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Frequently Asked Questions

We hope that the information on our site can help you understand orthodontics and give you some information about treatment. Here are the answers to some questions that have not been covered in other areas.

Q1. What conditions can benefit from orthodontic treatment?

General conditions such as:

  • difficulty with chewing or biting
  • speech difficulty
  • grinding or clenching of teeth
  • jaws that shift or make sounds.

There are also specific conditions of the teeth or bite that can be improved by orthodontic treatment:

  • Crowding - This happens when too many teeth emerge in too little space on your jaw. Some teeth are pushed backwards, forwards or to the side. Crowded teeth can be difficult to clean, with higher risk of decay or damage.
  • Protruded teeth - This is when the top front teeth emerge from the jaw and grow forward as well as down. These teeth can be more prone to damage. The lower front teeth can also grow too far up out of the lower jaw, and damage the palate behind the top teeth.
  • Under bite - The lower front teeth protrude beyond the top teeth, which can cause uneven wear of the front teeth.
  • Deep bite - The top front teeth cover the lower teeth. This can cause too much wear on the front teeth and gum damage behind the top front teeth.
  • Open bite - This happens when some teeth don’t meet when the jaws are closed. This can cause eating problems, speech difficulties, and too much wear on the teeth that do meet.
  • Cross bite - The top teeth should fit just outside the lower teeth, like the lid on a box. If the upper jaw is too narrow, the lower jaw may swing to one side, meaning that the top teeth on one side sit outside the lower teeth, but on the other side they don’t. This can cause uneven wear on the teeth.
  • Missing teeth - Where teeth are missing, orthodontic treatment can move the remaining teeth into the correct position so that the missing tooth can be replaced.
  • Thumb sucking - Sucking the thumb or fingers can move teeth and the supporting bone out of their proper place.

Q2. When should I see an orthodontist, and when should treatment start?

  • Children
    Orthodontic problems can usually be seen by the age of nine, when most of the adult front teeth have emerged from the jaw. Your dentist may find an orthodontic problem even earlier. Seeing an orthodontist as early as possible means they can look at any problems and make plans for treatment, even if the treatment does not start straight away. In most cases, treatment starts as soon as the last baby tooth has been shed, usually in the early teens. Starting treatment early may stop more serious problems from developing and/or make treatment at a later age shorter and less complicated. Early treatment may also achieve results that are not possible once the face and jaws have stopped growing.
  • Adults
    The basic process of moving teeth is the same, so adults can see an orthodontist and start treatment at any age. Because an adult's facial bones are no longer growing, some severe conditions cannot be corrected with braces alone. In these cases, orthodontic treatment combined with jaw surgery can achieve dramatic improvements.

Q3. Do I need a referral to see an orthodontist?

No, there’s no need for a referral - you can contact an orthodontist directly. Of course, your own dentist may suggest that you visit an orthodontist.

If you haven't seen your dentist for six months then your orthodontist will ask you to have a check up before treatment begins. Your orthodontist will be happy to send information about your treatment to your dentist.

Q4. Are there any risks I need to know about or any limits to what orthodontic treatment
can achieve?

Like all medical or dental procedures, there are risks to orthodontic treatment. Complications are rare, and they are usually minor. We still believe you should be aware of them before you make any decisions about your treatment. They include:

  • Root Shortening
    Treatment can shorten the roots on the teeth. It is nearly impossible to predict whether you will be susceptible to this. However, shortening of a tooth’s roots rarely has significant long-term effects on the tooth’s vitality.
  • Jaw Joints
    Occasionally, people can suffer pain or dysfunction in the temporomandibular joints (TMJs). These are the joints that hold the upper and lower jaws together. Stress is one of the main causes of problems with the TMJs, and some people are prone these problems, whether or not they have orthodontic treatment. Discomfort may last from a few days to several weeks. If it continues, your orthodontist may recommend that you consult a specialist in joint disorders.
  • Tooth Vitality
    Teeth may have nerve damage from decay, large fillings or from being knocked in an accident. Orthodontic treatment moves the teeth, and this might aggravate any nerve damage. In rare cases this could lead to loss of the tooth’s vitality and discolouration.
  • Atypical Growth
    During treatment, the jaws may grow too little, too much, or unevenly. This might limit our ability to achieve the results we have planned for your teeth, and treatment might need to be extended to do so. Growth of the jaws after your orthodontic treatment may also affect the results that have been achieved, and more treatment may be needed. In some cases, the bite may change so much that oral surgery is needed to achieve the best possible result.

Q5. Why does orthodontic treatment time sometimes last longer than anticipated?

Estimates of treatment time can only be that - estimates.

Patients grow at different rates and will respond in their own ways to orthodontic treatment. The orthodontist has specific treatment goals in mind, and will usually continue treatment until these goals are achieved.

Patient cooperation, however, is the single best predictor of staying on time with treatment. Patients who cooperate by wearing rubber bands, headgear or other needed appliances as directed, while taking care not to damage appliances, will most often lead to on-time and excellent treatment results.

Q6. Why are retainers needed after orthodontic treatment?

After braces are removed, the teeth can shift out of position if they are not stabilized. Retainers provide that stabilization. They are designed to hold teeth in their corrected, ideal positions until the bones and gums adapt to the treatment changes. Wearing retainers exactly as instructed is the best insurance that the treatment improvements last for a lifetime.

Q7. Will my child's tooth alignment change later?

Studies have shown that as people age, their teeth may shift. This variable pattern of gradual shifting, called maturational change, probably slows down after the early 20s, but still continues to a degree throughout life for most people.

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 incisor (front) teeth. Wearing retainers as instructed after orthodontic treatment will stabilize the correction. Beyond the period of full-time retainer wear, nighttime retainer wear can prevent maturational shifting of the teeth.

Q8. What about the wisdom teeth (third molars) - should they be removed?

The main indication for the removal of wisdom teeth is inflammation or infection of the gums around them.  Careful studies have shown that wisdom teeth do not cause or contribute to the progressive crowding of lower incisor teeth that can develop in the late teen years and beyond. Your orthodontist, in consultation with your family dentist, can determine what is right for you.