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What is orthodontics and what does an orthodontist do?
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Orthodontics is the specialization of dentistry that focuses on directing tooth movement and guiding facial development to improve the way your teeth work, the way you look - or both. An orthodontist is a specialist in the relationship of teeth to one another, in facial development and in the ways both affects dental function. Becoming an orthodontist requires completion of a four-year dental graduate program followed by a two- to three-year orthodontics residency.
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At what age should children have an orthodontic checkup?
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By age seven, enough permanent teeth have come in and enough jaw growth has occurred for an orthodontic checkup to be productive. A dentist or orthodontist can identify current problems, anticipate future problems and reassure parents if all seems normal. Crossbites, crowding and developing injury-prone dental protrusions can be evaluated, along with finger-sucking or other oral habits that affect the teeth. By age seven, enough permanent teeth have come in and enough jaw growth.
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What causes orthodontic problems (malocclusions)?
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Most malocclusions are inherited, but some are acquired. Inherited problems include crowding of teeth, excess space between teeth, extra or missing teeth, and a wide variety of other irregularities of the jaws, teeth and face. Acquired malocclusions can be caused by trauma, sucking on fingers or thumbs or pacifiers, airway obstruction by tonsils and adenoids, dental disease or premature loss of baby teeth or permanent teeth. Whether inherited or acquired, many of these problems affect not only alignment of the teeth but also facial development and appearance.
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What about wisdom teeth (third molars)? Should they be removed?
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If other teeth have not been removed for orthodontic treatment, there's a three-in-four chance that wisdom teeth could prove problematic. Removal of wisdom teeth, if necessary, usually takes place in the mid- to late-teen years. Your orthodontist, in consultation with your family dentist, can determine what is right for you.
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How can a child's growth affect orthodontic treatment?
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Orthodontic treatment and a child's growth often complement each other. Here's an example: If the upper front teeth protrude, the problem is often the result of a lower jaw that's shorter than the upper jaw. While the upper and lower jaws are still growing, orthodontic appliances can be used to help the growth of the lower jaw catch up to the growth of the upper jaw. A severe jaw length discrepancy, which can be treated quite well in a growing child, might require corrective surgery if left untreated until adulthood. Children who may have problems with the width or length of their jaws should be evaluated for treatment no later than age 10 for girls and age 12 for boys.
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What are the benefits of early treatment?
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When there are clear indications of future orthodontic problems, early intervention may be possible. The advantages of early treatment can be significant, providing opportunities to:- guide the growth of the jaw
- regulate the width of the upper and lower dental arches (the arch-shaped jaw bone that supports the teeth)
- guide incoming permanent teeth into desirable positions
- correct harmful oral habits such as thumb- or finger-sucking
- reduce or eliminate abnormal swallowing or speech problems
- improve personal appearance and self-esteem
- potentially simplify and/or shorten later orthodontic treatment
- reduce likelihood of impacted permanent teeth
- reserve or gain space for future permanent teeth
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How do braces feel?
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Most people have some discomfort after their braces are first put on or when the braces are adjusted. New braces may cause teeth to feel sore and tender when biting for three to five days. Patients can usually manage this discomfort well with whatever pain medication they take for a headache. The lips, cheeks and tongue may also be irritated for one to two weeks as they toughen and get used to the surface of the braces. Overall, orthodontic discomfort is short-lived and easily managed.
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Should sports activities be avoided?
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Having braces should not prevent you from carrying on normal daily activities. However some sports activities may increase your risk of falling and injuring your mouth and teeth. Tell your orthodontist about your sports activities. He or she may advise a mouth guard. Contact sports where injury to the jaws and mouth are common, such as boxing, should be avoided.
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Will I have to wear rubber bands on my teeth?
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Your orthodontist may want you to wear rubber bands. These are called elastics and are meant to apply forces to the teeth, helping to move them into the desired position. Your doctor will prescribe the right size bands for you and tell you how to use them correctly Incorrect use of elastics can do more harm than good.
If you fail to change the elastics as often as advised, your teeth may stop moving toward their target positions, prolonging your treatment. Old rubber bands also tend to snap off inside your mouth.
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Will talking be difficult?
