Can you be too
old for braces?
There is no
age limit for braces. As long as you have good periodontal
health, braces can be used to straighten your teeth and
correct your bite. More people over age 30 are getting
braces today than ever before. Most ArchWired.com readers are
between the ages of 25 to 55! However, if you have been on
a Bisphosphonate drug for osteoporosis (such as Fosamax or
Boniva) you need to talk to your orthodontist or dentist
first. Read this
article to find out why this is very important.
wore my retainer for a while when I was younger, but then I
stopped wearing it and my teeth shifted
years later. Is
Yes, it is
more common than you think. The teeth are actually more
dynamic than you'd expect. Sometimes, when wisdom teeth erupt,
your bite can change in adulthood. A large percentage of adults in
braces are in them for a second time!
My kids just
got braces and now I'm thinking of getting them, too.
"finally get their teeth done" when their kids go
in for orthodontic treatment. It's more common than you
think! Several ArchWired.com readers have an entire family in
What is it
like to have braces put on your teeth? Does it hurt?
braces put on your teeth does not hurt, and does not
require Novocain injections or anything painful. For a
full description of the process, read
Basics: When the Braces Go On.
much do braces cost?
cost for a full set of braces in a typical two-year treatment is
about $5,000 US. The cost varies depending on where you
live. Major metropolitan areas tend to be slightly higher in
cost than rural areas. Generally, metal braces cost less than ceramic
Invisalign treatment can be just as costly as traditional
braces, and sometimes is even slightly more expensive. Here
is a survey we did
on the subject a few years ago.
insurance cover the cost of braces?
people in the U.S. have dental insurance through their
employers or as individuals/families. This insurance
usually cover orthodontic treatment for children up to age 18, but does not cover
adult orthodontics -- or only covers it up to a certain
dollar amount. If your plan covers adult braces,
consider yourself in the lucky minority. I can't speak for
dental plans offered overseas, as I know very little about
them, and some are government-run (such as the NHS in the
most insurance plans and discount dental plans do not cover treatment that is already in
progress. So, if you are going to sign up for a dental plan
or insurance plan,
do it before any treatment begins. Also, beware of
any waiting periods your dental plan may enforce. And by the
way, jaw surgery or extraction is sometimes covered under
your medical plan, so be sure to look into this, too.
How can I
find an orthodontist or a
discount dental plan?
To help find an orthodontist near you, it's best to get
personal recommendations. Ask friends who have braces (or
whose kids have braces). If your insurance covers
orthodontics, see if it is limited to specific
dentists/orthodontists. Or, post a query on ArchWired's
Mouth Message Board; our readers are all over the US and around
the world, and are very helpful!
Dental plans come
and go; some are better than others. Please read the fine
print carefully before you sign up for anything and check
with the Better Business Bureau. If you don't have dental
insurance, you can sign up for a discount dental plan. A
discount dental plan is not insurance -- it is a
cooperative of dental professionals who have contracted
with a company to offer their services at a discounted
rate. Many are available, offered by different
companies. You can search for discount dental
plans on Google or
DentalPlans.com. Or, ask a
trusted insurance agent or your own dentist.
afford dental insurance or a dental plan. What can I do?
don't have dental insurance and can't afford a a
discount dental plan, there is still an alternative. If
there is a dental school in your area, call them and ask
if they have a clinic. Often orthodontists and dentists
in training will practice on patients in the school
clinic, under the watchful eye of experienced teachers
who are themselves dentists and orthodontists. This
service is offered to the public at a minimal cost.
I get those invisible braces (Invisalign) instead of
on your specific case. Invisalign braces are usually not
recommended for very complicated cases, or cases that
involve extractions. Only a qualified dental professional
who has examined your mouth can decide whether Invisalign is
right for you. If you are very concerned about your
appearance with braces, another thing to consider is
lingual braces, which are behind the teeth (such as
iBraces). An orthodontist must take special training to
do lingual braces -- not every orthodontist does them.
What is the
difference between a dentist and an orthodontist?
orthodontist is a dentist who has taken several years of
extra training beyond the basic dental degree. Here is what
the American Association of Orthodontists (AAO) says:
"It takes many years to become
an orthodontist. As in medicine, the educational
requirements are demanding.
First, an orthodontist must complete college.
Next is a
three- to four-year graduate program at a dental school in a
university or other institution accredited by the American
Dental Association (ADA).
are at least two or three years of advanced specialty
education in an ADA-accredited orthodontic residency
program. The program is difficult. It includes advanced
knowledge in biomedical, behavioral and basic sciences. The
orthodontic resident learns the complex skills required to
both manage tooth movement (orthodontics) and guide facial
development (dentofacial orthopedics).
Only dentists who have successfully completed this advanced
specialty education may call themselves orthodontists."
