FAQ
Pre-Treatment Questions
- What is Orthodontics?
Orthodontics is the branch of dentistry that specializes in the diagnosis, prevention and treatment of dental and facial irregularities. The technical term for these problems is “malocclusion,’ which means “bad bite.”
- What makes an orthodontist different than a dentist?
All orthodontists are dentists, but only about 6 percent of dentists are orthodontists. An orthodontist is a specialist in the diagnosis, prevention and treatment of dental and facial irregularities. Orthodontists must first attend college, and then complete a four-year dental graduate program at a university dental school or other institution accredited by the Commission on Dental Accreditation of the American Dental Association (ADA). They must then successfully complete an additional two-to three-year residency program of advanced education in orthodontics. This residency program must also be accredited by the ADA. Through this training, the orthodontist learns the skills required to manage tooth movement (orthodontics) and guide facial development (dentofacial orthopedics). Only dentists who have successfully completed this advanced specialty education may call themselves orthodontists.
- How can I be sure an orthodontist is ‘right’ for us?
An orthodontist is the best place to get advice regarding jaw growth and tooth movement. Treatment options associated with altering jaw growth and tooth movement will be provided to you at Patritto Orthodontics. If you would still like to compare your comfort level with another orthodontic office, or simply hear another orthodontist’s assessment of your child’s problem, arrange for a second opinion.
You may have already had more than one orthodontist recommended to you by family, friends, your dentist, or the AAO’s referral service. Seeking out a member of the AAO assures that your second opinion is from an educationally qualified orthodontic specialist. You should feel confident in the orthodontist and his or her staff, and trust their ability to provide you the care and lifetime orthodontic value you seek. - Why is orthodontic treatment important?
The value of an attractive smile and the increased self-esteem it results in should not be underestimated. A pleasing appearance is a vital asset to a person’s self-confidence. A person’s self-esteem often improves as treatment brings teeth, lips and face into proportion. In this way, orthodontic treatment can benefit social and career success, as well as improve one’s general attitude toward life.
Crooked and crowded teeth are hard to clean and maintain. This may contribute to conditions that cause not only tooth decay but also gum disease and tooth loss. Other orthodontic problems can contribute to abnormal wear of tooth surfaces, inefficient chewing function resulting in digestive problems, excessive stress on gum tissue and the bone that supports the teeth, or misalignment of the jaw joints which can result in chronic headaches or pain in the face or neck.
When left untreated, many orthodontic problems become worse. Treatment by a specialist to correct the original problem is often less costly than the additional dental and/or health care required to treat more serious problems that can develop in later years. - At what age should I schedule an appointment for orthodontic screening?
The American Association of Orthodontists recommends an orthodontic screening no later than age 7. By this age, the six-year molars and several permanent teeth have erupted, allowing the doctor to effectively evaluate potential orthodontic problems. At Patritto Orthodontics we provide these early screenings as a complimentary community service. There is no charge for the New Patient examination, panorex X-rays, or check-up visits. (If additional records and extensive consultation are recommended, charges may be incurred.)
- Why evaluate at such an early age?
Some orthodontic problems are easier to correct if detected earlier than waiting until jaw growth has slowed. Early treatment may result in shorter less complex treatment, or help a patient avoid the need for surgery later in life.
- Is it too late to have braces if I am already an adult?
A surprising percentage of our patients are adults, especially in light of advanced technological treatment appliances such as Invisalign®. Health, happiness and self-esteem are vitally important to adults, and because healthy teeth can be moved at any age, an orthodontist can improve the smile of practically anyone. No patient is “too old” to wear braces!
- How is adult treatment different from that of children and adolescents?
Adults are no longer growing and they may also have experienced some breakdown or loss of teeth and bone that supports teeth. Adults are also more likely to have worn, damaged or missing teeth. Orthodontic treatment may then be only a part of the patient’s overall treatment plan. The orthodontist, an oral surgeon, the family dentist, a periodontist, and/or an endodontist may need to work in close coordination to achieve the best treatment results.
- Am I required to have a referral from our general dentist to schedule an initial examination?
Absolutely not. As a matter of fact, many of our patients, because they have expressed concern about their dental health and appearance, have been referred by their family & friends. We encourage families to take charge of their orthodontic future and refer themselves for an evaluation.
- What will happen at the initial examination?
The patient and parent(s) will be greeted by one of our New Patient Coordinators who will review the Patient Health History form. You will then meet Dr. Patritto, who will take the time to answer any questions a patient or parent may have. He will perform a brief but thorough exam and help answer some of the most commonly asked questions, such as:
- Is there evidence and/or probability of an orthodontic problem?
