Orthodontic FAQ

Most people have lots of questions when they get braces. Here are the questions we get asked all the time. If your question isn’t answered below, please call our office. We’re here to help!

The American Association of Orthodontists (AAO) recommends an orthodontic screening for children by the age of seven years. At that age, the teeth and jaws are developed enough for a dentist or orthodontist to see if there will be any serious bite problems in the future.

Most of the time treatment is not necessary at age seven; however, an evaluation at this age gives parents and the dentist time to watch the development of the patient and decide on the best mode of treatment. When you have time on your side you can plan ahead and prevent the formation of serious problems.

Research has shown that serious orthodontic problems can be more easily corrected when the patient’s skeleton is still growing and flexible. By correcting skeletal problems at a younger age we can prepare the mouth for the eventual eruption of the permanent teeth. If the permanent teeth have adequate space to erupt they usually come in fairly straight. If the teeth erupt fairly straight their tendency to get crooked again after the braces come off is diminished significantly.

After the permanent teeth have erupted–usually from age 12 to 14–complete braces are placed for final alignment and detailing of the bite. Thus the final stage of treatment is quicker and easier on the patient. This phase of treatment usually lasts from 12 to 18 months and is not started until all of the permanent teeth have erupted.

Doing orthodontic treatments in two steps provides excellent results. It allows the doctor to avoid removal of permanent teeth and jaw surgery. The treatment done when some of the baby teeth are still present is called Phase 1. The last part of treatment after all the permanent teeth have erupted is called Phase 2.

If treatment is not immediately required, a follow-up appointment will be scheduled at either six or 12 months to monitor the child’s growth and dental development. Most children are simply monitored until the majority of their permanent teeth have erupted before initiating orthodontic therapy. This protocol limits the child to one phase of orthodontic treatment and reduces both the total treatment time and the cost of orthodontic treatment.

A number of factors can contribute to poor tooth positioning or crowded teeth:

  • Heredity
  • Extra teeth
  • Large teeth
  • Missing teeth
  • Wide spacing
  • Small jaws
  • Thumb sucking
  • Tongue thrusting
  • Premature loss of baby teeth
  • A poor breathing airway caused by enlarged adenoids or tonsils

Teeth naturally move in response to light pressure over time. We can apply pressure by using orthodontic hardware (AKA appliances). The most common appliance is a brace or bracket attached to the teeth and connected by an arch wire.

The periodic changing of these arch wires puts pressure on the teeth. Most orthodontic appointments are scheduled four to six weeks apart to give the teeth time to move. At different stages of treatment your child may also need to wear a headgear, elastics, a positioner or a retainer.

When teeth are first moved, discomfort may result. This usually lasts about 24 to 72 hours. Patients report a lessening of pain as the treatment progresses. Pain medicines such as acetaminophen (Tylenol) or ibuprofen (Advil) usually help relieve the pain.

Malocclusion is the technical term for teeth that are poorly positioned.

There are three types of Malocclusion
Class I: This is where the bite is okay (i.e., the top teeth line up with the bottom teeth), but the teeth are crooked, crowded or turned.
Class II: This is where the upper teeth stick out past the lower teeth–sometimes called an “overbite.”
Class III:This iswhere the lower teeth stick out past the upper teeth. This is also called an “underbite.”

This term refers to the alignment and spacing of your upper jaw and lower teeth when you bite down.

There are several types of occlusion:

  • Openbite refers to an anterior opening between upper and lower teeth.
  • Overbite refers to a vertical overlapping of the upper teeth over the lower.
  • Overjet refers to a horizontal projection of the upper teeth beyond the lower.
  • Crossbite is when the top teeth bite inside the lower teeth. It can occur with the front teeth or back teeth.

O rings, also called A-lastics, are little rings used to attach the arch wire to the brackets. These rings come in standard gray or clear, but also come in a wide variety of colors to make braces more fun. A-lastics are changed at every appointment to maintain good attachment of the arch wire to the bracket. If you want to try out different color schemes throughout your treatment, we can make it happen.

A separator is a plastic or rubber donut piece which the dentist uses to create space between your teeth for bands.

When you have braces, it’s easy for food to get trapped in your appliance’s brackets and wires. That’s a problem if the food is allowed to stay there; it can cause unsightly etching of the enamel on your teeth. It can also give you bad breath. It can further cause gum disease. And if that happens, and your gums are swollen and bleeding, your teeth won’t move as quickly. That means you’ll have to wear your braces even longer!

You can avoid all these troubles by simply keeping your mouth clean. Once your orthodontic treatment begins, we show you how to properly care for your teeth while you’re wearing braces.

Mostly, it comes down to this: You’ve got to clean your mouth thoroughly every time you eat.

