Patient Info

Information required prior to consent for orthodontic treatment

Introduction

Orthodontic treatment is an investment in your health. It produces a pleasing smile and facial appearance, a sound bite for better chewing, enhancement of self esteem and improved oral health. While recognizing the benefits of healthy teeth and and attractive smile, you should be aware that orthodontic treatment has limitations and potential risks. Fortunately in orthodontics these risks are rarely sufficient reason to avoid treatment but they should always be considered when deciding to undergo orthodontic treatment.

Issues to be considered include:

Finishing treatment on time

Successful orthodontic treatment is achieved by the patient and the orthodontist in partnership. If the patient cares for the appliances, wears appliances, headgear and elastics diligently then invariably treatment proceeds to a successful and pleasing conclusion within the anticipated treatment time frame. The most common reasons for longer than expected treatment times are failure to wear elastics and headgear as advised. If you run out of elastics please phone during working hours and we shall post you another pack the same day. Broken appliances and missed appointments can also lenghthen treatment times and adversely affect the quality of the final result. Please avoid chewing hard or sticky foods and report any broken appliances as soon as they are noticed.

Oral hygiene-toothbrushing-decalcification

Careful and regular toothbrushing with fluoridised toothpaste during treatment is essential. Tooth decay, gum disease and unsightly permanent markings (decalcification) on teeth can occur if patients eat foods containing sugars or acids too frequently or do not brush their teeth adequately. These same problems can occur without orthodontic treatment but the risk is greater when wearing braces. It is very important to continue with regular checkups with your general dentist throughout orthodontic treatment.

Oral hygiene program

Your oral hygiene will be monitored at each visit. If it is unsatisfactory for two consecutive appointments, you may be referred back to your dentist for a clean and fluoride.

If the oral hygiene continues to be unsatisfactory, we will need to consider removing the archwires and suspending treatment until it is safe to recommence orthodontic treatment. This will inevitably prolong your time in braces. Continued poor oral hygiene may result in early termination of treatment.

Mouthguard

It is strongly recommended that you obtain a special mouthguard if you play any form of sport that may result in injury to your teeth. Ask your orthodontist to provide the mouthguard as the braces are fitted.

Relapse

Teeth have a tendency to change their positions after treatment. The faithful wearing of retainers should reduce this tendency. Teeth can, however, move at any time whether or not they have been orthodontically treated.

The most vulnerable teeth are those at the front. Throughout life the bite can change from causes such as eruption of wisdom teeth, growth and maturational changes, mouth breathing and other oral habits.

Root shortening

Some patients have a susceptibility to shortening of the roots during orthodontic treatment. It is nearly impossible to predict susceptibility. Usually this shortening does not have significant consequences, but on rare occasions it may become a threat to the teeth involved.

Jaw joints

Some patients suffer problems in the jaw joints, including joint pain, clicking, headaches, or ear problems. These problems may occur with or without orthodontic treatment. Any of the above symptoms should be reported to the orthodontist. Stress is a major contributing factor in joint disorders.

Tooth vitality

Where a tooth has been injured by a previous accident or contains a large filling, damage to the nerve of the tooth may result. In rare instances, this may lead to loss of tooth vitality and discolouration of the tooth requiring root canal treatment or other dental treatment to restore the colour of the tooth.

General health

General medical problems can affect orthodontic treatment. You should keep your orthodontist informed of any changes to your medical health or any medication you may take for a health problem.

Impacted teeth - the hidden hindrance

For most orthodontic patients the only concerns about teeth that are blocked from erupting or are impacted are the third molars or the wisdom teeth. Usually wisdom teeth are impacted because of insufficient space and this is contributed to by our conservative approach to the extraction of other teeth. Generally assessment of third molars is delayed until growth of the face is slowing at the age of 16 or 17 years. Impacted third molars that remain in place can be associated with infection and pain, decay of inaccessible surfaces, resorption of the adjacent second molar roots, cysts and other pathology that occasionally develops in the walls of cysts.

The other reasonably commonly impacted tooth is the maxillary canine. 85% of impacted canines are tipped forwards and towards the palate. Palatally impacted canines frequently are first noticed by your dentist 1 to 3 years before the canine is due to erupt. Extraction of the primary canine at this stage leads to correction of the majority but braces and in some cases exposure surgery are required to realign and erupt the wayward canine. Treatment times with braces for impacred teeth are considerably longer than usual for other malocclusions.

Patient Information Brochures (click icon to view as pdf)