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braces and you

What is orthodontics?
Orthodontics is the branch of dentistry that specializes in the diagnosis, prevention and treatment of dental and facial irregularities. Braces are appliances or devices used to make these corrections.

Are braces necessary?
No. They are elective but people seldom grow out of the more severe problems.

What are the early warning signs of a bad bite?
Upper front teeth protrude or are "bucked" Top front teeth cover more than 25% of the bottom front teeth when the back teeth are biting together Top front teeth grow in behind the bottom front teeth A space exists between the top and bottom front teeth with the back teeth biting together Crowded or overlapped teeth or extra teeth Baby teeth are slow falling out The centers of the top and bottom front teeth don't line up Finger sucking habit continuing after 6 years of age Difficulty chewing Teeth wearing unevenly Jaws that shift off center when the teeth bite together Excessive spaces between teeth that persist after the top permanent canine teeth appear Teeth or smile often hidden by hands

When should I look for the early warning signs?
It is most important to examine your child's teeth as the permanent teeth grow in. Although children mature at different rates, there are some averages for permanent tooth arrival.

Will additional jaw growth allow self-correction of crowded teeth seen in an 8-year-old child?
No. The space available for the front teeth does not increase after the permanent 6 year molars erupt. In most people, the space available for the front teeth decreases with increasing age.

When should orthodontic treatment be started?
The most confusing question for most parents, and some general dentists, is when to actually start treatment. The objective is to treat at the time when it will minimize treatment time, achieve a normal profile, and get the best long term, stable result. Some orthodontic problems start developing at the age of 6 to 7 years, and it is usually a good time to get an initial consultation, especially if the parent or general dentist suspects that a problem may be developing. Though no active treatment may be initiated at this time in most cases, some problems may need to be intercepted to prevent them from later developing into complicated situations. An example of an indication to start early treatment is the presence of a cross-bite of the front or back teeth. However, if there are no unusual circumstances, the first visit to the orthodontist should be at the age of 11 years for girls and 12 years for boys.

What causes crooked teeth?
Heredity is the main cause although local factors such as finger sucking, high cavity rate, gum disease, trauma and premature loss of baby teeth can also contribute to a bad bite.

Why should I have my teeth straightened?
Poorly arranged teeth can break easily and can trap food particles that cause tooth decay and gum disease. They can also lead to poor chewing and digestion which can be bad for your overall health. Finally, poorly arranged teeth detract from your smile which is one of the more important features of your face.

How do braces straighten crooked teeth?
Braces use steady, gentle pressure over time to move teeth into their proper positions. They don't look like they're doing much just sitting there, but in fact, during every moment in your orthodontic treatment period, there's something happening in your mouth, something good for you. The brackets we place on your teeth and the main archwire that connects them, are the two main components. The bracket is a piece of specially shaped metal or ceramic that we stick on each tooth. Then we bend the archwire to reflect your 'ideal" bite- what we want you to look like after treatment. The wire threads through the brackets and, as the wire tries to return to its original shape, it applies pressure to actually move your teeth. Picture your tooth resting in your jaw bone. With pressure on one side from the archwire, the bone on the other side gives way. The tooth moves. New bone grows in behind. It may look like nothing is happening--but we're making a new smile here. Thanks to new materials and procedures, all this happens much quicker than ever before. It's kind of an engineering feat.

What do rubber bands do?
Rubber bands or elastics contribute a lot to straighter teeth. They are marvels of physics. Attached to your braces, elastics exert the energy force that creates the right amount of pressure to move teeth. It's important to wear your elastics all the time and change them every day so the force is constant, which is good for the teeth.

Will braces correct TMJ or jaw joint problems?
Braces may or may not improve jaw joint problems. More conservative approaches should be tried first.

How many people receive orthodontic care?
Approximately 4 million people are in braces in the USA at any one time. Statistics for India are currently not available.

Can you be too old for braces?
No. If the teeth and gums are healthy, age is not a factor. About 20% of orthodontic patients are adults. Dr. Joseph Varghese has successfully treated several patients over 40 years of age.

Will orthodontics change my lifestyle?
You'll have to give up extremely hard and sticky foods including gum. These foods can get caught on the braces and pull the braces off. And you'll have to spend a few extra minutes cleaning your braces after meals. But, for the most part, you'll find braces don't cramp your style. You'll still be able to sing, play your musical instrument, smile, play sports and of course, kiss.

Is orthodontic care expensive?
Well timed orthodontic treatment to correct a problem is often less costly than the additional dental care required to treat the more serious problems that can develop years later. Treatment charges vary depending on the type of orthodontic problem, the type of appliances needed, and the duration of the treatment. Orthodontic fees have not increased as fast as many other consumer products. Fees for an initial consultation are minimal.

