A selection of frequently asked questions.

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What is the difference between an orthodontist and a dentist?

Orthodontists are fully qualified dentists who have completed a further period of training and examinations in order to specialise in orthodontics. A specialist orthodontist will have carried out at least 3 years of extra training in a hospital setting after attending dental school and passed an exam set by one of the Royal Colleges. Only those dentists who have completed this training and hold an MOrth or equivalent can register with the GDC as a specialist orthodontist.

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What will happen at my first visit?

We will introduce ourselves and explain what will happen at the visit. An orthodontist will examine your jaws and teeth, using a small mirror and a special ruler. We may need to take photographs, x-rays and moulds (impressions) of your teeth. We will explain the problems with your teeth and how we can help. This may involve braces and/or extractions.
If you are under 18 years old, you will have an IOTN score done (index of orthodontic treatment need). This will help to determine if you need treatment and if you are eligible for NHS treatment.

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Can I play a wind instrument with my brace on?

Most people can continue to play their wind instruments after having braces fitted. Removable appliances can be removed and safely stored until the music session is over. Most wind instrument musicians will get used to wearing a fixed brace within a few months. The more you practice, the quicker you will adjust to your new brace.

If you play a woodwind instrument such as a clarinet or saxophone, you may adjust to your new brace very quickly. If you play a brass instrument such as a trumpet or trombone you may have problems playing high notes, especially soon after your brace is first fitted. If you are having a new brace fitted, try to arrange this at a time when you don’t have important music exams, auditions or performances. Your music teacher should be able to advise you about important dates.

This can all be discussed during your initial assessment & ongoing treatment.

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What is a functional appliance?

This is a type of removable appliance used to correct your bite, but not to align your teeth. Typical functional appliance treatment takes 1 year although the duration will vary in each individual case. The appliance works by moving your lower teeth forward and upper teeth backwards thereby reducing the prominence of the upper front teeth. A commonly used type of functional appliance in the practice is the Twin Block appliance which is easier to tolerate as it comes in 2 parts. The upper and lower parts of the appliance must be worn together to be effective. Functional appliances are normally followed by a phase of fixed appliances to align the upper & lower teeth.

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What is a removable appliance?

This is a type of orthodontic appliance that can be removed from the mouth for certain activities such as tooth brushing or contact sports. Removable appliances normally need to be worn full time ie. day & night. These appliances are commonly used now to facilitate the action of fixed braces such as correcting a deep bite.

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What is a fixed metal brace?

These are often referred to as “train track braces” by patients. They are composed of metal brackets bonded to the teeth and connected to each other by orthodontic archwires. The wires are normally held into the bracket by small elastics (elastomeric modules) with coloured modules available on request.

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What is a ceramic fixed brace?

Rather than using stainless steel, the attachments may be made from a ceramic material to blend in with the tooth colour, producing a more discrete appliance particularly for adults. Ceramic fixed appliances can be as effective as conventional fixed appliances at achieving tooth movement. Sometimes they are not recommended for the lower teeth, if the bite is deep, because the hard material can damage the opposing teeth that contact the attachments. Your orthodontist will be happy to answer any further questions you might have.

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What is a lingual fixed brace?

Unlike standard fixed braces, lingual appliances are attached to the inside surface of the teeth which makes them very discrete. The practice offers Incognito Lingual Braces and this system is capable of producing high quality results. Each Incognito appliance is specially made for each individual case helping to achieve the best possible results, patient comfort and treatment efficiency.

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What are clear aligners?

A clear aligner is like a thin gum shield, custom for each patient using a clear thermoplastic material. A succession of aligners is worn, each bringing the teeth a little closer to the desired position. The aligners are virtually invisible and are therefore an attractive option from the standpoint of appearance.

Aligners can be very effective at correcting mild/moderate dental irregularity, however there are several limitations. In the more severe cases, notably those where extractions are required, aligners may lack the necessary control of the teeth to give consistently good results and often lead to less than ideal results. The practice offers both Orthocaps and the Invisalign clear aligner systems.

