Introduction

Orthodontics is devoted to building beautiful smiles by bringing teeth, lips, and jaws into proper relationship. Straight teeth function better, are easier to clean, and are likely to last a lifetime.  When left untreated, many orthodontic problems become worse. Orthodontic treatments to correct the original problem is often less costly than the additional dental care required to treat more serious problems that can develop in later years. The value of an attractive smile should not be underestimated. A pleasing appearance is a vital asset to one’s self-confidence. A person's self-esteem often improves as treatment brings teeth, lips and face into proportion. In this way, orthodontic treatment can benefit social and career success, as well as improve one’s general attitude toward life.

Treatment Guideline

1. First Visit

Our objective is to make sure your visits with us will be pleasant and informative. Your initial appointment will consist of an examination and a discussion of potential treatment options. This important visit will address the orthodontic needs of you or your child.

Please assist us by providing the following information at the time of your first visit:

·         Any x-rays (if applicable)

·         A list of medications you are presently taking

·         If you have medical or dental insurance, bring the necessary completed forms. This will save time and allow us to help you process any claims.

Please alert the office if you have a medical condition that may be of concern (i.e. diabetes, high blood pressure, artificial heart valves and joints, rheumatic fever, etc.) or if you are on any medication (i.e. heart medications, aspirin, anticoagulant therapy, etc.)

Broken Appointments: If for some reason you cannot make it to your appointment, please contact our office at 86-010-5785-3689. By doing so you allow another patient to use that time as well as reschedule your appointment.

2. Diagnostic Records & Treatment Planning

If it is determined that treatment is indicated, you will be scheduled for diagnostic records. These records usually consist of study models, diagnostic photographs and orthodontic x-rays. Once these orthodontic records have been obtained, our orthodontists will review them and determine a specific treatment plan for your orthodontic needs. Then our office will give you a call to review your treatment plan, set up the necessary appointments to begin your orthodontic treatment and set up financial arrangements for you.

3. Successive Visits

Periodic visits are an important part of orthodontic treatment. Generally, we will want to see you every 4 to 8 weeks to check your progress and make adjustments to your braces. During this time, you will need to keep appointments, follow instructions, eat nutritiously and practice good oral hygiene. Also continue to visit general dentist if necessary.

Once your braces are removed, retainers are utilized to hold your teeth in their new positions until your bone, gums and muscles adapt to the new teeth positions. The retention period is an important part of your overall treatment and should not be neglected!

4. Length of Treatment

Braces may be on between 6 months to 30 months or longer depending on the age of the patient, the severity of the problem, the patient's cooperation and the degree of movement possible.

5. Dental Care

Before any orthodontic treatment, general dentist should make certain that all cavities have been treated and the health of your gums and underlying bone are free of periodontal disease.

In addition, general dentist or an oral surgeon will remove any teeth that our orthodontists prescribed to correct your bite. General dentist should also schedule cleaning and cavity checkup visits during your orthodontic care. We would like to reinforce the need to keep your regular visits with general dentist.

Please contact our office if you have any questions. The timing of your treatment is very important. You or your child may or may not be ready for treatment. Therefore, a consultation will allow us to better understand your needs.

Treatment Information

1. Treatment Timing

Our orthodontists provide orthodontic treatment for adults, adolescents and children. We follow international guidelines by recommending that an orthodontic evaluation take place at age 7 for all children. This early evaluation can help to determine the best time to begin any necessary treatment.

Many growth modification treatments are now available for patients 7 to 11 years of age, that provide significant benefits, especially when jaw irregularities are present. These treatments may also prevent certain conditions from worsening. Treating children with these types of problems during their growth stages allows our treatment to achieve results that may not be possible when face and jaw bones have fully developed. This early treatment can simplify or eliminate additional treatment for the child.

2.Braces

How do braces straighten crooked teeth? 

Braces use constant, gentle pressure, which over time, move teeth into their proper positions. Your braces are at work every moment of your orthodontic treatment. The two main components of your braces are: the brackets that are placed on your teeth and the main archwire that connects them. The bracket is a piece of shaped metal or ceramic that we affix to each tooth. The archwire is bent to reflect your "ideal" bite. In other words, it reflects the way we want you to look after treatment.

