Orthodontic FAQs

How does a brace move teeth?
Braces use steady gentle pressure to gradually move the teeth into their proper position. Fixed braces or ‘train tracks’ have little buttons called ‘brackets’ which can be made from metal (or sometimes from clear ceramic material) that are placed on each tooth and a wire then connects them all together. This wire is called an ‘arch-wire’ and when it is tied into each individual bracket, it gradually moves the teeth to fit along the original shape of the wire. So the deflection of the wire when it is tied into your teeth is transient and as the wire gradually returns to the original shape, it has the ability to move the teeth into the same shape as the wire.

The braces can be made of metal, ceramic or plastic, they are sometimes removable but generally fixed to your teeth. The constant gentle force that the appliance exerts on your teeth can carefully and predictably direct your teeth in a controlled fashion towards their ideal position.

Do braces hurt?  
Having the braces fitted is straightforward and not at all painful. However, you may feel some soreness or discomfort for a couple of days after the braces are placed and following your routine adjustments every 6-8 weeks. The first day your braces are fitted is generally focused on giving your lips and cheeks time to become accustomed to having an attachment permanently bonded to the tooth surface. Your lips and cheeks will toughen up after a number of days, however they can feel irritated for the first 3-4 days after the initial placement of the brace. This can be eased by the placement of specialist orthodontic wax to reduce the rubbing tendency; we will give you the wax and show you how to do this on the day the braces are fitted.

Once the teeth begin to move, you will notice a general soreness in your mouth which may last for up to 3 or 5 days. About a third of our patients are quite aware of this ‘ache’ and for these individuals, we suggest you take a paracetamol or nurofen for the day (s) that your teeth are tender.

You may also find that your teeth feel loose, don’t worry this is completely normal and is a necessary part of treatment so that they can be moved to a better position. The teeth will firm up once again once we stop the movement when they have reached their corrected position

What age is a good time to schedule an appointment?

As an adult if you would like to improve your smile and are keen to correct your teeth, then any age is a good time to visit us.

Most children are treated from age 12 onwards once we have established that the growth and development of the face, jaws and teeth is progressing normally.

At age 7, several permanent teeth have erupted and it is at this stage that the AAO recommend a quick screening exam with the orthodontist to look out for any growth problems with the teeth or jaws. Treatment success can be optimised by timing the treatment to coincide with the pubertal growth spurts which allows maximum improvement to the problem. Early intervention in severe cases can possibly avoid the need for jaw surgery later in life.

Most patients assessed at age 7 do not need any intervention before all permanent teethare present. So although only a few orthodontic problems need to be corrected at an early age, the early exam will allow Dr O’Donnell to guide you as to when is best to start treatment and maybe to also help in the cessation of any habits.

Intervention and early orthodontic treatment between ages 7 to 10 would be indicated if it was necessary to:

1. Correct cross bites
2. Manage problematic eruption of teeth
3. Correct incisal protrusion with a functional appliance if there is a significant risk of:

- Psychological distress and teasing by peers or

- Accidental damage from falling, sport or daily activities.

So the benefits of early intervention for the small number of patients who require it allow:

1. The jaw growth to be influenced positively
2. Improved eruption of the teeth,
3. Reduction in  the likelihood of impacted permanent teeth
4. Preserve and gain space for the permanent teeth that have yet to erupt.
5. Lower the trauma risk to the front teeth
6. Help correct thumb and digit sucking habits
7. Harmonise the co-ordination of the upper and lower jaws
8. Improve aesthetics and therefore self- esteem.

So, early detection and prompt treatment will shorten and perhaps avoid the need for later comprehensive orthodontic treatment.

Is it necessary to have a referral from my dentist if I wish to book a consultation with you?
No, you can contact us directly and arrange a time to suit yourself. Many of our patients are referred by their family dentist but a significant amount of patients initiate the consultation themselves.

How long does orthodontic treatment take?  
This depends on the position and stage of development of your teeth, jaw and face. In general though treatment times are reduced as the latest technologies allow treatment to be easier and faster.