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Are fixed braces painful?

When orthodontic fixed braces are initially fitted and teeth start to move there may be some discomfort. This is normal and will only last a few days. If necessary ‘headache type’ painkillers can be used. Fitting the fixed brace itself is a relatively painless procedure during which the teeth need to be kept dry & free from saliva during the process with cheek retractors & suction.

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What are clear aligners?

A clear aligner is like a thin gum shield, custom for each patient using a clear thermoplastic material. A succession of aligners is worn, each bringing the teeth a little closer to the desired position. The aligners are virtually invisible and are therefore an attractive option from the standpoint of appearance.

Aligners can be very effective at correcting mild/moderate dental irregularity, however there are several limitations. In the more severe cases, notably those where extractions are required, aligners may lack the necessary control of the teeth to give consistently good results and often lead to less than ideal results. The practice offers both Orthocaps and the Invisalign clear aligner systems.

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Are fixed braces painful?

When orthodontic fixed braces are initially fitted and teeth start to move there may be some discomfort. This is normal and will only last a few days. If necessary ‘headache type’ painkillers can be used. Fitting the fixed brace itself is a relatively painless procedure during which the teeth need to be kept dry & free from saliva during the process with cheek retractors & suction.

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Will my teeth get marked or discoloured during orthodontic treatment?

If a patient does not take proper care food and plaque can build up around braces and cause tooth decay, gum disease and/or white or brown marks (decalcification) on the surface of the teeth. These marks are permanent and cannot be removed later! To prevent these from happening it is essential to brush the teeth carefully, avoid foods and drinks with a high sugar content and use a fluoride mouthwash daily. The brace itself does not cause the marking on the tooth surface.

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How often do I need to attend?

After the braces have been fitted they must be adjusted regularly and you will normally need to attend every 6-8 weeks. Missed appointments or appointments cancelled at short notice will cause treatment delays so it is important to attend regularly. We will do our best to accommodate you regarding appointment times although this is not always possible.

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How long will treatment take?

A comprehensive of treatment takes 18 months to 2 years; however it can be longer in some more complex cases. In some simpler cases the treatment can be carried out in less time. Your orthodontist will discuss this further at the initial visits.

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Will I need teeth removed during my treatment?

You may need teeth extracted as part of your orthodontic treatment, your orthodontist will discuss this with you at your initial visits. Extractions are used in orthodontic treatment for a variety purposes, for example, to provide space to align the teeth or to reduce the prominence of the upper or lower teeth. If you need extractions your orthodontist will write a letter to your dentist at the appropriate time and keep you fully informed.

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Should I continue to attend my dentist during my orthodontic treatment?

Yes. It is essential to continue seeing your dentist during your orthodontic treatment. Your dentist will check the health of your teeth and gums and carry out any routine dental treatment required. Your dentist may contact our practice if any dental health issues become apparent during treatment.

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What is a retainer?

Retainers are fitted at the end of orthodontic treatment after the braces are removed. Retainers are designed to minimise unwanted movement of teeth after orthodontic alignment ie. relapse. Retainers normally need to be worn indefinitely, as long as you want your teeth to remain straight. Retainers can be either removable or fixed onto the teeth and there are different types of retainers. The choice of retainer is affected by a number of different factors and your orthodontist will explain which retainer is best for you. Sometimes you will be recommended to wear more than one type of retainer to reduce the chances of relapse.

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What is a vacuum formed retainer?

This is a clear retainer, like a thin gum shield, normally worn full-time initially and then on a part-time basis. Vacuum formed retainers are now widely used in orthodontic practice. You must never eat or drink with this type of retainer in place. Initially it may feel quite tight fitting and a little strange, but most patients adapt very well in time.

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What is a bonded or permanent retainer?

This is a short length of wire bonded to the back of your front teeth using an adhesive resin. There are specific clinical situations when this type of retainer is indicated, these retainers are not used routinely in all cases. You must spend extra time cleaning around it and if it ever gets loose, you should seek advice immediately. You should continue to wear your removable retainer(s) as advised by your orthodontist.

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