Common Orthodontic Problems

 Crowding

Protruded Teeth

Anterior Cross Bite

Cross Bite

Open Bite

Deep Bite

Missing Teeth

Jaw Joint (TMJ) Problems

Cleft Palate Patients

 Surgery/Orthodontic Treatment

Frequently Asked Questions

What kind of retainer will I have?

At Smile Design Orthodontics we use removable overlay retainers (like a very thin, clear mouthguard), and fixed retainers which are a flat ribbon-shaped wire bonded behind the six front teeth. The type of retainer, or combination of retainers, will depend on your individual circumstances such as your pre-treatment malocclusion (orthodontic problem) and even personal preference. Both upper and lower teeth require retention – everything about us will change as we get older, including our teeth unless we retain them.

How do I take care of my teeth and braces?

The most important care for your teeth, particularly when braces are fitted, is regular, thorough brushing. Ideally you should brush after each meal and snack, which realistically is not always possible. So at least brush three times every day – after breakfast, after lunch or when you get home in the afternoon/evening and after dinner. You will be given instruction on brushing when braces are fitted, we monitor oral hygiene at every appointment and we will assist with further instruction if oral hygiene problems arise during your treatment. Vigorous rinsing and gently chewing sugar-free gum can at least reduce food residue from braces when brushing is not accessible but won’t substitute for thorough brushing.

What happens if a bracket is broken off?

Take care when eating so you avoid breakages which can cause discomfort and slow treatment progress. If a breakage occurs, please phone to let us know the nature of the problem so that we can schedule the appropriate time to repair your braces. This also applies for broken or bent wires. We avoid repairing braces during the busy (short appointments) after-school sessions.

Is there anything I can’t eat?

There is very little restriction on diet other than avoiding hard, crunchy foods such as nuts, hard biscuits, raw carrots and avoid crunching ice. Also avoid altogether any sticky hard lollies such as minties, fantails, toffees and some muesli bars are too sticky and hard. We can’t give you a list that would cover everything, it’s more a matter of common sense and being aware to take care of your braces.

Does it hurt to eat with braces?

Your teeth will not be sore during or immediately after placement of braces and you can eat right after that appointment. However, some teeth will become tender when biting or chewing as the teeth respond to the light pressure of the braces and start to align. This initial discomfort lasts only for the first few days, sometimes a week, when eating softer foods for comfort is advisable. Anti-inflammatory pain relief tablets, taken as directed, can also help. Although your teeth are tender for the first few days following commencement of treatment and sometimes after adjustents, they continue aligning progressively over the duration of treatment.

Will braces cause ulcers in my mouth?

We are highly focussed on making your entire experience at Smile Design Orthodontics as comfortable and enjoyable as possible, which includes using particular braces and the appliances we design specifically for your treatment to achieve the very best result with minimum discomfort and mouth irritation. Although we intentionally choose to use braces that are small yet functionally efficient to achieve optimum results, mouth ulcers are not common but can be relieved using the orthodontic wax we provide as your mouth adjusts during the first few days of treatment.

Will I still be able to talk when I have braces?

Although at first it may seem otherwise, braces do not interfere with speech. Some appliances used in conjunction with braces, particularly expanders, will initially feel awkward when speaking and swallowing but your tongue will adapt after a short period of time.

Do braces hurt?

Placement of braces is usually a painless procedure – the braces are bonded to the surface of your teeth, no drilling or injections. You can eat straight after placement of braces, however later that same day your teeth may become tender as they start to move which can last a few days, but is easily managed by eating softer foods, chewing sugar free gum or by taking over the counter pain relief tablets (please follow directions carefully).

Will I need to have teeth removed?

At Smile Design Orthodontics we are philosophically committed to avoiding removal of teeth, although in rare cases there can be exceptions. We can explain in detail how our treatment techniques and timing of orthodontic treatment will avoid removal of teeth.

How often do I need to have my braces adjusted?

Adjustment intervals following placement of braces can vary from 4 to 6 weeks for repeated procedures involved in space closure and eruption of impacted teeth, to longer 8 to 10 week intervals for routine procedures such as wire changes. The latest wire and bracket technologies that we use at Smile Design Orthodontics allow fewer adjustments and greater comfort while achieving optimum results over shorter treatment times.

Are there any alternatives to wearing braces?

At Smile Design Orthodontics we not only offer alternative treatment to braces, we also offer different types of braces to suit your individual needs and preferences. We have extensive experience treating orthodontic problems using Invisalign as an alternative to braces. Our hi-tech braces include Clear (tooth coloured) braces, Damon self-ligating braces, and Harmony self-ligating lingual braces which are custom made to fit on the inside of your teeth. We also use combination techniques where both Invisalign and braces are used during the same treatment process to take advantage of the best features of both appliances.

How much does orthodontic treatment cost?