The wire threads through the brackets and, as the wire tries to return to its original shape, it applies pressure to 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.

Attached to your braces, elastics (rubber bands) exert the proper force that creates the right amount of pressure to move teeth. In order for this force to remain constant, elastics must be worn all the time and changed every day.

Different Types of Braces

(1) Traditional Metal Braces:

Traditional metal braces are used to be the most popular with kids and teenagers. They love using different colors of ligature ties. These braces are much smaller than ever before.

In the "old days", metal braces were not just brackets, but bands that wrapped around the entire tooth. Today, metal brackets can be boned to the surface of each tooth, which is a big improvement in orthodontic field!  The bands are now only reserved for back teeth (molars) or teeth with large fillings.

The metal brackets are very strong and can withstand most types of treatment.  They require an o-shaped band, or metal tie wire (thin wire which is twisted around the bracket) to hold the arch wire onto the bracket.

However, the traditional metal braces are not very comfortable and require more frequent visits for regular adjustment comparing with modern self-ligating metal braces.

(2) Modern Self-ligating metal braces:

Self-ligating metal brackets are now the most popular brackets for kids and teenagers.  It has a special-designed part which can hold the arch wire in place or release it off the bracket through opening or closing movements. This lets the archwire move smoothly through the brackets to create efficient, comfortable tooth movement, which decides several outstanding advantages of self-ligating braces:

·           Fewer appointments needed to apply braces or to make adjustments

·           Increased comfort because of low-profile brackets and no ties

·           Efficient tooth movement for shorter treatment time

·           High-tech archwire design and creation

There are several types of self-ligating brackets according to their different design of “self ligature” part, which can be a built-in “sliding door” or “special clip”. Damon-Q braces from American Ormco company is a typical reprehensive of “sliding door” design; Bio-Quick braces from German Forestadent company is a reprehensive of “special clip” design.

(3) Ceramic Braces:

Translucent clear ceramic braces are the most popular with adults. You have to be very close to someone to be able to see them. Yet, because they are a ceramic material, they are more fragile. Quite often, we will put ceramic braces on the top teeth and metal braces on the bottom.

Ceramic brackets are made of tooth-colored material and generally do not stain. Adults prefer ceramic braces because they "blend in" with the teeth and are less noticeable than metal braces.

The ligatures (little o-shaped rubber bands) that hold the arch wire onto the ceramic brackets can also be clear, which really looks great at first, but the ligatures can stain, especially when you eat a lot of curry, drink a lot of black coffee, or smoke. While, it's only the ligatures that stain, not the brackets themselves, and the ligatures are changed each time you get an adjustment -- usually, monthly, therefore the stained ligatures won’t be a big issue.

(4) Ceramic Self-ligating Braces:

Cosmetic self-ligating brackets are now also available. It improves the appearance of people who wear the brackets, and also has all the advantages that self-ligating brackets should have. If you are interested in them, please ask our orthodontists.

Among all of the aesthetic or cosmetic braces or techniques, including lingual braces and Invisalign, ceramic braces have the largest range of indication, actually they can be used in any cases for which conventional metal braces are suitable; meanwhile the patients will not have to suffer any extra discomfort compared with the conventional metal braces.

(5) Lingual Braces:

Lingual braces are mounted behind a patient's teeth.  Generally, lingual braces are more uncomfortable than standard braces. In addition, some people have trouble talking with lingual braces. Presently, lingual braces are only used in special clinical cases.

3.Headgear

Orthodontic headgear is a very important part of the treatment for some patients. Headgear creates forces that guide the growth of the face and jaws. It also is used to move teeth i, nto better positions or to prevent teeth from moving.

Maintaining constant use of your headgear will achieve the best results. If instructions on usage are not followed, treatment will take longer and our treatment plan may have to change.

·         Always be careful when removing your headgear. If the headgear is removed carelessly, the part that fits in your mouth and attaches to your teeth could injure your lips, cheeks, face and possibly your eyes.

·         Never remove the headgear until the straps have been disconnected.

·         Never lift the headgear over your face.

·         Never wear the headgear when running or playing sports.

Take your headgear with you to every appointment. If it becomes soiled, our orthodontists will tell you how it should be cleaned.

Your teeth may be tender for the first few days of wearing your headgear. This tenderness will disappear as you adjust to the new pressures.