Should I get
braces done by a dentist or by an orthodontist?
opinion leans toward orthodontists.
orthodontics into their practices. They have probably
completed some extra coursework in tooth movement management
and facial development. Some dentists who practice
orthodontics have completed more coursework than others.
Don't feel shy about asking a dentist about his orthodontic
qualifications -- what extra training he has completed, and
how many orthodontic patients he has seen. Just because a
dentist says he or she "can do braces for you" doesn't mean
that they have all the training necessary to successfully
handle complicated treatments. Some dentists confer with
their their orthodontic colleagues to ensure that they're doing
things optimally. If you have minor orthodontic problems,
your dentist might be able to handle your case. Complicated
cases are probably best handled by an orthodontist who has
If you're considering getting braces, you
should probably get at least one opinion from an
orthodontist to ensure that you are getting the correct type
orthodontic consultations should I get?
You can get as
many orthodontic consultations as you want. In a
consultation, an orthodontist looks at the alignment of your
teeth and your facial aesthetics and gives you a general
opinion of what he or she would do to correct your problems.
consultations are free or of minimal cost. While an
orthodontist can look at your teeth and give you a general
opinion, he or she can't put together a comprehensive
treatment plan for you until teeth molds and panoramic
x-rays have been done.
usually no one right way to correct orthodontic problems --
there are many ways, and different orthodontists may give
you different opinions. That is why it's a good idea to
consult with two or three orthodontist before you start
treatment, especially if they recommend extractions,
headgear, or jaw surgery.
some of the risks of getting braces as an adult?
any medical or dental procedure, there are some risks
involved in orthodontic treatment, no matter your age.
The forces involved in braces can cause some amount of
trauma to the dental tissues and structures. However,
most adults successfully complete their treatment
without any major complications. Orthodontists often
give their patients a booklet outlining some of the
risks that may be involved and make them sign a waiver
that they understand these risks, which include:
- The structure of the tooth's root may break down,
causing its destruction.
Gum recession -
The loss of gum tissue around the tooth, which in
severe cases can expose the tooth's root. The
"triangle" of gum tissue surrounding some teeth may
- If you are already allergic to nickel or latex,
tell your orthodontist. There are alternative
brackets and bands which are nickel and latex free.
You may be sensitive to these substances and not
realize it until you get braces. If you develop
unusual swelling or tenderness in your gums during
your treatment, or any sort of hives or rash on your
face and mouth, allergy may be the culprit.
What is a
"bite" and what is malocclusion?
is another word for your bite -- how the teeth in
your top and bottom jaw meet with each other. Mal
comes from the Latin root meaning "bad." So, a malocclusion
means a bad bite -- a bite with problems. It means
that your top teeth do not line up properly with your bottom
What are the
"classes" of malocclusion?
Malocclusion is most often
caused by hereditary factors such as an abnormal
relationship between the size of the teeth and the size of
the jaws. Malocclusion may also result from missing teeth or
habits such as thumb sucking or tongue thrusting.
classified based on the relationship of the maxillary (upper
jaw) and mandibular (lower jaw) first permanent
There are three basic
classes of malocclusion, Class I, Class II, and Class III:
I malocclusion involves
crowding, spacing, or overlapping of the teeth. In this
classification the upper jaw is in a normal relationship
to the lower jaw; that is, neither jaw protrudes.
II malocclusion occurs
when the bottom jaw is in a more posterior (backward)
position than normal. The top teeth appear to protrude
out over the lower teeth. One example of this type of
malocclusion is often referred to as "buck"
III malocclusion occurs
when the lower jaw is in a more anterior (forward)
position than normal. The lower teeth protrude out
beyond the upper teeth. This is often the most difficult
type of malocclusion to correct.
and illustrations from http://www.dentallearningsystem.com
What are the "types
of bite" and what do they mean?
The most common types of
bite problems are:
Patients with overbites appear "bucktoothed"
and have a receding chin. The lower front teeth are
positioned too far behind the upper front teeth. This
condition can result from a horizontal overdevelopment
of the upper jaw or an underdevelopment of the lower jaw
or a combination of both.
Patients with underbites have a strong jaw with a chin
that juts straight out. The lower front teeth are
positioned in front of the upper front teeth. This
condition is caused by the horizontal underdevelopment
of the upper jaw, the horizontal overdevelopment of the
lower jaw, or most frequently a combination of both.
