1. DECALCIFICATION: Tooth decay and permanent markings (decalcification) on the teeth is common (2-96%) and can occur if orthodontic patients consume foods or drinks containing excessive sugar and/or acid (eg, sweets, fizzy drinks, diluting juice, etc). This tooth scarring also occurs if patients do not brush their teeth frequently and properly. These same problems can occur without orthodontic treatment, but the risk is greater to an individual wearing braces.
2. ROOT SHORTENING: In some patients the length of the roots may be shortened during orthodontic treatment. Some patients are prone to this happening while some are not. Blunt or pipette shaped roots and previous trauma (periapical radiograph monitoring pre and during treatment is essential) may exacerbate root shortening. Usually this does not have significant consequences, but on occasion it may become a threat to the longevity of the teeth involved.
3. GOOD ORAL HYGIENE: There is a need to maintain an excellent standard of brushing, with the use of fluoride, to avoid damage to the teeth and supporting tissues, and there are necessary dietary restrictions.
4. DIET & BREAKAGE OF THE BRACE: Eating hard sticky and chewy foods will cause the brace to break. Avoid using the front teeth to bite into hard things like apples or crusty bread and cut all food up into small pieces. Also, avoid very sticky foods like toffee and gummy bears and chewing gum, habits like nail biting. In case of a breakage, please contact us on practice number.
5. PERIODONTAL HEALTH: Health of the bone and gums, which support the teeth, may be affected by orthodontic tooth movement if there is already a pre-existing condition, but also may occur in some rare cases where a condition does not appear to exist. This means you may notice increased mobility (wobbling) of a tooth. This can be more noticeable if the tooth has short roots or already has moderate level of bone loss from poor periodontal health. We will work with your periodontist to help you in such situations.
6. POST- ADJUSTMENT PAIN: After adjustment of your brace, tenderness should be expected, and the period of tenderness or sensitivity varies with each patient and the procedure performed. Typical post-adjustment tenderness may last 3-5 days. You should inform the clinic of any unusual symptoms, broken or loose appliances, as soon as they are noted.
7. LOSS OF TOOTH VITALITY: Sometimes a tooth may have been traumatized by a previous accident or a tooth may have large fillings, which can cause damage to the nerve of the tooth. Orthodontic tooth movement may in some cases aggravate this condition and in rare instances may lead to loss of vitality and possible root canal treatment. Any tooth with a large restoration or a crown could be damaged or fractured during treatment.
8. ALLERGIES: Occasionally, patients can be allergic to some of the component materials of their orthodontic appliances. This may require a change in treatment plan or discontinuance of treatment prior to completion. Although very uncommon, medical management of dental material allergies may be necessary.
9. RETENTION & RELAPSE: Wearing retainers is the most important part of treatment without which teeth will move. The extent to how much teeth move is variable; they may go back to the original position or move even worse. The bite can change adversely from various causes, such as: eruption of wisdom teeth, growth and/or maturational changes, mouth breathing, playing of musical instruments and other oral habits, all of which may be out of the control of the orthodontist. Retention is life-long and your retainer will be maintained by the practice for the first 12 months, after which replacements need to be made at your GDP. There will be a charge for replacing lost and broken appliances on the NHS and this is currently £84.80 per appliance, but they are increased each year by the NHS.
10. TREATMENT TlME: Average treatment time takes about 18 months to 2 years with regular appointments every 6-8 weeks. Complex cases require sometimes 3-4 years in treatment. Treatment time may be lengthened in cases of excessive or deficient bone growth, poor cooperation in wearing the appliance(s) the required hours per day, poor oral hygiene, broken appliances and missed appointments. Treatment will be discontinued in the event of more than twice broken braces from not following the instructions, missed appointments, and poor oral hygiene. This means you may have residual gaps, teeth that are sticking out or teeth that are not as straight as they should be. If you are under 16 years of age and miss two appointments, as a part of the safeguarding children’s policy we will inform the Safeguarding office. We will also notify your dentist and doctor.
11. REMOVAL OF TEETH: On occasion, teeth may need to be extracted as part of the orthodontic treatment. Your orthodontist will recommend removal only if it improves your prospects of successful treatment. Missing teeth, from previous extractions on the other hand, can make therapy more difficult. In such cases, treatment compromises may be necessary, and an ideal result may be impossible to achieve. This means you may need bridges/implants following your orthodontic treatment from your dentist.
12. RECORDS: Records will be needed prior to commencing treatment and may be needed to monitor the progress of your treatment. These may include x-rays, plaster models and photographs. In addition, after your braces are removed, our team will make a new set of records. The new records will be used to plan your ‘retention’ program, to check for tooth decay, and to determine the position of your wisdom teeth, if applicable. These records will also be used to gauge what changes might occur in the future due to tooth movement or growth.
13. ADJUNCTIVE DENTAL CARE: Due to the wide variation in the size and shape of teeth, achievement of the most ideal result (for example, complete closure of excessive space) may require restorative dental treatment (in addition to orthodontic care). The most common types of treatment are cosmetic bonding (white fillings as “build ups”), crown and bridge restorative dental care and/or periodontal therapy
14. VISITS TO DENTIST: Regular visits to the dentist must be maintained throughout treatment.
15. PERFECTION IS OUR GOAL: In dealing with human beings and problems of growth and development, genetics and patient cooperation, achieving perfection is not always possible. Orthodontics is an art, not an exact science; therefore, a functionally and aesthetically adequate result, not 100% perfection, must be acceptable. Your comments in regard to your expectations prior to, during and after orthodontic treatment will help us understand your concerns. Please keep us regularly informed of your feelings, concerns and results that do not meet your expectations.
16. MISSED APPOINTMENTS: Orthodontic appointments are high in demand and missed appointments / appointments cancelled providing less than 24 hours-notice reduces availability for other patients. Where a patient misses an appointment and/or cancels an appointment at short notice, the practice will automatically apply a fee of £75.00 per hour per occurrence as missed appointments also increase practice expenses.