- Is there anything that should be done at this time to correct or prevent a problem, or is it still too early?
- If nothing needs to be done right now, what is the likelihood treatment will be needed in the future, and what might that involve?
- Will any teeth need to be removed?
- How long will the treatment take to complete?
- How much will the treatment cost?
- Is there a fee for the initial examination?
There is no fee for the initial examination. At this visit, a complimentary panoramic X-ray will also be taken if recommended by Dr. Patritto. (Charges may occur if records in addition to the panorex X-ray are obtained during this visit.)
Because early orthodontic evaluation is so strongly encouraged, most orthodontists will provide an initial examination and brief consultation free of charge. Should it be determined the time is not yet right for active treatment, Dr. Patritto will continue to monitor young children on a yearly or semi-annual basis. Sometimes he eventually determines no treatment is ever necessary and never charges a thing! - How do I schedule an appointment for an initial examination?
Simply call our office and we will be happy to schedule an appointment for you! Or you may click Request an Appointment now.
- What is First Phase treatment?
First Phase treatment, when needed, is usually started between the ages of 7 and 10. First-phase treatment typically takes about 12-18 months. There are several primary objectives for First Phase treatment:
- To address significant problems early in an attempt to prevent severe corrections later.
- To develop jaws for crowding concerns and modify jaw growth for an improved jaw relationship.
- To improve self-esteem and self-image.
- Will my child need full braces if he/she has First Phase Treatment?
While it is most common for children to need full braces after First Phase treatment, this is not always the case. Growth and tooth eruption are closely monitored following this phase of treatment. Throughout this period, parents and patients are kept informed as to any future treatment recommendations.
- Can orthodontic correction occur while a child still has some baby teeth?
Yes. Some orthodontic problems are significant enough to require early intervention. However, if a patient is not yet ready for treatment, we will follow that patient’s growth and development until the time is right for treatment to begin. At Patritto Orthodontics, we have a system that makes sure each patient is evaluated when appropriate.
- Why do baby teeth sometimes need to be pulled?
Sometimes pulling baby teeth is necessary to allow severely crowded permanent teeth room to come in at a normal time in a reasonably normal location. Sequential removal of baby teeth and permanent teeth is sometimes recommended to allow severely crowded teeth to move on their own into much more favorable positions. This sequential extraction of teeth, called serial extraction, is typically followed by comprehensive orthodontic treatment after tooth eruption has improved as much as it can on its own.
- Will any permanent teeth need to be removed for braces?
Removing permanent teeth is sometimes needed to get the best orthodontic result. Straight teeth and a balanced facial profile are always the goal. However, because today’s technology has resulted in advanced orthodontic procedures and appliances, the need for removing permanent teeth has been greatly reduced.
- Will an expander be needed?
At the completion of diagnosis, Dr. Patritto will determine whether a patient will need an expander or not. An expander is a device that painlessly spreads the halves of the upper jaw apart. New bone fills in between the two halves and the upper jaw remains permanently wider.
- What are the most commonly treated orthodontic problems?
Please visit our Common Problems section.
- How can a child’s growth affect orthodontic treatment?
Orthodontic treatment and a child’s growth can compliment each other. A common orthodontic problem to treat is protrusion of the upper front teeth ahead of the lower front teeth. Quite often this problem is due to the lower jaw being shorter than the upper jaw. While the upper and lower jaws are still growing, orthodontic appliances can be used to help the growth of the lower jaw catch up to the growth of the upper jaw. Abnormal swallowing may be eliminated. A severe jaw length discrepancy, which can be treated quite well in a growing child, might very well require corrective surgery if left untreated until a period of slow or no jaw growth. Children who may have problems with the width or length of their jaws should be evaluated for treatment no later than age 10 for girls and age 12 for boys. The AAO recommends that all children have an orthodontic screening no later than age 7 as growth-related problems may be identified at this time.
- What kinds of orthodontic appliances are typically used?
Please see our Types of Appliances section.
Active Treatment Questions
- What are the most commonly treated orthodontic problems?
Please see our Common Problems section.
- How do braces feel?
Most people have some discomfort after their braces are first put on or when adjusted during treatment. After the braces are on, teeth may become sore and may be tender to biting pressures for three to five days. Patients can usually manage this discomfort well with whatever pain medication they might commonly take for a headache. The orthodontist will advise patients and/or their parents what, if any, pain relievers to take. The lips, cheeks and tongue may also become irritated for one to two weeks as they toughen and become accustomed to the surface of the braces. Overall, orthodontic discomfort is short-lived and easily managed with over-the-counter medications. We do not prescribe pain medications.
- Can I return to school or work the day my braces are placed?
