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I’m getting braces. Why must I have teeth removed?

Patients often ask why it’s necessary to have teeth removed when getting braces. Well, if possible, we prefer not to remove teeth—treament is faster if we don’t. However, to ensure your treatment is successful, the removal of some teeth is often recessary.

There are several reasons why you may need teeth removed when receiving orthodontic treatment. Here are three common reasons:

  1. crowding
  2. poor lip posture
  3. mismatched jaw size.

The teeth that most often need to be removed are premolars — the ones between your eyeteeth (below your eyes) and molars (the biggest ones at the back of your mouth).

Note: As orthodontists, we don’t usually remove teeth ourselves. Instead, we’ll refer you to your family dentist.

1: Crowding

Crowding is more common in modern humans than our ancestors. This is because, thanks to evolution, modern jaw bones have become smaller and are often too small for their teeth to fit.

You see, we don’t need as much force to eat our food like we used to. Our diet is softer — less gritty — so our jaws have become smaller and our teeth are subjected to less wear and tear.

With crowding, removing some teeth is sometimes necessary to get the best and most stable outcome long term for the patient.  Trying to keep teeth in cases where there is severe crowding,  can cause a patient’s teeth to stick out and also result in gum or bone loss.

In the case of mild crowding, expansion, rather than extraction, can be an option. (This is when the size of the patient’s arch is increased by moving the teeth outwards using what’s known as an expander appliance).

2: Poor lip posture

If you have poor lip posture, your face can have an unbalanced look. Lip posture is affected by the position of the underlying teeth. If your front teeth stick out, removing some teeth will enable us to move them back to improve your lip posture. If your lip posture is already good, failure to remove teeth could cause your teeth and lips to stick out, and we won’t be able to close your lips.

3: Mismatched jaw size

If your upper and lower jaws are mismatched, you will have either an under or overbite. With an overbite, your lower teeth could bite into the roof of your mouth. In the case of severely mismatched jaws, surgery can be the best treatment. However, if the mismatch is mild, or surgery is not an option for you, the removal of teeth can compensate and camouflage the jaw mismatch.

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How much longer before I can get my braces removed?

As an orthodontist, I’m often asked is “how long will my treatment take?” Well, like many things in life, the answer is not straight forward.

In reality, it’s hard to provide a definitive answer. I wish I could, but I don’t like raising expectations that can’t be fulfilled. With a lot of orthodontic treatment, until close to the end point, it’s impossible to tell when it will be finished.

Sometimes, treatment can be fast. For example, a small gap in your front teeth can be fixed within six months. However, orthodontic treatment usually takes between one-and-a-half to two years, sometimes longer. It depends upon the orthodontic problems we are going to correct.

The ingredients of a healthy smile

Of course, the whole point of getting braces is to create a healthy smile. Here’s what a healthy smile looks like.

  • jaws are properly coordinated to allow the teeth to function well together
  • teeth are aligned making it easy to brush and floss
  • lips close naturally because of correctly positioned incisors
  • roots are well set up and anchored in healthy gums and bone.

Creating a healthy smile doesn’t happen overnight. It takes time to do it properly, so that the patient can get the best possible outcome.

What affects treatment time?

The length of your treatment depends on several factors:

  • The problem being fixed (crowding, poor lip posture, mismatched jaw sizes, etc.)
  • Your age (treatment can be faster with younger, growing patients)
  • Your cooperation
  • Your face type.

We are not all the same

The way you respond to orthodontic treatment will depend on your face type. For example, if you have a strong face type with powerful muscles, the bone will be denser and treatment will likely take longer. On the other hand, if you are receiving treatment for crowding (when there are too many teeth in your mouth), your teeth will move more easily into the spaces where teeth have been removed, which may result in a quicker treatment time.

It’s about below the surface

When you first get your braces fitted, you will probably see HUGE changes happen. Three months into your treatment, you might think things are going super well, and the job is done. However, don’t get too excited. Though the parts of your teeth you can see may well be lining up nicely, the roots below won’t be — to get the roots and everything else lined up nicely in your mouth takes time. And as the old saying goes, “Good things come to those who wait.”

Orthodontic technology is always improving. And today we now have sophisticated technology, such as Suresmile, that makes orthodontic treatment more efficient than ever before.

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If your dental braces are causing discomfort, here are some helpful tips

When you get dental braces fitted, it’s not uncommon to feel a little discomfort. In this post I offer some tips on managing pain you may feel when having braces fitted or adjusted. If you find this useful, please share.

Be prepared

Like a good Boy or Girl Scout, be prepared. Before you visit the clinic, take pain relief, like Panadol. It is much more effective when taken before the pain starts, rather than after. It also pays to have eaten a decent meal. This is because you will probably feel a bit ‘weird’once your braces are fitted (it can take a little while to get used to all the bumps in your mouth), and you might not feel like eating.

What can you eat?

For about three days after having braces fitted, most people feel a little sore. So, pre-plan the meals you would like to eat during this time. I suggest you stick to soft food, like scrambled eggs, but there are plenty of tasty choices available. For recipe ideas, check out our Facebook and Pinterest pages. Depending on your treatment, you could be wearing braces for between six months and two years. During this time it pays to be careful about what you eat. As a rule, don’t eat anything you can’t crush between your finger and thumb. You should also avoid chewy or sticky foods, sticky or crunchy foods, like toffee or muesli bars or biting straight into a raw carrot or crunching on popcorn. Fruit, like apples, is okay — just cut it into small pieces first.

Children with braces

If your child is getting braces, and they are particularly active, during those first few days, feed them a protein shake before school. This way you can be certain they’re getting all their energy requirements for the day, even if they don’t eat as much as usual. They’ll be much happier: active kids burning through calories but not eating much can get a bit ‘tetchy,’ to say the least.

Protecting your mouth

Braces can sometimes irritate the inside of your cheek. So, we provide a little container containing braces wax. If it’s a bracket that’s causing the problem, use the wax to create a little pad on the bracket. Or, if a piece of wire is the culprit, put a long ‘sausage’of wax over the bracket. At Turner Lim, you needn’t come to the clinic if you run out of wax. Just phone up and we’ll put some in the mail. While you’re waiting for new wax to arrive, silicon earplugs are an excellent alternative — you can even use chewing gum, though it’s not ideal.

Got a pencil?

A pencil with an eraser on the end can also be useful for pushing back a distorted wire, and there is no risk of hurting your finger.

More tips for pain relief

For patients with particularly sensitive mouths, I often recommend taking Nurofen as well as Panadol. Also, some types of braces, like SureSmile, use heat activated wires. These wires are in their working form at room temperature. If you ‘chill them down’ by eating or drinking something cold, they go into a soft, bendy state. You’ll notice less pressure when this happens.

What do you think?

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