The average time is 12-18 months, however treatments can range from 4-30 months depending on:

1. The complexity of the problem
2. The stage of jaw growth
3. Large variation in each individual’s response of the teeth
4. Compliance for example, wearing elastics as prescribed (these are sometimes necessary to allow complete correction of the bite towards the end of treatment)

Treatment duration would increase if:

-you miss many appointments

-you damage your brace by eating very crunchy or hard foods

Is it necessary to extract teeth?

The majority of our patients are successfully managed without having to remove teeth, however there are some severe cases of overcrowding or asymmetry that do necessitate extractions.  The specifics of your individual problem will be discussed with you at your consultation visit.

What foods are not advised to eat while I have my braces on?
To generalise it is the hard, crunchy and sticky foods that are best avoided as the brace can be easily damaged by eating these foods (see  list below). This damage can distort the wires causing a change of direction of tooth movement and can actually sometimes break the brace.

Avoid tough meats, crusty rolls, crunchy vegetables/ fruit, hard or sticky sweets, fizzy drinks and acidic drinks. Hard foods can break or damage the brackets, sticky foods can get caught between the wire and the bracket and are difficult to remove with the tooth brush. Sugary foods will obviously cause tooth decay and increase plaque levels which in turn will lead to gum disease and potential bone loss.

Chewing pens, pencils and biting nails etc. must also be avoided so as not to place excess stress on the front teeth.

Examples of sticky food best avoided: Liquorice, toffees caramels, starburst, and skittles.

Examples of hard food best avoided: Ice, nuts, crusty rolls, corn on the cob, hard apples and raw,hard bagels, crunchy peanut butter, hard pizza bases. Ideally drink your fruit juice with a straw to minimise the amount of time the juice is in contact with your enamel. Throughout your treatment you do not have to avoid apples and raw carrots but we advise that you shred the carrots and cut your apples into small bite sized pieces, so your two front teeth are not biting through a lot of resistance.

Some people prefer to eat soft foods such as yogurt or soups following adjustment visits or perhaps just initially when the brace is first applied.

Treats such as ice-cream, chocolate bars such as ‘ twirl’ or ‘flake’ can be enjoyed on special occasions followed by a thorough clean!

What are the risks of braces?

1. Brushing your teeth when you are wearing braces is more difficult. Inadequate oral hygiene (tooth brushing/ flossing)especially if combined with a high sugar intake can lead to weak spots or cavities on your teeth and swollen and bleeding gums.
2. The roots of your teeth tend to shorten when moved by a brace. This is unlikely to cause a problem unless you happen to be born with very short or slender roots. Occasionally teeth can die if they are unable to cope with the pressures of a brace. It is impossible to predict this, often it can be linked to a previous traumatic incident when the tooth was weakened by a fall or from a sports injury. However, sometimes it can occur in a tooth with no previous history. Any subsequent treatment would generally  be to resolve the discolouration that does occur when a tooth dies and root treatment would be carried out by your family dentist.
3.  Some people who have very thin gums may be at risk of further recession, particularly if the gums are not kept meticulously clean throughout the treatment.
4. You must maintain the teeth in their corrected position once we remove the braces. We provide you with retainers to wear in bed. They are often a combination of a fixed (invisible) retainer glued to the inside of your 4 front teeth, supplemented by a plastic retainer which you wear in bed at night. Some people prefer to avoid the wire inside their teeth and instead commit to wearing the plastic retainer as necessary following the removal of the brace

How often will I have appointments?

Generally, the appointments are every 6 weeks, occasional shorter or longer intervals will be advised depending on the type of work that is been carried out.

Do I need to take time off work to accompany my child to each visit appointment?

Other than the initial consultation visit and the day that the braces are fitted, there is no necessity to accompany your child to each visit. We realise that most parents are working and it is not possible to attend as often as you would like. We are of course happy to telephone and speak with parents with treatment updates or answer any questions you may have along the way.