When is the best time to schedule an initial consultation?
Early consultation allows the orthodontist to determine the optimum time for treatment to begin. In some cases, satisfactory results are unattainable once the face and jaws have finished growing. Seven years old is a good rule of thumb for a child unless you see a noticeable problem earlier. Early examination often permits maximum improvement with the least amount of time and expense.

Why should you choose an orthodontic specialist?
Teeth and sometimes faces are permanently changed by orthodontic treatment; therefore, it is very important that the treatment is done right the first time. An orthodontist has undergone years of specialized training in orthodontics, and dedicates his entire professional life to treating orthodontic problems only.

Do you need a referral from your family dentist to see an orthodontist?
You don't need a referral from your family dentist. Word of mouth recommendations from friends and families of existing patients is often the primary way orthodontists meet new patients. Spread the word if you like your orthodontist!

Getting Started:
• Your initial consultation will take a few minutes in the orthodontists’ office. Please call to make an appointment.
• You will be asked what you want to change about your smile and what questions do you have about braces.
• Your orthodontist will do a detailed examination of your face, jaws and teeth.
• Your orthodontist may recommend records (x-rays, photos and impressions of the (teeth) in order to plan treatment.
• Your orthodontist will try to answer the following questions: Can the problem be corrected? How long will it take? How much    will it cost? When should it begin? What kind of appliance or device will be used? What does the patient do for treatment to    succeed? What kind of final result can you expect? After active treatment, what do you need to maintain the results?
• Your orthodontist will tailor treatment specifically for you.
• Your orthodontist will indicate if other dental care is necessary before starting braces treatment.

What To Expect:
• Experiences similar to friends who have worn braces.
• Special instruction on how to clean your teeth with braces.
• Adjustment of your braces approximately every 4-6 weeks.
• Mild tooth soreness during the first week in braces and after adjustment appointments.
• A treatment time of 6-36 months depending on the complexity of treatment.
• A period of retainer wear will follow removal of your braces.
• A discussion of the effect of wisdom teeth on the orthodontic result.
• The degree of success is almost always a reflection of a person's cooperation during treatment and retention. Active patient    participation is always essential for success.

New Techniques:
• Space age low force wires that remember their original shape allowing teeth to move faster without kinking.
• New-generation low-friction self-locking braces.
• Clear, tooth-colored braces, and gold braces.
• Totally Invisible braces (Invisalign)
• Braces glued to teeth with adhesives that contain cavity fighting fluoride.
• Combined treatment of orthodontics and surgery for abnormalities that are beyond the capabilities of orthodontics alone

Preserving Your Smile:
• Brush after meals with a fluoride toothpaste.
• Minimize chocolates and confectionery which stick to your braces, are difficult to clean, and cause white spots   (de- calcification) on the tooth surface.
• Have your teeth examined and professionally cleaned by your family dentist at least once a year.
• Wear your retainer after your braces are removed, to keep your teeth from moving out of alignment.

First Aid for Braces:
• If a wire is causing irritation, try pushing the wire away from the area being irritated using the eraser end of a pencil or the    blunt side of a spoon. If the wire cannot be tucked in, cover the end of the wire with a small piece of wax, a cotton ball, or a    piece of chewing gum, and call us as soon as possible to fix the problem. Cutting the wire should only be done as a last resort.
• If your teeth are sore after an orthodontic appointment, take a pain-killer such as aspirin, paracetamol or ibuprofen unless    you are allergic to them. Rinsing your mouth with a teaspoon of salt dissolved in a glass of warm water can also be soothing.    If you teeth get sore suddenly in between appointments, give your orthodontist a call because it is unusual for the teeth to get    sore several weeks after your last office visit.
• If food becomes stuck between your teeth, use your toothbrush without using toothpaste, to dislodge the food particles.
• If a piece of your appliance breaks, save the piece and call your orthodontist to schedule a repair visit.
• If you swallow a piece of your appliances, try to remain calm. A swallowed piece will usually go either into the stomach or the    lungs. Most of the time it will go in the stomach and pass out of the body in a bowel movement. However, if difficulty    breathing is experienced, you should seek immediate medical attention. X-rays will be taken to determine the position of the    swallowed piece and your physicians will counsel you on your options concerning retrieval of the stray piece.
• If a retainer cracks, bring it to your orthodontist for a professional repair.
• If a permanent tooth feels excessively loose, call your orthodontist to discuss the movement. A little movement is normal    when wearing braces, but if a tooth can be pushed upward towards the gums with just finger pressure, that is unusual.

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