Let our orthodontists know if you continue to be uncomfortable for more than a few days. Wearing headgear is necessary for your treatment. Follow the instructions exactly, and you will complete your treatment without any changes in your treatment plan.

4.Functional Appliances

Removable appliances require care. Although you may notice an effect on eating and speaking along with an increase in the flow of saliva, you will eventually adjust to the appliance.

5.Retainers

Once the active period is completed, your braces are removed. The next step is called retention. Retainers are utilized to hold your teeth in their new positions until your bone, gums, and muscles adapt to the new teeth positions. You must wear your retainer as instructed, otherwise your teeth may move toward their original positions and the benefit of wearing your braces will be lost.

Our orthodontists will determine how long you need to wear your retainer. Time varies with each patient. Some people may need retainers for an extended period of time in order to eliminate shifting of the teeth. In some cases, permanent retention may be necessary.

The retention period is an important part of your overall treatment and should not be neglected!

Remember, wear them in your mouth, not in your pocket. Retainers work when you follow our instructions.

Clean your retainers! After meals, clean all parts of the retainer with a brush.

Handle your retainers with care. Retainers are easy to lose. If you take your retainers out, always place them in your retainer case for safety.

Home Care

1. Braces

Check braces once a week for anything loose or bent. If a bracket or band comes loose or you break a wire, please call our office so that we can arrange an appointment long enough to repair it. If you lose your rubber bands, call us so we can mail you some more or drop by the office and pick some up.

2. Sore Teeth

After braces are placed in the mouth it is normal for the teeth to be sore for about 2 or 3 days. Tylenol or Ibuprofen (unless allergic or contraindicated) will help relieve this discomfort. Some irritation to the cheeks and tongue is normal, but if you feel anything sharp is poking you or any sores are developing, please call our office at 86-010-57853689.

3. Elastics

Attached to your braces, elastics (rubber bands) exert the proper force that creates the right amount of pressure to move teeth. In order for this force to remain constant, elastics must be worn all the time and changed every day. Any time missed in wearing your elastics will only make your treatment take longer, so remember these things:

You are responsible for placing the elastics on your braces between appointments. Make sure to wear them as instructed. Remove them only when brushing your teeth, gums and braces after meals. Then put them back on immediately.

Always carry a few elastics with you, so if one breaks you can replace it right away. If your supply is low, call the office and we will mail you an additional supply of elastics.

If you forget to insert your elastics one day, don't double up the next day — just follow your regular instructions.

Elastics become worn out. When they lose their elasticity, they don't provide the proper pressure on your teeth and jaws. It is very important to change them as directed, even when they are not broken.

If your elastics break frequently, a wire or band loosens, or a hook breaks off — call our office immediately. Don't wait until your next appointment. These problems need to be corrected as soon as possible!

4. Brushing

You will notice that it is much harder to keep your teeth clean with braces. Food compacts in the brackets and between your teeth, and can only be removed by brushing and flossing. If plaque remains on the teeth for any length of time, it will leave a permanent white scar on the surface. Brushing after meals should become part of your daily schedule. Use a soft toothbrush with firm pressure and brush at a 45-degree angle to the tooth; brush in small circles above and below the brackets. Your toothbrush will wear out faster because of your appliances, so be sure to replace it whenever the bristles start to fray. A Waterpik can be a useful addition but it cannot remove the sticky plaque that adheres to the teeth. Interplak toothbrushes are great. Flossing is important and should be done every day. The floss threaders are reusable.

Here are some important details about brushing and flossing:

Brush after every meal.

Use a toothbrush with a small amount of toothpaste.

Use circular, vibrating motions around the gum line for about 10 seconds on each tooth.

Brush every tooth slowly.

Brush the lower teeth up and the upper teeth down. Also brush your tongue and the roof of your mouth.

Floss nightly after brushing to remove the plaque missed by brushing.

Carefully pull waxed floss between wire and braces.

Floss carefully around the braces.

Floss carefully around the gum area.

Floss around each tooth.