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Most orthodontic braces do not interfere with talking. If your orthodontist prescribes a removable plate or retainer, however, you may find it difficult to speak clearly for the first few days until you get used to wearing it.
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Will I have to restrict what I eat while wearing braces?
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For the first few days after your braces are put on, it's a good idea to eat soft food. Throughout your treatment, you should avoid hard, crunchy and sticky foods such as hard candy, nuts and toffee. When you eat fruits like apples, make sure you cut them into pieces before eating.
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How have new high-tech archwires changed orthodontics?
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Today's braces are smaller and more efficient. The wires are no longer made solely from stainless steel but are alloys of nickel, titanium, copper and cobalt. Some wire materials are heat-activated, such as the nickel-titanium alloy originally engineered by NASA to automatically activate antennae or solar panels of spacecraft orbiting into the sun's rays. SureSmile's "smart" archwires, made from Shape Memory Alloy, return to their configured shape when subjected to body heat, causing the teeth to move steadily toward their target positions. The result may be fewer appointments to make adjustments.
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How are the braces removed?
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Once the treatment is completed, the orthodontist will use special pliers to remove the braces. There's no pain involved in removal.
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Why use a retainer?
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One of the greatest challenges in orthodontics is relapse, when the teeth go back to their original positions. Relapse can occur for a number of reasons. It's prevented by wearing a retainer to maintain the corrected position, especially during the first months after treatment while the bone and oral tissues are still adapting.
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How important is patient cooperation during orthodontic treatment?
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Successful orthodontic treatment is a two-way street, requiring consistent cooperation between the orthodontist and patient. To successfully complete the treatment plan, the patient must be willing to brush and floss diligently, wear rubber bands, use headgear or other appliances as prescribed by the orthodontist and keep appointments as scheduled. Damaged appliances can lengthen treatment time and may jeopardize the outcome of treatment. For teeth and jaws to respond to treatment, the patient consistently wear elastics as prescribed. To keep teeth and gums healthy, regular visits to the family dentist must continue during orthodontic treatment. Adults who have concerns about periodontal (gum) disease might also see a periodontist (gum specialist) during orthodontic treatment.
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Will my child's tooth alignment change later?
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Studies have shown that as people age, their teeth may shift. This variable pattern of gradual shifting, called maturational change, usually slows down after the early 20s, but subtle changes continue. Even children whose teeth developed into ideal alignment and bite without treatment may develop orthodontic problems as adults. The most common maturational change is crowding of the lower front teeth. Wearing retainers as instructed after orthodontic treatment will stabilize the correction.
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Can orthodontic treatment do for an adult what it does for children?
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Healthy teeth can be moved at almost any age. Many orthodontic problems can be corrected as easily and effectively for adults as children. Orthodontic forces move teeth the same way in a 75 year old adult as in a 12 year old. Complicating factors, such as lack of jaw growth, may present special treatment challenges. One in five orthodontic patients is an adult. The AAO estimates that nearly 1,000,000 adults in the United States and Canada are currently undergoing orthodontic treatment.
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How does adult treatment differ from that of adolescents?
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Adults have stopped growing and may have experienced some loss of the bone that supports the teeth. Treatment may require coordination between the orthodontist, oral surgeon, periodontist, endodontist and family dentist to assure that a complicated adult orthodontic problem is managed comprehensively
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Can orthodontic treatment help painful jaw muscles and jaw joints?
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Jaw muscle and jaw joint discomfort are commonly associated with bruxing - habitual grinding or clenching of the teeth, particularly at night. Bruxism is a muscle habit pattern that can cause severe tooth wear and overload or traumatize the jaw joints. Chronic or acute soreness and jaw pain may result. An orthodontist can help diagnose this problem. Your family dentist or orthodontist may prescribe a bite splint or nightguard appliance to protect the teeth and help jaw muscles relax, substantially reducing pain. Sometimes structural damage can require joint surgery and/or restoration of damaged teeth.
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What do the dentists' initials DDS and DMD mean?
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The initials DDS stand for doctor of dental surgery. The initials DMD stand for doctor of dental medicine. Both sets of initials refer to the degree awarded upon graduation from dental school. Both degrees have the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school are required to become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional postgraduate training is required to become a dental specialist, such as an orthodontist.
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