This occurs when the upper teeth are biting inside the
lower teeth. This is frequently the result of a narrow
upper jaw. Crossbites also occur because of a mismatch
in jaw size and position between the upper and lower
jaw. Some crossbites also lead to asymmetry of the lower
jaw by causing the jaw to be abnormally deflected to one
side when closing the teeth together. Proper diagnosis
determines how and when a crossbite needs correction.
bite. This occurs when the upper front teeth cannot
meet or overlap the lower front teeth even though the
back teeth have closed together. Sometimes this this
makes eating difficult. Open bites are caused by the
overdevelopment of the back portion of the upper jaw in
a vertical direction. As the back portion of the upper
jaw grows vertically downward, the lower jaw will open
in a clockwise direction. This explains why open bite
patients have a long facial appearance.
Can I get
braces just on the top or bottom?
on your case. Orthodontics isn't just about making your
teeth straight or making them look better. Most dentists and
orthodontists take a lot of things into consideration when
recommending treatment, such as:
the top and bottom teeth meet with each other (i.e.,
well you can chew your food
you have a tongue thrust problem
extraction or surgery will be necessary to correct your
you will need any appliances in your treatment, such as
a palate expander or headgear (yes, some adults do wear
So you see, it
isn't just a matter of making your teeth look pretty. There
are lot of other factors to take into consideration. This is
why you sometimes need a full set of braces, even if you
think that you only need them on top or bottom. Of course,
some people are lucky. Their bites are good and perhaps they
only need a bit of straightening. People in this position
often can get braces only on top or bottom
When will I
begin to see changes in my teeth after the braces are put on?
According to a
recent ArchWired.com poll, most people begin see changes in their
teeth in the first 2 to 6 weeks of treatment.
going to think I look geeky or weird with braces on my teeth?
you're self-conscious because it is YOUR mouth, but frankly
most people don't give a hoot. Your braces are a
conversation piece for about 3 minutes; after that, nobody
pays much attention. Really. And most people don't think you
look geeky. In fact, they probably think you look cute, or
applaud that you are doing something positive to improve
your appearance and your dental health. Whenever you become
self-conscious about your braces, think about how great
you'll look after they come off!
FYI, here are
the results of a poll of ArchWired.com readers on this very
subject, conducted in January, 2004:
What if I
move away and change orthodontists or dentists once my
orthodontic treatment has begun? What happens?
orthodontists mid-treatment can be tricky. Most
orthodontists work on a "pay as you go" plan. In
other words, you pay a certain amount of money at the outset
of treatment (for the molds, consultations, and having the
braces installed). Then, each month, you pay a percentage of
the rest of your balance. So, if you move away from your
orthodontist, be sure to tell him/her ASAP so that you will
not be charged extra. You orthodontist will probably
"pro-rate" your balance or refund some of your
money. You should also request your dental records, or ask
your orthodontist to forward them to your new doc.
you may wind up paying a few hundred dollars more to your
new orthodontist. After all, this new doc has never seen you
before, and you are a new patient to him. Hopefully,
changing orthodontists mid-treatment won't raise your costs
any event, this is a good argument for NOT PAYING THE ENTIRE
BALANCE UP FRONT. Personally, I think that paying it all
up-front is a really bad idea, even if it saves you money. For example, there was a
story in the news a few years ago about an unscrupulous dentist who
took full payment from his patients -- and then closed his
practice! Some of them had to pay the full amount (in excess
of $5,000) again to the new orthodontist, and some
just couldn't afford the unexpected expense and had to stop
their treatment. The odds are that your dentist would
not do this to you -- but even under the best circumstances,
nobody knows what the future holds, so I think that "pay as
you go" is safest option. For
more details on this subject, read Braces
get teeth extracted as part of my orthodontic treatment?
It depends on
your specific case. When we are young and our jaws are still
growing, dentists/orthodontists can work with our growth to
straighten the teeth without extraction.
once we are adults, dentists are limited to what is already
in place. If your orthodontist recommends extraction, it may
be wise to get at least one more (if not two more) opinions
before going through with the procedure -- once the teeth
are gone, they're gone! Your teeth and jaw help to shape
your face. Changing the underlying structure will result in
some changes in your facial appearance. You should discuss
this with your orthodontist. There are newer types of bracket
systems that apply lighter forces and may be able to correct
your problems without extractions, such as Damon Brackets.
You may want to ask your orthodontist about it.
depending on your unique case, extraction may be the only
way to successfully straighten your teeth and correct your
bite. For more information about extractions, see
Getting Teeth Extracted for Braces.
long does it take to close gaps between teeth after an
on your body's unique physiology. Gaps in teeth on the lower jaw
tend to close slower than on the upper jaw. It can take
anywhere from a few months to a year to close extraction
you have to change your diet when you wear braces?
Yes, you do,
to some extent. At first your teeth will hurt and you won't
be able to bite into hard foods, big sandwiches, or anything
too chewy or crunchy. It is best to stick to soft foods until
your teeth begin to feel better -- usually in a few weeks.
Read Soft Food Suggestions to
help you cope.