5. Eating Habits

Please do not eat hard foods: nuts, ice, crisp taco shells, whole apples and carrots (cut them into pieces first), hard French bread crust and rolls, spareribs, corn on the cob (cut the corn off the cob before eating), and popcorn! These foods risk breaking brackets and wires. Also beware of nail biting and pen or pencil chewing habits, since these can damage your braces. Do not eat sticky foods: taffy, caramels, bubble gum, or sticky candy of any sort. Use common sense about most foods.

Absolutely No

Gum:

Sugarless or otherwise

Sticky Foods:

Caramels/Sugar Daddies/Starbursts/Caramel Apples/Sugar Babies/ Licorice Toffee/Tootsie Rolls

Hard Foods:

Nuts /Popcorn /Bagels /Apples /Corn on the Cob /Pizza Crusts /Carrots (uncooked) /Doritos

Minimize Sugar Intake

Eat Much Less:

Candy /Ice Cream /Cake/ Cookies /Pie /Foods with Sugar

Drink Much Less:

Pop /Drinks with Sugar

6. Removable Retainers and Appliances

The removable retainers and appliance is carefully designed to hold or move your teeth. , It is important that it is worn according to instructions and brought to each appointment. Wear your retainers or appliance at all times, even while you are asleep. It may be removed while eating, swimming, or playing vigorous sports activities. In two or three days your speech will return to normal with the appliance in place. Avoid flipping your appliance with your tongue. This can cause damage to your teeth or breakage of your retainers or appliance. New appliance may make your teeth sore for a day or two, especially after an adjustment. If you have a sore spot on your gums call our office so that we can adjust the appliance.

Clean your retainers or appliance by brushing it daily without toothpaste. Denture cleaner can be used for a more thorough cleaning. If you are wearing a bonded wire retainer behind your front teeth, be extra careful to clean the wire and the area around it. Flossing should be done every day.

Never wrap your appliance in a paper napkin or tissue and set it down on the table. You or someone else may throw it away. Don't put it in your pocket when playing or you may break or lose it. Whenever it is not in your mouth it should be in its plastic appliance case.

Keep your appliance away from dogs or cats as they love to chew on them. Avoid storing them near any source of heat. Do not boil your retainer to sterilize it!

An additional charge will be incurred for lost or broken appliances.

First Aid- Emergency Care

If a wire causes irritation, push the wire away from the area using the eraser end of a pencil or a Q-Tip. If the wire cannot be tucked away, cover the end of the wire with a small piece of wax, a cotton ball, or a piece of sugarless gum until you can see our orthodontists for an adjustment.

If the main wire has come out of the tube or pipe on your back molar tooth, attempt to reinsert the wire with a pair of needle-nosed pliers or tweezers. If the wire is not sticking you, place a piece of wax over the area.  If the wire is sticking you and wax does not help, the wire can be cut with a small wire cutter or toenail clipper close to the back of the last brace. This is a last resort if professional help is unavailable.

In case a rubber spacer falls out, take two pieces of dental floss and insert them through the spacer. Pull on both pieces of floss to stretch the spacer, and then slide the spacer back and forth between the two teeth where it belongs. Once the bottom half of the spacer slips under the tight spot between the teeth, release and remove the floss and the spacer will fit back properly.

If a bracket becomes loose, it usually remains connected to the main wire by a little rubber colored ring. Eyebrow tweezers can be used to reposition the brace if it flips around the wire and becomes a source of irritation. Call our office and inform us of your situation.

If a piece of your braces breaks, save the piece and call our office to schedule a repair visit.

Remain calm if you swallow a piece of your appliance. This will usually go into the stomach, passing out of the body in a bowel movement. However, should difficulty breathing be experienced you should seek immediate medical attention. X-rays will be taken to determine the location of the swallowed piece.

If a retainer cracks, remove the retainer from your mouth and bring all the pieces to our office for professional repair.

Take Aspirin, Tylenol or Ibuprofen (unless allergic or contraindicated) if your teeth are sore after a monthly visit.

Rinsing your mouth with a cup of warm water and teaspoon of salt can also be soothing. If you teeth get sore suddenly in the middle of the month, give us a call. It is unusual for the teeth to get sore several weeks after your last office visit.

If food becomes stuck between your teeth, use dental floss or a proxy brush to dislodge the food.

If you cut your gums, tongue or the inside of your cheek, apply finger pressure to the bleeding site for several minutes. If the bleeding does not clot, call your orthodontist or general dentist.