Johnny sucks his thumb, is teased at school, or has a few more-serious tooth/orthodontic issues it may be advantageous to do a short phase of treatment early (before 12).
That is, whenever Johnny has at least a few permanent teeth in (usually around 7) it may be a good time to do a short phase of braces (usually 6-12 months long). But, as indicated earlier, we usually only do early treatment (usually braces, and expander, and sometimes both) on kids when there is something fairly alarming: buck teeth, sucks thumb, teased at school, etc (see image above). For phase I we create a clear treatment plan and achieve our goals in under one year. Please keep in mind that your child may still need additional treatment when all permanent teeth have erupted (around 12).
To determine if this type of early treatment is beneficial for your child, we will need to take records (pictures and x-rays). So, please call to schedule a (free) orthodontic consultation: 520-732-8631.
Do braces hurt? Yes. And no.
But to patients and parents, I try to never use the P or pain word. I also like to avoid the H or hurt word. Instead, I describe the discomfort someone is about to experience during braces as just that: discomfort. Not pain.
Wires move teeth. Once teeth begin to even subtly move, each now-moving tooth sends signals to our brain. Those signals are (unfortunately) nociceptive or interpreted as uncomfortable. Again, I avoided the use of the P (Pain) word.
Those negative signals are best handled by modifying one’s diet to soft things. In addition, thinking of other positive things and using your best attitude helps your sore mouth and teeth. The hurt won’t last for too long, though. Usually, after hours to days most of the discomfort passes. However, if the discomfort is sufficient or simply puts one in a cranky mood one hopes to avoid, I recommend Tylenol. I don’t advise on to be tough just for the sake of being tough. Yet, I don’t advise taking any type of medication until one feels he/she needs it.
Motrin is truly a better analgesic, but Motrin (as an effective anti-inflammatory) blocks the tooth-moving pathway — also involving the inflammatory process. So, to block pain, but to allow tooth movement to occur most efficiently I request parents provide Tylenol. If one does take Motrin it won’t absolutely stop Jimmy’s tooth movements. But it is true that progress will likely slow as Motrin will more greatly inhibit the inflammatory process involved with braces.
I hope this discussion makes sense and is helpful. Dyscomfort, unfortunately, is part of braces. And these 2 meds — Tylenol (our favorite during braces) and Motrin — can reduce common orthodontic pain or discomfort.
General dentists clean, repair, and replace teeth. Orthodontists study and practice 2-3 years longer than dentists to become specialists at braces and Invisalign.
Orthodontists studied a lot. An awful lot. And virtually all orthodontists excelled in their coursework and with patients. In other words, orthodontists usually graduated at the top of their classes. Orthodontists attended a college or university for at least 4 years. Then they trained in dental school for 4 years. Finally, orthodontic residency lasted another 2-3 years.
Orthodontists are specialists in the area of braces and aligners (Invisalign). Doing braces for 2-3 years in a residency setting after dental school — treating a huge variety of patients — before venturing into business is the best way to produce consistently great results in private practice. Once they complete school, orthodontists do braces every day, all day.
General dentists do amazing work, and sometime also do braces. Usually, general dentists spend most of their time filling teeth, cleaning teeth, making crowns, making dentures, placing implants, etc. This is what dental school trained them to do. General dentists did not attend a 2-3 year orthodontic residency after dental school.
If you’re thinking of getting braces or Invisalign from your general dentist please consider asking these questions to your (non-specialist) dentist:
- Do you ever refer cases to an orthodontist?
- Do you have cases that don’t go well that you pass on to the specialist/orthodontist to finish for you?
- Do you refer your kids to the orthodontist?
- How many cases have you finished that are similar to my teeth?
- How many cases did you do before you started practicing with braces and/or Invisalign?
Difference between Dentist and Orthodontist
• Dentists and orthodontists are both doctors of teeth and oral care. Yet, orthodontists are those dentists who have done an additional 2-3 year residency program in orthodontics.
- During this residency training (and before they see patients in their practices) orthodontic specialists have supervised 100s of braces and Invisalign patients.
- Many general dentists simply take weekend courses at hotels and immediately begin doing orthodontics and Invisalign.
• Less than 10% of dentists are qualified and licensed orthodontists.
*** Dr. Neal Jones attended BYU and graduated Magnum Cum Laude with a major in Zoology and minor in Business Management. He then spent 5 years in Iowa City: 4 in dental school and 1 year working in the Oral Surgery Department. Dr. Jones completed orthodontic training at the University at Buffalo’s 2.5-year highly rated orthodontic program, earning a Master’s Degree.