Yes. There is no reason not to return to school or work after an orthodontic appointment.
- Can I still play sports?
Yes. We recommend a mouthguard for all sports.
- Will braces interfere with playing musical instruments?
Playing wind or brass instruments, such as the trumpet, will clearly require some adaptation to braces. With practice and a period of adjustment, braces typically do not interfere with the playing of musical instruments. Wax and/or ‘Kissable Kovers’ are available and can help.
- Do you give shots?
No, shots are not necessary in orthodontic treatment.
- Do you use recycled appliances?
Absolutely not! It is our belief that each patient be provided with their own braces to achieve the very best orthodontic result. We maintain the highest standards for all sterilization requirements.
- Do teeth with braces need special care?
Patients with braces must be careful to avoid hard and sticky foods that can damage the braces. Damaged braces will almost always cause treatment to take longer, and will require extra trips to the orthodontist’s office.
Keeping the teeth and braces clean requires more precision and time, and must be done every day if the teeth and gums are to be healthy during and after orthodontic treatment. Patients who do not keep their teeth clean may require more frequent visits to the dentist for a professional cleaning.
The orthodontist and staff will teach patients how to best care for their teeth, gums and braces during treatment. They will tell patients (and/or their parents) how often to brush, how often to floss, and, if necessary, suggest other cleaning aids that might help the patient maintain good dental health. - Are there foods I cannot eat while I have braces?
Yes. Sticky foods like caramels, caramel apples, taffy, licorice, gummy bears, starburst, skittles, sugar daddies, sugar babies and tootsie rolls should be avoided. Hard foods such as apples, carrots (unless cooked or cut into small pieces), nuts, popcorn, hard candy, corn on the cob, bagels, pizza crusts, jerky, hard pretzels, ice and Doritos should be avoided as well.
- How often should I brush my teeth while in braces?
Patients should brush their teeth at least four times each day: after breakfast, lunch (or as soon as they get home from school), dinner, and before going to bed. We will show each patient how to floss their teeth with braces on, and will also recommend using a fluoride/rinse.
- Do I need to see my family dentist during orthodontic treatment?
Yes! To keep teeth and gums healthy, regular visits to the family dentist must continue during orthodontic treatment. Adults who have a history of or concerns about periodontal (gum) disease might also see a periodontist on a regular basis throughout orthodontic treatment.
- How long will orthodontic treatment take?
In general, active treatment time with orthodontic appliances (braces) ranges from one to three years. Interceptive, or early treatment procedures, may take only a few months. The actual time depends on the growth of the patient’s mouth and face, the cooperation of the patient and the severity of the problem.
- Why does orthodontic treatment time sometimes last longer than anticipated?
Estimates of treatment time can only be that - estimates. Patients grow at different rates and will respond in their own ways to orthodontic treatment. The orthodontist has specific treatment goals in mind, and will usually continue treatment until these goals are achieved. Patient cooperation, however, is the single best predictor of staying on time with treatment.
- How important is patient cooperation during orthodontic treatment?
Successful orthodontic treatment requires a consistent, cooperative effort by the orthodontist, the patient and their family. To successfully complete the treatment plan, the patient must carefully clean his or her teeth, wear rubber bands, headgear or other appliances as prescribed by the orthodontist, and keep appointments as scheduled. Damaged appliances can lengthen the treatment time and may undesirably affect the outcome of treatment. The teeth and jaws can only move toward their desired positions if the patient consistently wears the forces to the teeth, such as rubber bands, as prescribed.
- I think something’s broken on my braces. What should I do?
Please visit our Emergency Info section.
- I just got my braces off and my gums seem puffy and red. Is this common?
When you first get your braces off your gums will feel puffy and seem somewhat red. With continued gentle gum massage this will decrease within a couple of days. If you are experiencing ongoing problems with your gums longer than a couple of days, please contact your general dentist.
- How often will I need to visit my orthodontist now that my braces are off?
You will have very few visits to our office now, but checking your retainer is still very important. We will continue to see you for a year or so at which time you are invited to call as needed. Always remember to bring your retainer to every appointment.
- Why are retainers needed after orthodontic treatment?
Your invisible retainer is designed to hold your teeth in their corrected position until the bone surrounding the roots of the moved teeth “fill in” and make them “solid.” If we do not retain (or hold) orthodontic tooth movement, the teeth will move back to their old positions and all that time wearing braces would be wasted.
- How often and how long will I need to wear my retainers?
When you’ve completed the moving part of your treatment, you’re ready for the holding part! The next few months will be a critical part of your treatment. If your retainer is going to do the job, you need to wear your retainers as instructed! As an unofficial “insurance policy”, it is recommended you wear your retainer on a nightly basis indefinitely.
