Orthodontics

Malocclusion is the technical term for teeth that don’t fit together correctly. Malocclusions not only affect the teeth, but also the appearance of the face. Most malocclusions are inherited; however some are due to acquired habits such as thumb sucking and tongue thrusting. The spacing left from an adult tooth being extracted or an early loss of a baby tooth can also contribute to a malocclusion.

Straighter teeth perform chewing, biting and speaking functions more effectively than crooked teeth. In addition, a straight smile boosts confidence, is aesthetically pleasing to look at, and can help stave off a wide variety of dental ailments.

There are several types of malocclusion including overbite, underbite, crossbite, and overcrowding. Each of these alignment problems negatively impacts the functionality and cosmetic appearance of the teeth.

Here is a brief overview of some of the main disorders associated with crooked teeth:

Periodontitis – Periodontitis or gum disease begins with a bacterial infection. The bacterial infection is caused by inadequate oral hygiene. Crooked teeth are hard to clean effectively, which means that debris, plaque and bacteria can build up in hard-to-reach areas. Straight teeth are much easier to clean and are at less risk of contracting gum disease.

Temporomandibular Disorder (TMJ) – Crooked teeth can lead to improper jaw alignment, which in turn causes a painful condition known as TMJ. Severe headaches, jaw pain, lockjaw and the grinding of teeth characterize this debilitating disorder.

Tooth injury – Straight teeth creates a strong wall, which means injuries are less likely to occur. Crooked teeth are weaker and often protrude, making them far more vulnerable to external injury.

Uneven wear – Crooked teeth cause some of the teeth to work harder than others when biting and chewing. Straight teeth share the workload evenly, meaning less risk of injury and better aesthetics.

Teeth can be straightened using either orthodontic braces or customized aligning trays. Orthodontic braces are usually affixed to the teeth for a set duration. The brackets and archwires are tightened regularly by the orthodontist and removed when treatment is complete.

Aligning trays are fully removable and are used where the malocclusion is less severe, and the teeth need to move a shorter distance. These trays are replaced every few weeks for the duration of the treatment, and have proven to be equally effective for straightening teeth.

Many children are ambivalent about getting braces. On the one hand, they like the idea of perfect teeth, but on the other hand they are nervous about whether the braces will cause pain and discomfort. The good news is that the placement of orthodontic braces is not at all painful, and the end result will be a beautiful straight smile.

Although patients of any age can benefit from orthodontic braces, they tend to work much quicker on pre-teens and teenagers since they are still experiencing jaw growth.

What Causes misalignment of teeth?

Poorly aligned teeth often cause problems speaking, biting and chewing. Misaligned teeth are prone to cavities, gingivitis, and periodontitis. Most irregularities are genetic or occur as a result of developmental issues. Conversely, some irregularities are acquired or greatly exacerbated by certain habits and behaviors such as:

• Mouth breathing
• Thumb or finger sucking
• Prolonged pacifier use
• Poor oral hygiene
• Poor nutrition

What’s involved when a child gets braces?

The dentist initially conducts a visual examination of the child’s teeth. This will be accompanied by panoramic x-rays, study models and computer generated images of the head and neck. These preliminary assessments are sometimes known as the “planning phase” because they aid in making a diagnosis and planning the most effective treatment.

In many cases, we will recommend “fixed” orthodontic braces for a child. Fixed braces cannot be lost, forgotten or removed at will, which means that treatment is completed more quickly. Removable appliances may also be utilized, which are less intrusive, and are generally used to treat various types of defects. Removable appliances are limited in use on children due to their compliance issues.

Here is a brief overview of some of the main types of orthodontic appliances used for children:

• Fixed braces – Braces comprised of brackets which are affixed to each individual tooth, and an archwire which connect the brackets. The brackets are usually made of metal, ceramic, or a clear synthetic material which is less noticeable to the naked eye. After braces have been applied, the child will have regular appointments to have the braces adjusted. Orthodontic elastic bands are often added to the braces to aid in the movement of specific teeth.
• Headgear – This type of appliance is most useful to treat developmental irregularities. A headgear is a custom-made appliance attached to wire that is worn to aid in tooth movement. A headgear is intended to be worn for 12-20 hours each day and must be worn as recommended to achieve good results.
• Retainers – Retainers are typically utilized in the third phase (retention phase). When the original malocclusion has been treated with braces, it is essential that the teeth do not regress back to the original misalignment. Wearing a retainer ensures the teeth maintain their proper alignment, and gives the jawbone around the teeth a chance to stabilize.

