Orthodontics, Braces & Retainers

Orthodontics is a specialist form of dentistry which aims to straighten the teeth to produce a healthier bite. Treatment usually lasts around 18 months, although it will depend on the type of brace fitted and how much treatment is needed. Your orthodontist will explain your course of treatment to you and what you will need to do to keep your brace clean.

Although you will have regular check-ups with your orthodontist, it will be up to you to look after your brace on a day-to-day basis.

The majority of orthodontics is carried out on teenagers, but increasing numbers of adults are opting for orthodontics too. Your dentist will probably refer you to a specialist – an orthodontist – who will take examine and probably x-ray your teeth to see how best to straighten them.

While orthodontic treatment is usually free for children on the NHS, most adults will have to pay privately.

Crooked Teeth

Having crooked teeth or large gaps between your teeth can cause problems. Food and bacteria could get stuck between the teeth which could cause decay. Similarly, if your teeth stick out, this could cause problems, either with mouth ulcers and decay, or with speech problems. Your dentist might suggest that you have your teeth straightened through orthodontics – by wearing a brace.

Braces

The type of brace – or appliance – will depend on how much your teeth need to be straightened.
One of the most common is the fixed or ‘train track’ brace. The orthodontist will glue small metal or tooth-coloured blocks directly to each tooth, then run a fine wire through those blocks. Special elastic bands may then be added to help straighten the teeth. The wire and the bands are tightened and adjusted on a regular basis.
Another common type of brace is the removable brace. This is a special plate which either sits in the roof of the mouth or just under the tongue with a special wire that runs across the teeth to pull them into line.

A similar type of appliance is the retainer, this is used following the removal of the ‘train track’ type brace to make sure the teeth stay in position.

One of the newer types of brace is like a transparent cover for the teeth which, when adjusted regularly, has a similar effect as the other braces. This type of brace is proving popular with adults as it is barely visible.

Fixed braces

Fixed braces are often referred to as ‘train track’ braces. The orthodontist attaches metal or tooth-coloured brackets – small blocks – to the teeth and then runs a special wire over the brackets to pull the teeth into the right position. Because the brackets are stuck to the teeth, you won’t be able to take the brace off during your treatment.

When the brace is first fitted, it may feel strange and possibly uncomfortable. Because the brackets are raised, they may rub against the inside of your lips or cheeks. Your orthodontist will give you some special wax to prevent this rubbing which should make it more comfortable. You may also find that, for the first few days, your jaw aches because of the pressure of the brace. If this is the case, you may find a painkiller helps – the sort of thing you might take for a headache will be fine. If the discomfort lasts longer than a few days, though, you may wish to go back to your orthodontist, who can then readjust the brace.

Although you’ll still be able to eat most of the foods you were eating before, you will need to take care not to damage your brace. There are some foods that you’ll need to cut out altogether though:

• Toffees
• Chewy sweets, like marshmallows and Turkish Delight
• Hard foods, like crusty bread

With other foods, like apples, you might need to cut them up, but you’ll still be able to eat them.

Because your brace provides food with more places to hide, you’ll need to be extra careful with your hygiene routine. Brushing your teeth twice a day with a fluoride toothpaste is essential, and you may also find using a fluoride mouthwash last thing at night is helpful to protect your teeth while you sleep. If you don’t look after your teeth while you’re wearing your brace, they may become permanently stained.

As well as the brace itself, your orthodontist may attach elastic bands to it to increase the pressure on certain teeth. Some brace wearers customise their braces with coloured elastics.

Once the brace is taken off, you will need to wear a retainer brace which is removable.

Retainers

Once your fixed braces have been removed, you will need to wear a retainer to make sure the teeth don’t move back to their original position. You’ll probably need to wear the retainer for around six months – all the time at first, and then probably just at night. Your orthodontist will tell you when you can make this change – don’t be tempted to reduce your wear of the retainer yourself, as this could have an impact on your treatment.

Brushing your teeth twice a day with a fluoride toothpaste and keeping your diet healthy is important whether you wear a retainer or not, but you should be especially aware of cutting down on sugary snacks and fizzy drinks, as these may cause more damage to your teeth while you are wearing your retainer. You should take your retainer off when you brush your teeth but make sure you give it a clean too to get rid of any old food. If you are using your toothbrush, though, do be careful not to damage the retainer.

Even if your brace is removable, you should still wear it for the amount of time recommended by your orthodontist. Don’t be tempted to flick it in and out as, not only will this not help your treatment, it may also damage your retainer.