You will gradually be able to cut back on the number of nights you need to wear your retainer. Eventually, you will be able to simply try your retainer on and if it feels somewhat tight, wear it for the night. If it feels okay, you can skip that night. - What kind of special care do my retainers require?
Brush your retainers every morning with cool water and a product called Retainer Brite. Do not use hot water or place near hot surfaces; this can distort the shape of your retainer. Keep your retainers away from pets-they love to chew on them! Never wrap your retainer in a napkin or Kleenex—they are easily mistaken for garbage and thrown away! Always store them in the case (not your pocket).
- What if I need new retainers?
Retainers are like eyeglasses, contact lenses, or any other personal item that is worn daily-they will wear out. With proper care and use, the average life of your retainer should be two years. If you lose or break a retainer, please call us as soon as possible. If you have the molds from when your retainers were originally made, you can drop these off at the front desk of our office. If you do not have the original molds, we will need to schedule an appointment for you to have impressions taken for new retainers. A nominal fee will be charged for replacement of retainers.
- Will I need to have my wisdom teeth removed?
If still present, your wisdom teeth should be evaluated by an Oral Surgeon between the ages of 17 and 19.
- I just got braces put on yesterday and am experiencing pain. What can I do?
Slight tenderness and achiness is normal and will get better after the first couple of days! We recommend taking what you typically take for your average aches and pains—appropriate doses of ibuprofen or acetaminophen (Advil, Tylenol, Motrin, etc.).
- One of my brackets came loose. What should I do?
If you notice a bracket is loose and you are experiencing extreme pain that cannot be tolerated until our next business day, please contact our Emergency Line at 641-777- 2141. If you have a bracket loose but are not having any discomfort, we ask that you call our office during regular business hours to see if an extra appointment needs to be scheduled. If you do not have a routine appointment in the near future, we will schedule an emergency appointment for you. If you do have a routine appointment in the near future, we will make a note in your chart alerting the staff this needs to be taken care of when you come in.
- Is it normal to have loose bands and brackets during treatment?
During the initial stages of treatment, particularly for the first couple of months after having braces placed, you might have a bracket or two come unglued. Typically this is due to the way some teeth hit on the brackets until they become better aligned. The likelihood of breaking brackets significantly decreases as your treatment progresses, and after the first couple of months a broken bracket or loose molar band is typically the result of chewing or biting hard/sticky foods or biting hard objects such as pen caps, pencils, ice, etc. Remember, problems with multiple broken appliances can result in additional fees and can also prolong your treatment!
- I have something poking my cheek/lip. Do I need to come in?
If it feels like you have a sharp wire or hook, simply try pushing in the sharp edge with the eraser of a pencil. If you have a wire poking out and causing pain, try clipping it with a nail clipper, being extra careful not to cut your cheek! If you are still experiencing discomfort, call our office to schedule an appointment. If necessary, place a small ball of wax over the area to help reduce irritation until you can be seen.
- One of those little colored things broke. Should I schedule an appointment?
If the ‘colored thing’ is a linked ‘chain’, we are probably trying to close space so this should be replaced within a couple of days in order to keep your treatment progressing.
Please contact our office to discuss your individual situation and schedule an appointment if necessary. - Why is there a space between my front teeth that wasn’t there before?
Specifically in treatment involving an expander and/or a headgear, you might notice space opening up between you two front teeth. This is normal and exactly what we want to see happening. Don’t worry; we will close all of this space when the time is right!
- The strap for my headgear keeps popping apart. Can that be fixed?
After a while, the attachments on your headgear’s neckstrap may weaken and unsnap. If you are having trouble with the facebow of your headgear actually popping out of your molar bands inside your mouth, try increasing the tension by advancing to the next hole on your neckstrap. If that still is not helping, contact our office, as an appointment may be necessary to adjust your headgear.
- What should I do if my rubber bands keep breaking?
A rough or poking edge on a bracket or wire can easily break your rubber bands. Try pushing in the edges of wires/hooks with the eraser of a pencil. If this does not help smooth out any rough/sharp edges contact our office for an appointment.
Post-Treatment Questions
Only you can keep your teeth straight after your orthodontic treatment! Your teeth will likely move if you don’t wear your retainers. If you choose not to wear your retainers, you must assume responsibility for any tooth movement. If the teeth shift, the only way to recover could be through re-treatment and additional expense.
In most cases, about 95 percent of orthodontic correction is retained. We’ve worked hard together getting to where you are now. Please wear your retainers so that you can keep a beautiful smile and a healthy bite for years to come!