The initial consultation usually lasts about 30-40 minutes which provides sufficient time to undertake a comprehensive detailed exam and allow an adequate follow- up discussion with you in a non- rushed manner so as to address your concerns and questions.

How do I brush my teeth when I have braces? 
We provide you with a range of specialised toothbrushes, fluoride mouthrinse and flossing aids when your brace is fitted. Ideally you should brush your teeth after each time you eat (i.e. at least three times a day) so that your teeth gums and mouth remain healthy, fresh and clean. Regular brushing will prevent the build-up of any food and daily flossing will allow you to get in between your teeth where your brush is unable to reach.

Do I need to see a hygienist?
Regular hygienist visits should be continued as normal and any adults with a history of gum disease should see their family dentist or a gum specialist to receive the ‘all clear’ before beginning your orthodontic treatment.

General dentist visits
If have braces do I still attend my family dentist for check-ups?  Yes in fact, it is probably more important that you continue to visit your dentist regularly whilst receiving treatment from us. With braces in place, food finds it easier to hide in places that your toothbrush cannot reach, this results in plaque and bacteria build-up which can result in cavities and gum disease.

How much do braces cost?

It is impossible to give an accurate quote for your treatment until you have attended for your consultation visit and your treatment needs have been established. Once we know what work is necessary, we can then give you detailed information regarding cost and payment plans.

The cost for treatment includes all of the work done with us, the provision of retainers at the end of your treatment and supervision of same for up to 2 years after the active treatment has been completed.

There is no need to pay the treatment fees up front. Fees can be paid in increments throughout the treatment period on a 0% interest basis. All our treatments are eligible for the 20%’ med II’ rebate for Irish tax payers.

Can I return to work/ school after my braces are placed?
Yes, you will not be in any discomfort and your speech will be normal. It generally does feel strange for the first day or so but it is very easy to adapt and there is no reason why you should depart from your normal routine.

Some people prefer to eat softer foods on the day the braces are placed; others adapt very readily and eat as normal, however the avoidance of hard, crunchy and sticky foods begins as soon as the braces are placed.

Can I get braces even though I have crowns and a denture?

Yes, a tooth with a porcelain crown will respond to forces from your orthodontic appliance as will teeth with fillings.

When teeth are missing you may wish to have the spaces closed or alternatively re-arrange the space so that an implant can be placed in liaison with your family dentist.

When should I wear a gumshield?

Gumshields should be worn for any contact sport which may allow significant physical contact between:

1. Players
2. Moving objects such as rackets and balls.

Anyone with or without a brace should wear a mouthguard or gumshield over their fixed brace to avoid damage and permanent injury to their teeth and gums. The brace in itself can provide a lot of support to the teeth as it will spread the load.

There are several different types of orthodontic mouthguards specially designed to fit over fixed appliances and we can recommend which is the best type for you. We supply the full range in our practice and will help you obtain one most appropriate to you. It is important to be aware that some dental insurance plans will not pay out, if damage occurs during contact sports when a mouthguard is not in position.

Wind Instruments
Advice for patients who play wind instruments:  Some experienced musicians who play a wind instrument may find that braces affect their ability to perform. Fortunately singing is not at all affected by braces unless the lingual appliances are worn as these do have usually a transient but sometimes an on-going effect on speech.

Most wind instrument musicians will adapt to the brace within a few months, the more you practice your instrument, the quicker you will adjust to it. If you play a wood wind instrument such as a saxophone or a clarinet, it is easier to adjust and your playing should return to normal quite quickly however a brass instrument such as a trumpet or trombone may take number of months to fully adjust, particularly for the high notes.

Before you start your treatment please talk to us about the instrument you play. We have special lip protectors that you can place between your brace and the lips when playing your instrument as we realise that the mouthpiece of the instrument is pressed quite tightly against the lips.

Link to Typical Orthodontic Problems

Link to Brushing with Braces

Link to Explanation of the Parts of a Metal Brace

View over the benefits of Orthodontic Treatment

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