Dental Braces—Top 10 Frequently Asked Questions

1. Do braces hurt?
For the most part, braces do not hurt. The procedure of getting braces simply involves gluing the braces to your teeth. The day after you get braces, your teeth may start feeling sore and may stay sore for a few days. The soreness usually peaks during days 2-3, but should start getting better by days 4-5. Future adjustments may or may not cause you discomfort depending on what is being done to your teeth. To alleviate the discomfort, you can take whatever pain medications you would normally use for a headache.
Because your lips, cheeks and tongue are not accustomed to rubbing against the braces, you may experience sores. The sores may last for one to two weeks until your lips, cheeks, and tongue get used contacting your braces. If there is part of the braces that is irritating your mouth, you can place orthodontic wax to help smooth the rough area of the braces. After your lips, cheeks and tongue get used to the braces, you may even forget you have them on.

2. What causes crooked teeth?
If you have crooked teeth or a bad bite you probably inherited these traits. However, losing some baby teeth early or indulging in harmful habits such as thumb or fingersucking can also cause your teeth to be crooked.

3. When is the best time to schedule a consultation with the orthodontist?
The American Association of Orthodontists recommends that all children see an orthodontist for an evaluation no later than age seven. There are a few orthodontic problems that should be corrected at that age. If your orthodontist determines that no treatment is necessary at that time, he or she will be able to offer you guidance on when to start treatment or when to bring your child back for re-evaluation.
For adults, treatment can be started at almost any age as long as the gums and bone surrounding the teeth are healthy.

4. Can I get my braces off sooner?
Unfortunately, orthodontic treatment time is limited in part to how quickly or slowly your bone can remodel, thus allowing your teeth to move. In younger patients with less-developed bone, teeth tend to move faster than in older patients with more-developed bone. Some patients think that if the orthodontist “tightens” the braces more, the teeth will move faster. Indeed, the teeth need force in order to move. However, there is an optimal force that moves teeth, and increasing the force level after the optimal level has been reached may actually cause damage to the bone and surrounding tissues, and may slow down tooth movement. The best way to ensure that your braces come off on time is to not break anything, wear your elastics and prescribed, and keep your teeth and gums healthy.

5. Can I get braces just on my top or bottom teeth?
That depends. Besides straightening your teeth, orthodontists are also concerned about correcting your bite if needed. Many times, if only one arch is treated, the bite will still be uncorrected. Over time, a malocclusion (bad bite) could cause damage to your teeth, tissues, and jaw joints.

6. Do I need a referral from my dentist to see the orthodontist?
No. While dentists can refer patients to the orthodontist, many patients actually are referred to the orthodontist by family and friends of existing patients. Exceptions to this rule may be if you are in an HMO plan that will only allow you to see certain orthodontists.

7. Are there clear or less noticeable braces?
Yes. Compared to 30 years ago, braces have gotten smaller and can be directly bonded (glued) to teeth. The bands or metal rings that used to be placed on every tooth now only need to be placed on the back teeth, if they are placed at all.
Besides smaller braces, there are also clear braces or even lingual braces that are bonded on the tongue-side of the teeth. Another option to straighten teeth is not to use braces at all, but a series of clear aligners such as Invisalign. Your orthodontist can determine which option would be best for you.

8. Can wisdom teeth (third molars) cause crooked teeth?
Research has shown that wisdom teeth or third molars do not necessarily crowd teeth. In fact, some people who have had their wisdom teeth removed still get crowding, while others that still have their third molars erupted or impacted do not have crooked teeth.

9. What is an orthodontist?
An orthodontist is a dentist who has completed an additional two to three years of full-time training at an accredited residency program after graduating from dental school. During their residency program, orthodontists learn to diagnose and treat dental, facial, and jaw problems. Orthodontists typically limit their practices to the field of orthodontics to focus on correcting misaligned teeth and jaw problems.
When choosing an orthodontist, you are not only getting someone who has undergone significant additional training, but someone who deals with orthodontic problems every day.
How many years of schooling does an orthodontist have to go through? If we start calculating at first grade, orthodontists must graduate high school (12 years), college (4 years), dental school (4 years), and orthodontic residency (2-3 years). So by the time they finish their orthodontic training, most orthodontists have been in school for 22-23 years!

10. Do I need shots?
No shots are generally needed for orthodontic treatment. However, if your orthodontist refers you out for other procedures such as extractions, surgical exposure of teeth, or miniscrews, you may need a local anesthetic.