Orthodontic braces were historically associated with teenagers. Today, an increasing number of adults are choosing to wear braces to straighten their teeth and correct bad bites. In fact, it is now estimated that almost one third of all current orthodontic patients are adults.

Orthodontic braces are predictable, versatile and incredibly successful at realigning the teeth. Braces work in the same way regardless of the age of the patient, but the treatment time is greatly reduced in patients who are still experiencing jaw growth and have not been affected by gum disease. In short, an adult can experience the same beautiful end results as a teenager, but treatment often takes longer due to the density of the bone and use of growth modification.

Can adults benefit from orthodontic braces?

Absolutely! Crooked or misaligned teeth look unsightly, which in many cases leads to poor self esteem and a lack of self confidence. Aside from poor aesthetics, improperly aligned teeth can also cause difficulties biting, chewing and articulating clearly. Straight teeth tend to be healthier teeth and can often play an important role in the preventive and restorative aspects of dental treatment.

Straight teeth offer a multitude of health and dental benefits including:

• Reduction in general tooth decay
• Decreased likelihood of developing periodontal disease
• Decreased likelihood of tooth injury
• Reduction in digestive disorders
• Reduction in orofacial pain
• Fortunately, orthodontic braces have been adapted and modified to make them more convenient for adults. There are now a wide range of fixed and removable orthodontic devices available, depending on the precise classification of the malocclusion.

The most common types of malocclusion are underbite, overbite, and overcrowding, where there is insufficient space on the arches to accommodate the full complement of adult teeth.

Prior to recommending specific orthodontic treatment, the dentist will recommend treatment of any pre-existing dental conditions such as gum disease, excess plaque and tooth decay. Orthodontic braces can greatly exacerbate any or all of these conditions.

What are the main types of orthodontic braces?

The following are some of the most popular orthodontic braces:

• Traditional braces – These braces are strong and tend not to stain the teeth. They are comprised of individual brackets which are cemented to each tooth and accompanied by an archwire which constantly asserts gentle pressure on the teeth. Traditional braces are generally metal but are also available in a clear synthetic material and “tooth colored” ceramic. The ceramic brackets are generally more comfortable than the metal alternative, but can become discolored by coffee, wine, smoking and certain foods. Not all patients are candidates for traditional braces.
• Clear Aligners – Invisalign and Clear Correct aligners are favored by many adults because they are both removable and invisible to onlookers. The aligners are clear trays, and should be worn for the recommended amount of time each day for the quickest results. Aligners are more comfortable and less obtrusive than traditional braces, but also tend to extend treatment time and requires strict use. Not all patients are candidates for clear aligner technology.

Invisalign®

Invisalign is a series of clear, removable teeth aligners that dentists use as an alternative to traditional metal dental braces. Sure, there are other options out there for straightening your teeth, but none offers the level of comfort, convenience and confidence that you will find with Invisalign. What is not to love about this cutting edge approach to treatment.

ClearCorrect invisible braces are the clear and simple way to straighten your teeth so you can show off your smile! With ClearCorrect, your dentist can straighten your teeth using a series of clear, custom, removable aligners. Each aligner moves your teeth just a little bit at a time until you eventually get straight teeth. The ClearCorrect system is affordable and your doctor will likely have payment options to suit your needs.

Cleaning and caring for your teeth won’t change, and once you begin your treatment you can eat whatever you want. Because ClearCorrect is so clear and easy to remove, treatment has low or no impact on the way you look and your daily routines. ClearCorrect can help you achieve your best smile whether your teeth are crowded or spaced. It can correct most overbites and underbites and can straighten and align teeth that are crooked or turned.

Obviously, an actual assessment of your case will be necessary, but ClearCorrect has a very broad application and the chances are good that you can benefit from treatment.

The Damon® System is an innovative new way to straighten the teeth quickly and comfortably. Traditional dental braces are comprised of large metal brackets and a wide variety of elastics. Damon® Braces straighten teeth up to six months quicker than traditional braces and leave teeth healthy and beautiful.

Prior to the adhesion of traditional braces, a tooth or multiple teeth often need to be removed to create space. Damon® Braces can be affixed without the removal of healthy teeth, because this system uses the body’s biological forces to create space naturally.