BRUSHING: You should brush your teeth four to five times per day.

  1. Brush back and forth across……between the wires and gums on the upper and lower to loosen any food particles.
  2. Next, brush correctly as if you had no brackets or appliances on.
  3. Start on the outside of the uppers with the bristles at a 45-degree angle toward the gum and scrub with a circular motion two or three teeth at a time using ten strokes, then move on.
  4. Next, do the same on the inner surface of the upper teeth.
  5. Then go to the lower teeth and repeat steps one and two.
    Look in a mirror to see if you have missed any places. Your teeth, brackets, and wires should be free of any food particles and plaque.

Note: If your gums bleed when brushing, do not avoid brushing, but rather continue stimulating the area with the bristles. Be sure to angle your toothbrush so that the area under your gum line is cleaned. After three or four days of proper brushing, the bleeding should stop and your gums should be healthy again.

FLOSSING: Use a special floss threader to floss with your braces on. Be sure to floss at least once per day.

FLUORIDE RINSE OR GEL: May be recommended for preventive measures.

Clean your retainer by brushing it with toothpaste. If you are wearing a lower fixed retainer, be extra careful to brush the wire and the inside of the lower teeth. Always bring your retainer to each appointment. Avoid flipping the retainer with your tongue because this can cause damage to your teeth.

Place your retainer in its plastic case whenever you remove it from your mouth. Never wrap your retainer in a paper napkin or tissue–that’s how a lot of retainers get tossed in the trash can! Don’t put your retainer in your pocket or you may break or lose it. Also, excessive heat can warp and ruin your retainer.

When you don’t wear your elastics (rubber bands) consistently, it basically “shocks” your teeth and causes more soreness. Sore teeth between appointments usually signals improper wear of headgear or elastics or inadequate hygiene. Wear your elastics correctly, attaching them as you were told. Wear your elastics all the time, unless otherwise directed. Take your elastics off while brushing. Change elastics as directed, usually once or twice a day.

Does all this get annoying? After a while, yes. But as you follow these directions, keep telling yourself, “This is helping me get straighter teeth and a better-looking smile!”

Unless you want more trips to the dentist and a longer time of wearing braces, avoid sticky foods like:

  • Caramels
  • Candy bars with caramel
  • Fruit Roll-Ups
  • Gum
  • Candy or caramel apples
  • Skittles
  • Starbursts
  • Toffee
  • Gummy Bears

Also, avoid hard or tough foods such as:

  • Pizza crust
  • Nuts
  • Hard candy
  • Corn chips
  • Ice cubes
  • Bagels
  • Popcorn kernels

Afraid you’ll starve? You won’t. You can cut the following foods into small pieces and chew with your back teeth:

  • Apples
  • Carrots
  • Corn on the cob
  • Pizza
  • Pears
  • Celery
  • Chicken Wings
  • Spare Ribs

Still have questions? Schedule an Appointment or give us a call.

Please feel free to contact the office if you are experiencing any discomfort or if you have any questions. Below are a few simple steps that might help if you are unable to contact us or if you need a “quick fix”.

Occasionally, a glued bracket will come loose. You can remove the loose bracket and save it in an envelope to bring to the office or leave it where it is, if it is not causing any irritation. Call the office as soon as possible in order for us to allow time to re-glue the bracket.

If a wire is poking your cheek or gums, try these temporary solutions until you can get to our office for an appointment.

  • Put a small ball of wax on the wire that is causing the irritation.
  • Use a nail clipper or cuticle cutter to cut the extra piece of wire that is sticking out.
  • Turn down or tuck the wire out of the way using a pencil eraser or smooth object until it no longer causes discomfort.


Hard or sticky foods can bend a brace wire and cause it to come loose. If this happens, you can try using a pair of needle nose pliers or tweezers to put the wire back into the hole in the brace. If you are unable to do this, you may clip the wire to ease the discomfort. Whatever you do, please call the office as soon as possible to schedule an appointment to replace the wire.

Some brackets have small hooks on them for elastic wear. These hooks can occasionally become irritating to the lips or cheeks. If this happens, you may either use a pencil eraser to carefully push the hook in, or you can place a ball of wax on the hook to make the area feel smooth.

Many new “braces-wearers” experience some discomfort after beginning treatment or at the change of wires or adjusting of appliances. This is normal and should diminish within 24 to 72 hours. A few suggestions to help with the discomfort:

  • Rinse your mouth with warm water, eat a soft diet, take acetaminophen (Tylenol) or ibuprofen (Advil) as directed on the bottle.
  • Chewing on your sore teeth may make them feel sorer at first, but help them adjust faster.
  • If the pain persists more than a few days, call our office.