There are several factors that determine the cost of orthodontic treatment including whether one or both arches are involved, the estimated treatment duration and the appliances used which can also involve the type of braces. Your Treatment Co-ordinator will provide you with an itemised written quotation at the initial consultation for any proposed treatment. Payments can be made by initial instalment followed by monthly payments over the course of treatment and will cover all aspects of your treatment including post-treatment retention supervision. If you are in a private health fund you will be able to claim rebate entitlements and because Smile Design Orthodontics is a specialist orthodontic practice, your rebates will be paid to you at your highest possible rate which can vary according to conditions specified by your health fund.

How long will Orthodontic treatment take?

Treatment duration depends on many variables, particularly severity of the orthodontic problem, your particular treatment priorities, compliance and care for appliances. Although only an estimate, we will be able to give you a reasonable indication of treatment duration.

Oral Hygiene & Care

Although orthodontic treatment is certainly a significant financial and time commitment, perhaps the most important commitment is looking after your teeth and orthodontic appliances to ensure that the appliances are not lost or broken and teeth remain healthy. Good oral hygiene throughout orthodontic treatment is the most important priority for a successful treatment result. Under normal circumstances we should thoroughly brush our teeth morning and night, systematically and looking at a mirror, including flossing at night. During orthodontic treatment with appliances attached to the teeth, particularly braces, teeth should be brushed ideally after each meal, or more realistically, three times every day – morning, afternoon (when returned home) and before bed.

Every member of our clinical team, Dental Assistants, Orthodontists and Hygienists, can advise regarding oral hygiene, diet and care for orthodontic appliances. We monitor our patients’ oral hygiene at each appointment during active treatment by recording a score on the computer treatment record and we periodically conduct an oral hygiene competition to focus attention on how important it is.

Jaw Surgery Orthodontics

A disharmony between the position of the upper and lower jaws, or the jaws and surrounding cranio-facial structures, can be the cause of bite discrepancies, functional problems (breathing, eating, speaking) and compromise facial appearance. Disharmony of jaw position can also include the size of the jaw, particularly narrow width of the upper jaw and small or long lower jaw.

Minor disharmonies of jaw position can be compensated by using braces to adapt the alignment of teeth to the position of the jaws.

Mild jaw disharmonies can be corrected or partially corrected using orthopaedic appliances in conjunction with braces.

Moderate to severe jaw disharmonies can only be corrected by surgically repositioning the jaw or altering the jaw shape/dimension. Orthognathic (jaw) surgery procedures are arranged and meticulously planned with a specialist Oral & Maxillofacial Surgeon, in conjunction with orthodontic treatment to align the teeth on both jaws so the bite co-ordinates correctly following jaw surgery. Most jaw surgery procedures and associated orthodontic treatment are deferred until completion of skeletal growth and involve one to three days in a private hospital. The jaw surgery is scheduled at the appropriate stage during the course of orthodontic treatment which usually involves braces that are removed after surgery because they are necessary for stabilisation during the healing phase and also for post-surgery orthodontic finishing to achieve the optimum result.

Oral Surgery & Orthodontics

Occasionally minor oral surgery procedures are necessary in conjunction with orthodontic treatment. Often the more simple procedures such as removal of erupted teeth because of decay or crowding can be comfortably managed by your Dentist using local anaesthetic (injection) at the Dental Surgery. More complex surgical procedures such as removal of impacted or unerupted teeth are often arranged to be done under a short general anaesthetic (day surgery) by either your Dentist or a specialist Oral & Maxillofacial Surgeon at a private hospital. These arrangements are made according to individual patient preferences and recommendations from the Orthodontist and Dentist. Oral surgery procedures include:

Extraction of teeth: As mentioned above, erupted teeth might need to be removed because of decay, poor long term prognosis (stability), over-retention of deciduous (baby) teeth or very occasionally to correct crowding.

Extraction of impacted teeth: Wisdom teeth are the most likely teeth to become impacted which is where they remain completely or partially unerupted because of inadequate space for eruption or ectopic (abnormal) position. Surgical extraction of wisdom teeth is generally recommended due to concern regarding recurrent infection of surrounding gum, not because they cause crowding.

Extraction of ankylosed teeth: Permanent or deciduous teeth can become ankylosed which is where they are fused to surrounding bone and either remain unerupted or don’t continue to erupt to maturity alongside adjacent teeth. Ankylosis can be idiopathic (no apparent cause) or due to trauma, and ankylosed teeth cannot be orthodontically repositioned or aligned.

Ligation of impacted teeth: If we decide to orthodontically erupt impacted teeth into normal alignment, most commonly the upper canines, the unerupted impacted tooth can be surgically ligated, which usually involves attachment of a short length of fine gold chain to the tooth so that the tooth can be guided into alignment using braces.

Types of Orthodontic Appliances

Invisalign

 Orthodontic treatment using Invisalign is an almost invisible alternative to  braces. A series of very thin, clear “mouthguard-like” aligners are used in  sequence at two-weekly intervals to incrementally move teeth to the desired  position. The aligners are worn full-time, day and night, except when eating  and are suitable for treatment of a wide variety of orthodontic problems.  Using Invisalign 3-D computer imaging technology, we can customise your treatment on-line, demonstrate specific tooth movements expected during treatment and accurately predict your treatment result.