Why should I choose Damon® Braces?

Damon® Braces utilize a unique type of technology to optimize the straightening process. Traditional archwires are replaced with lighter, shape-memory, self-ligating wires that need no tightening. There are no elastics, no ties and no palate expanders. The Damon® System reduces the amount of friction each tooth feels by incorporating a sliding mechanism. Teeth can move gently into alignment without discomfort.

The Fast Smile system offers quicker and more efficient treatment times than traditional dental braces. In fact, Fast Smile braces can reduce the overall treatment times by as much as 40%. Though the majority of people love the thought of straight, healthy teeth, most do not relish the prospect of spending several years wearing braces. Contrary to popular belief, Fast Smile does not move the teeth more quickly. The teeth move with added precision at the same speed.

The Fast Smile technologies allow the dentist to view the teeth in 3D from every angle, and then plan treatment accordingly. Treatment can be tailored to fit your needs including the upper teeth, lower teeth, or just the from teeth. We recommend treating both arches for the longest lasting result.

Although there are very few true orthodontic emergencies, during the course of treatment you may discover that you have loose or broken braces. You may also discover that the orthodontic wires may shift and begin irritating your lips or cheeks. Below is a list of common braces problems and how they may be remedied at home. If you have a problem that you cannot resolve on your own, call our office. Your orthodontic team will be able to give you advice on how to solve the problem yourself or schedule you the appropriate appointment so that your braces problem can be fixed.

Loose or Broken Braces

You may discover that you have loose or broken braces. This is usually caused by playing with your braces or eating hard or sticky foods. This is generally not an emergency unless it is associated with pain or discomfort. If the bracket is attached to the wire, leave it in place and cover it with wax as needed for comfort. If the bracket comes out completely, bring it with you to your next appointment. Avoid connecting elastics or headgear appliance to any loose brackets. Call the office to schedule an appointment to repair the bracket. Be careful not to break too many brackets during your orthodontic treatment. You may be charged an extra fee to repair broken braces which may increase your overall braces cost.

Loose Band

Eating hard or sticky foods or playing with your orthodontic braces can loosen a band. This is generally not an emergency unless it is associated with pain or discomfort. Avoid connecting elastics or headgear appliance to any loose bands. If the band is still attached to the wire, it will usually wobble slightly. You can call the office to see if you need a special appointment to have the band recemented or if it can be done at your regularly scheduled appointment time. If the band comes off your tooth, the space needed to recement the band may close in a few days so call our office to schedule an appointment to have the band recemented. If no recementation appointment is available within a few days of the band coming off, the office can usually have you in for a quick appointment to place separators so the band space does not close. Remember to bring the band with you to your appointment.

Long Poking Archwire

Sometimes as your teeth shift, the ends of the wire will start poking out the back of the molar tubes and begin irritating the cheeks. This problem may be resolved by moving the wire away from the irritated area using a cotton swab or pencil eraser. If the wire does not move, cover it with a small pea-sized amount of wax or cotton. You may also try cutting the wire with nail clippers that have been washed and sterilized in alcohol. Call the office for an appointment if you cannot resolve the problem.

Tooth Discomfort or Soreness

Teeth may become sore or achy following an orthodontic activation appointment. Usually the teeth are most sore during the first 24-72 hours. After 72 hours, the teeth usually start feeling better. Maintain a soft food diet as needed. If necessary, take the pain reliever you would use for a headache.

Sores or Ulcerations Inside the Mouth

During the first week of treatment, you may notice sores or ulcerations inside your mouth. This can happen because your lips and cheeks are not yet used to rubbing against your orthodontic braces. Over time, your skin on the inside of your mouth will get tougher and you will not have sores anymore. To provide some relief for your lips and cheeks rubbing against your rough braces, you can place a small pea-sized amount of wax or cotton on the area of the braces that is causing the sore or ulceration. The sore should improve within a couple of days and completely heal within a week. If the sore or ulceration does not improve or gets worse, call our office to have it examined.

Wire Out of Tube or Slot

During treatment, flexible wires may slip out of the bracket slots of the back teeth. This may be avoided by eating appropriate foods your orthodontist recommends. If the wire comes out of the tube, try placing the wire back in the tube using tweezers. If necessary, cover the loose wire with wax and call our office for an appointment.

