Following orthodontic treatment, your will surely move back to their mal-aligned positions unless a “retainer” is in place to hold the teeth in their new positions. Retainers should be worn full time for at least one year. After the first year, removable retainers may be worn only at night (permanent retainers should be kept in place indefinitely). Although the degree of stability increases over time, your teeth will always be capable of moving out of line unless they are being held in place by a retainer. Therefore, retention is forever! The goal is to “maintain” the correct position of the teeth for a lifetime by holding them with some type of retainer.
How will I feel after getting braces?
The discomfort you are likely to encounter during your orthodontic treatment will generally be derived from the actual tooth movement and from the appliance’s irritating lips and cheeks. The actual procedure where braces are placed is not painful and no injections (no needles) for local anesthesia are necessary. The only discomfort experienced during this procedure will be derived from the struggle to keep your mouth open for an extended period of time.
Once the braces are placed, you will be immediately aware of the increased bulk against your lips and cheeks and the tension from the wire as it applies a gentle force to the teeth. As several days pass you will notice that certain areas of your lips and cheeks may become mildly irritated as they are constantly rubbing against the braces. The degree of soreness experienced is generally mild but different for everyone. If you experience a great deal of irritation to the lips and cheeks as they rub against the braces, place wax on the braces at the source of the irritation. The wax simply creates a smoother surface against which your cheek or lip can rest without being irritated. Often you will unknowingly injure your lips and cheeks at night while sleeping and then experience more soreness during the daytime. If you experience a lot of soreness, prior to going to bed at night, take a long piece of wax and flatten it with your fingers. Then press this length of wax against your braces and embed it into the braces. This will produce a smooth surface over an extended length for your lips and cheeks. Do this every night until the sore spots resolve. Over time, your lips and cheeks will toughen and you will no longer experience many instances of this type of soreness. It is always a good idea to place wax on sore spots at night to prevent irritation while you sleep.
In the days following the placement of your braces, and also following adjustments, your teeth will likely become sensitive to pressure and may become sensitive to thermal stimuli (hot and cold). This is normal and indicates that the teeth are being moved. Certain of your teeth will become sorer than others. Some may get very sore while others do not get sore at all. The degree of discomfort should be nothing more than annoying and is easily managed by over-the-counter medications such as ibuprofen and acetaminophen. It is best to take these medications as prescribed on the bottle and be sure and take them at the intervals indicated. They will be more effective when taken at regular intervals, as this will maintain a constant level of the drug in the bloodstream. Narcotic medications should not be needed to manage this level of discomfort.
Most patients will experience changes in the way their bite feels. This is normal and will resolve as the teeth move toward their improved positions. Because the bite may feel uncomfortable and because your teeth will be pressure sensitive, chewing may become difficult. Do the best you can and try to eat only soft foods. It also helps to cut your food into small pieces. Always avoid hard foods when wearing braces because of the likelihood of breaking them.
The sensitivity to pressure and thermal stimuli will be greatest during the first few weeks after the braces are applied or after an adjustment and will begin to diminish thereafter. After several months, as the teeth align, the degree of soreness you feel after an adjustment will be less and less. The further along you get, generally, more comfortable you will become.
Will I need teeth pulled?
Current treatment philosophies in orthodontics today tend toward non-extraction (not pulling teeth). Whether a patient would benefit from having teeth removed depends upon many factors and the doctor will address these issues on an individual basis. Just because your teeth are very crowded (mal-aligned) does not mean you need teeth pulled. These days, the vast majority of patients are being treated without removing teeth!
How long will it take?
The duration of treatment depends upon many factors: the severity of your initial condition, the type of problems present, and your ability to comply with treatment recommendations. Technological advances in just the past few years have vastly improved treatment efficiency and patients are finishing faster than ever and with better results. The doctor will make an estimate of the duration of your treatment after he has an opportunity to examine your condition.
Will I need to wear rubber bands (elastics)?
Most patients will need to wear elastics for some duration of time. But again this is highly variable depending upon the condition being treated. There are many, however, who do not need them at all.