At Smile Design Orthodontics we have extensive experience using Invisalign since its inception and maintain active involvement in ongoing advancement of the technique through the Invisalign Future Elite program and the Invisalign Asia Pacific Forum. We can extend the application of Invisalign practice to include more complicated treatments by combining Invisalign with other orthodontic techniques such as sectional (partial) braces and temporary implant anchorage (TADs).

Metal Braces

 Metal braces consist of small metal brackets that are directly  bonded to the teeth, in conjunction with an archwire that connects  all the brackets. Brackets can be either “twin” brackets requiring  coloured, silver or clear elastic modules for archwire attachment, or  “self-ligating” brackets. Although brackets of either style might look  the same, each bracket is individually designed for a particular tooth  with specific design features, or prescription, for that tooth.

The archwires we use at Smile Design Orthodontics are made of latest technology alloys with properties that make orthodontic treatment as comfortable. The brackets we use are also latest technology and design including the option of titanium brackets for patients with metal sensitivities (usually nickel in stainless steel).

Self Ligating Braces

 The technology of braces has been evolving, particularly over the past  decade and arguably the state of the art self-ligating orthodontic appliance is  the Damon System. This technique has the advantages of efficient, friction  free orthodontic tooth movement, extended appointment intervals that  reduce the frequency of orthodontic adjustments, and development of the  dental arches compatible with facial anatomy to produce beautiful, broad smiles.

At Smile Design Orthodontics we offer the option of Damon braces, including the tooth-coloured Damon Clear braces. Not only is this technique a feature within our practice, we teach the technique to post-graduate orthodontic students in the doctoral orthodontic program at Sydney University.

Clear Braces

 Clear or tooth coloured braces can be used for upper teeth that are usually  more obvious when talking and smiling. At Smile Design Orthodontics our  patients have the option of clear braces of either Twin Bracket or Self-  ligating design and also the option of clear braces on lower front teeth.

 

 

Lingual Braces

 For patients who need braces to resolve their orthodontic  problem but  want the braces to be completely “invisible”. At  Smile Design  Orthodontics we can offer the option of lingual  braces that are fitted to  the inside or lingual surface of the teeth.  We use the Harmony  system  lingual braces that are custom  made for accurate fit and  placement onto  every tooth and are self-ligating style braces for  efficient tooth movement to ensure optimum treatment results in minimum treatment time.

Orthopedic Appliances

 At Smile Design orthodontics we treatment plan to ensure that facial  aesthetics, harmony and balance are maintained or enhanced as an  important treatment priority as well as straight teeth and a beautiful  smile. We carefully assess the entire face and profile in our treatment  planning process and projected treatment outcome. The airway and even allergies and sleep patterns are important treatment planning considerations that can require management.
These treatment goals can in most cases be achieved by orthodontic or tooth movement. In some cases however, jaw growth or co-ordination is modified with the use of orthopedic appliances that are used in conjunction with braces. The orthopedic appliances we use at Smile Design Orthodontics are custom designed and made for comfort and normal function (smiling, speaking, chewing) during treatment.
By taking into consideration the entire face and airway, not just the mouth, we can include orthopedic appliances when indicated to correct jaw and bite discrepancies rather than adapt the position of the teeth to a pre-treatment discrepancy.

Removable Appliances

 Removable appliances, sometimes referred to as “plates”, usually consist  of a plastic or acrylic framework supporting a variety of wires that can be  active to move teeth or passive to hold the appliance in place. The acrylic  “plate” can also support auxiliaries such as expansion screws to widen the  dental arch or springs to move specific teeth. Removable appliances can’t  substitute for braces but can be used for simple tooth movements, sometimes as a preliminary measure prior to more comprehensive treatment when all permanent teeth have erupted. Plates can also serve as retainers which are worn at night on completion of comprehensive orthodontic treatment to maintain the treatment result.

Space Maintainers

 Space Maintainers are used to preserve or maintain space in the dental  arch for later eruption of permanent teeth. The most common indication  for a space maintainer is following premature loss of a deciduous (baby)  tooth usually due to decay or partial impaction of a permanent molar.  Space maintainers are passive appliances, fixed to one or two stable teeth  and generally removed when the intended permanent tooth or teeth  erupt into the arch.

General Dentistry & Orthodontics

At Smile Design Orthodontics our practice is limited to orthodontic treatment which is provided by our orthodontists who are registered specialist orthodontists. Throughout your orthodontic treatment we maintain a close professional relationship with your general Dentist who will continue to provide your routine dental treatment such as fillings, preventive treatments or specific dental procedures that your Dentist considers necessary. It is important that correction of dento-facial problems is comprehensively achieved for you through a team, or “multi-disciplinary” collaboration between your general Dentist, Orthodontist and sometimes other dental specialists.

We recommend that you see your Dentist for regular check-ups every six months throughout your orthodontic treatment and sometimes every three months if there are oral hygiene problems that require more frequent management. We specifically encourage you to maintain your dental check-ups with your Dentist through our Dental Care Partnership Program which is put in place when you commence orthodontic treatment.