Poking Metal Tie

Occasionally, metal wires are used to tie the archwire to the brackets or bands. Sometimes during eating or brushing, this metal wire tie can accidentally be redirected and start to cause irritation to your lips or cheeks. You can try to push the poky wire back into place by using the end of a pencil eraser. If that is not possible, you can place wax on the area causing the irritation until you can be seen by our office to have it fixed.

Lost Elastic Tie

If an elastic tie falls off, call our office. Sometimes, you can wait until your next appointment to have it replaced. Other times, your orthodontist will want to see you for a quick visit to put the elastic tie back on.

Headgear or Other Orthodontic Appliance Does Not Fit

Call the office for an appointment to have the orthodontic appliance or headgear adjusted.

Accidents Involving the Teeth

If an accident occurs during treatment involving the teeth, call our office immediately.

When you have braces, it is important to take care of them and not break anything. When a part of your braces breaks, your teeth can stop moving and sometimes can even move the wrong way! It often takes a longer appointment to repair a broken appliance and get the teeth moving the right direction again. This results in a loss of treatment time. The end result is that loose or broken braces or appliances often mean you will need braces for a longer time. Fast treatment and a great smile are your rewards for following these guidelines.

Hard foods – Anything that is hard cannot be chewed with braces on. Remember, braces are fragile, and strong forces from hard foods will break them off. Damaged appliances will extend treatment time. Extended treatment time will increase the risk of cavities and stains on your teeth.

• Apples or Carrots (unless cooked or cut into small pieces)
• Ice – Do not chew on ice!
• Nuts
• Corn on the Cob
• Popcorn
• Hard Candy
• Peanut Brittle
• Bagels
• Jerky
• Hard Pretzels
• Pizza Crust
• Doritos, corn chips, hard tacos, cheetos, fritos and the like
• Hard rolls and bagels
• Raw carrots

Sticky foods – Braces can be pulled apart with sticky foods. Again, this could extend your treatment time.

• Taffy
• Caramels
• Gummy Bears
• Any sticky candy in general
• Gum

Anything high in sugar – Braces make it harder to keep your teeth clean. Sugar will feed the bacteria that cause cavities. If you do eat any foods high in sugar, brush your teeth immediately.

• Suckers
• Sour Patch Candy
• Any Candy

Acidic Foods – Acidic Foods can also cause permanent stains and damage to your teeth. Avoid acidic foods such as:

• Sodas (even diet sodas can be very acidic)
• Lemons and lemon juice

Other Precautions:

Do not bite through hard foods with your front teeth. This may loosen your front brackets

Do not chew on pens, pencils, or fingernails as this may break parts of your braces. Remember to brush and floss your teeth to keep them strong and healthy. If you experience a part of your braces that is loose or broken, you can call our office. You can also see our Orthodontic Emergencies section to learn how minor orthodontic problems may be handled at home.

Orthodontic treatment is highly predictable and immensely successful. Depending on the severity of the malocclusion or irregularity, orthodontic treatments may occur in either two or three distinct phases.

The benefits of correcting misaligned teeth are many. Straight teeth are pleasing to look at and greatly boost confidence and self esteem. More importantly, properly aligned teeth enhance the biting, chewing and speaking functions of the jaw. There are several types of irregularities, including:

Overbite – The upper teeth protrude further than or completely cover the lower teeth.

Underbite – The lower teeth protrude further than the upper teeth causing the chin to look prominent.

Crossbite – Some of the upper teeth may close inside the lower teeth rather than on the outside.

Overcrowding – Insufficient room on the arch causes some adult teeth to erupt incorrectly and become rotated.

The Phases of Orthodontic Treatment

Generally, orthodontic treatment takes between six and thirty months to complete. The treatment time will largely depend on the classification of malocclusion, the type of dental devices used to correct it and the perseverance of the patient.

Phase 1 – The Planning Stage

The dentist makes an exact diagnosis in order to realign the teeth in the most effective and expedient way. The first several visits may comprise of some of the following evaluations:

Medical and dental evaluations – Dental and physical problems tend to go hand in hand. Problems in the oral cavity can lead to (or be caused by) medical problems. The goal of this evaluation is to ensure that prior medical and dental issues are completely under control before treatment begins.

Study model – The patient is asked to bite down into a dental tray filled with a gel substance that hardens around the teeth. The trays are removed from the teeth and filled with plaster to create models of the patient’s teeth. Study models enable the dentist to scrutinize the position of each tooth, and how it relates to the other teeth. Come see our digital impression technique with no more gel.

Panoramic X-rays – X-rays are fantastic tools for viewing potential complications or pre-existing damage to the jaw joint. X-rays also allow the dentist to see the exact position of each tooth and its corresponding root.

Computer generated images – Such images allow the dentist to treatment plan and examine how specific treatments may affect the shape of the face and symmetry of the jaw.

Photographs – Many dentist like to take “before, during and after” photographs of the face and teeth to assess how treatment is progressing, and the impact the treatment is having on the patient’s face shape.

Phase 2 – The Active Phase

All of the above records will be used to diagnosis and develop a customized treatment plan for the patient. Next, the dentist will recommend custom orthodontic device(s) to gently move the teeth into proper alignment. This orthodontic appliance may be fixed or removable. Most commonly, traditional fixed braces are affixed, which utilizes individual dental brackets connected by an archwire.

Removable devices are an alternative to fixed braces. Examples of removable devices include the Invisalign system, headgear and face mask. These devices are designed to be worn for a specified amount of hours each day to expedite treatment.

Whatever the orthodontic device, the dentist will regularly adjust it to ensure adequate and continual pressure is being applied to the teeth. It is essential to visit the dentist at the designated intervals and to call if part of the device breaks or becomes damaged.

Phase 3: The Retention Phase

When the teeth have been correctly aligned, fixed braces and removable devices will be removed and discontinued. The most cumbersome part of the orthodontic treatment is now over. The dentist will next create a custom retainer. The goal of the retainer is to ensure that the teeth do not begin to shift back to their original positions. Retainers need to be worn for a specified amount of time per day for a specified time period. During the retention phase, the jawbone will reform around the realigned teeth to fully stabilize them in the correct alignment. Retention is the final and permanent phase although the amount of time to worn can be as little as two nights a week. If the retainers are lost or stop fitting make sure you come back in to see us.

One of the most commonly asked questions about dental braces is whether placing them causes any pain or discomfort. The honest answer is that braces do not hurt at all when they are applied to the teeth, so there is no reason to be anxious. In most cases, there may be mild soreness or discomfort after the orthodontic wire is engaged into the brackets, which may last for a few days.

There are two common types of fixed dental braces used to realign the teeth: Ceramic fixed braces and metal fixed braces. Both types of fixed appliances include brackets which are affixed to each individual tooth, and an archwire fits into the bracket slot to gently move the teeth into proper alignment. Elastic or wire ties will be applied to hold the wire in place. We offer the use self-ligating brackets which do not require a rubber or wire tie to secure the wire.

Fixed dental braces are used to treat a wide variety of malocclusions, including overbite, underbite, crossbite and overcrowding. If the malocclusion has been caused by overcrowding, it is possible that teeth may need to be extracted to increase the amount of available space to properly align the teeth.

Here is an overview of what you can expect when getting braces:

• Placement day – The placement of braces will not be painful in the slightest. It may take longer to eat meals, but this is largely because it takes some time to adjust to wearing the braces. In some cases, the teeth may feel more sensitive than usual. Hard, difficult to chew foods should be avoided in favor of a softer, more liquid-based diet for the first few days after placement of braces.
• Two days after placement – The first several days after placement of braces can be slightly uncomfortable. This is because the teeth are beginning the realignment process and are not used to the pressure of the archwire and orthodontic elastic bands. We will provide relief wax to apply over the braces as necessary. Wax helps provide a smooth surface and alleviates irritation on the inner cheeks and lips. Additionally, over-the-counter pain medication like generic Ibuprofen or Advil may be taken as directed to relieve mild soreness.
• Five days after placement – After five days, any initial discomfort associated with the braces should be completely gone. The teeth will have gradually acclimated to the braces, and eating should be much easier. Certain hard foods may still pose a challenge to the wearer, but normal eating may be resumed at this point.
• Orthodontic appointments – Regular orthodontic appointments are necessary to allow the dentist to change the archwire, change the rubber or metal ties, and make adjustments to the braces. Fixed braces work by gradually moving the teeth into a new and proper alignment, so gentle pressure needs to be applied constantly. The first several days after an orthodontic adjustment may be slightly uncomfortable, but remember that this discomfort will quickly fade.
• Dealing with discomfort – Over-the-counter pain medication and orthodontic relief wax will help alleviate any mild soreness and discomfort following placement of braces and orthodontic adjustments. Another effective remedy is to chew sugar-free gum, as this increases blood flow which helps reduce discomfort and can also encourage the teeth to align quicker.

When braces are removed, the “retention” phase begins for most individuals. The objective of this phase is to ensure the teeth do not regress back to their previous position. A retainer will be used to maintain the improved position of the teeth. A retainer is a fixed or removable dental appliance which has been custom-made by the dentist to fit the teeth. Retainers are generally made from transparent plastic and thin wires to optimize the comfort of the patient.

Retainers are worn for varying amounts of time, depending on the type of orthodontic treatment and the age of the patient. Perseverance and commitment are required to make this final stage of treatment successful. If the retainer is not worn as directed, treatment can fail or take much longer than anticipated.

What types of retainer are available?

There are a variety of retainers available; each one geared towards treating a different kind of dental problem. The dentist will make a retainer recommendation depending on the nature of the original diagnosis and the orthodontic treatment plan.

The following are some of the most common types of retainers:

• Hawley retainer – The Hawley retainer consists of a metal wire on an acrylic arch. The metal wire may be periodically adjusted by the dentist to ensure the teeth stay in the desired position. The acrylic arch is designed to fit comfortably on the lingual walls or palate of the mouth.
• Essix – The Essix retainer is the most commonly used vacuum formed retainer (VFR). A mold is initially made of the teeth in their new alignment, and then clear PVC trays are created to fit over the arch in its entirety. VFRs are much cheaper than many other types of retainers and also do not affect the aesthetic appearance of the smile in the same way as the Hawley retainer. The disadvantage of VFRs is that they break and scratch more easily than other types of retainers.
• Fixed retainers – A fixed retainer is somewhat similar to a lingual brace in that it is affixed to the tongue side of a few teeth. Usually, a fixed retainer is used in cases where there has been either rapid or substantial movement of the teeth. It usually consists of a single wire. The inclination of the teeth to move rapidly means they are also more likely to regress back to their previous position if a fixed retainer is not placed.

What do I need to consider when using a retainer?

• Don’t lose the appliance – Removable retainers are very easy to lose. It is advisable to place your retainer in the case it came in while eating, drinking and brushing. Leaving a retainer folded in a napkin at a restaurant or in a public restroom can be very costly if lost because a replacement must be created. A brightly colored case serves as a great reminder.
• Don’t drink while wearing a retainer – It is tempting to drink while wearing a retainer because of the unobtrusive nature of the device. However, excess liquid trapped under the trays can vastly intensify acid exposure to teeth, increasing the probability of tooth decay.
• Don’t eat while wearing a retainer – It can be difficult and awkward to eat while wearing a removable retainer and it can also damage the device. Food can get trapped around a Hawley retainer wire or underneath the palate, causing bad breath. When worn on the upper and lower arches simultaneously, VFR retainers do not allow the teeth to meet. This means that chewing is almost impossible.
• Clean the retainer properly – Removable retainers can become breeding grounds for calculus and bacteria. It is essential to clean the inside and outside thoroughly as often as possible. Hawley retainers can be cleaned with a toothbrush. Because harsh bristles can damage the PVC surface of a VFR, denture cleaner or a specialized retainer cleaner is recommended for this type of device.
• Wear the retainer as directed – This phase of treatment is critical. The hard work has been done, the braces are off and now it is tempting not to wear the retainer as often as the dentist recommends. Retainers are needed to give the muscles, tissues and bones time to stabilize the teeth in their new alignment. Failure to wear the retainer as directed can have regrettable consequences, such as teeth returning to their original position, added expense and lost time.

The following are the most commonly used terms in orthodontics. If you have any questions about orthodontics or would like to schedule an appointment, please contact our office.

Anterior Teeth: The upper and lower six front teeth on each arch.

Appliance: Any orthodontic device which moves or retains teeth. Appliances may also alter the positioning of the jaw.

Arch: The entire upper or lower jaw.

Archwire: The metal wire that connects orthodontic brackets. This wire guides the teeth into their new alignment.

Band with bracket: Metal bands (rings) that are generally cemented around the back teeth.

Braces: Fixed orthodontic appliances designed to align teeth.

Brackets: The tiny metal, ceramic or clear brackets that are affixed to each individual tooth on the arch.

Brushing: This is a crucial part of home dental care. Orthodontists recommend those wearing braces to brush after every meal and snack to eliminate bacteria and plaque.

Buccal: The outer (cheek) side of posterior teeth in the lower and upper arches.

Cephalometric Radiograph: A side x-ray of the face and head used to show growth and development.

Chain: Elastics connected together and placed around the brackets to stabilize the archwire and gently close spaces.

Class I Malocclusion: Molars are correctly aligned, but there is an anterior/posterior crossbite, an open bite or overcrowding on the arches.

Class II Malocclusion: Also known as an overbite. The upper front teeth are positioned further forward than the lower teeth.

Class III Malocclusion: Also known as an underbite. The lower front teeth are positioned further forward than the upper front teeth.

Closed Bite: The upper front teeth completely overlap the bottom teeth causing a deep overbite.

Congenitally Missing Teeth: Some permanent teeth fail to develop and erupt due to genetic factors.

Crossbite: A malocclusion in which the upper back teeth bite inside or outside the lower back teeth, or the lower front teeth bite in front of the upper front teeth.

De-banding: The removal of orthodontic bands from the teeth.

Debonding: The removal of affixed orthodontic brackets from the teeth.

Diagnostic Records: Records used to assess, plan and implement treatments. These records usually include medical and dental history, radiographs, panoramic radiographs, bite molds and intraoral/extraoral photographs.

Digital Radiograph: Digital x-rays of the teeth which can be viewed, stored and transmitted via computer.

Elastics: Some braces may require that elastic rubber bands be attached to exert additional pressure to an individual tooth or a group of teeth.

Eruption: The way in which teeth surface through the gums inside the mouth.

Fixed Orthodontic Appliances: Orthodontic appliances which are affixed to the teeth by the orthodontist and cannot be removed by the patient.

Flossing: An essential part of home care that removes debris and plaque from above and below the gumline.

Functional Appliances: Orthodontic appliances that use the muscle movement created by swallowing, eating and speaking to gently move and align the teeth and jaws.

Gingiva: The gums and soft tissue around the teeth.

Headgear: A removable appliance comprised of a brace and external archwire. This device modifies growth and promotes tooth movement.

Impressions: Teeth impressions are taken to allow the orthodontist to see exactly how a patient’s teeth fit together.

Interceptive Treatment: Treatment performed on children who have a mixture of adult and baby teeth. Early treatment can help reduce the need for major orthodontic treatment in the future.

Invisalign®: A newer, removable type of dental aligner that is completely transparent and doesn’t interfere with eating because it’s removable. Not all patients are candidates for Invisalign®.

Ligating Modules: An elastic donut-shaped ring which helps secure the archwire to the bracket.

Ligation: Securing the archwire to the brackets.

Lingual Side: The side of the teeth (in both arches) that is closest to the tongue.

Malocclusion: Literally means “bad bite” in Latin, and refers to teeth that do not fit together correctly.

Mandible: The lower jaw.

Maxilla: The upper jaw.

Mouthguard: A removable plastic or rubber device that protects teeth and braces from sporting injuries.

Open Bite: Upper and lower teeth fail to make contact with each other. This malocclusion is generally classified as anterior or posterior.

Orthodontics: The unique branch of dentistry concerned with diagnosing, preventing and correcting malocclusions and jaw irregularities.

Palatal Expander: A removable or fixed device designed to expand the palate in order create room on either the upper or lower arch.

Panoramic Radiograph: An extraoral (external) x-ray that shows the teeth and jaws.

Plaque: The sticky film of saliva, food particles and bacteria that contributes to gum disease and tooth decay.

Posterior Teeth: Back teeth.

Removable Appliance: An orthodontic brace or device that can be removed at will by the patient. It must be worn for the designated amount of time each day to be effective.

Separators: A wire loop or elastic ring placed between the teeth to create room for the subsequent placement of bands or orthodontic appliance.

Space Maintainer: A fixed appliance used to hold space for permanent (adult) tooth. This is usually used when a baby tooth has been lost earlier than anticipated.

Wax: Orthodontic relief wax is a home care remedy used to alleviate irritations caused by braces.

Wires: Attached to the brackets to gently move the teeth into proper alignment.