Orthodontics can be a lengthy process. Some adult patients prefer to have crowns or veneers fitted to their teeth instead in order to mask the irregularity. Whether this is feasible in any particular case needs good professional advice. Veneers are added to the front surface of the teeth to mask the irregularity. The teeth can be reduced in size and crowns or “caps” can be fitted to give a larger change in appearance. These approaches also allow defects in the tooth surface to be hidden.

These restorative approaches offer the attraction of rapid results and may be the treatment of choice in some cases. Drawbacks that you need to be aware of are: the preparation of the teeth is, to a greater or lesser extent, a destructive and irreversible process the crowns or veneers cannot be expected to last indefinitely and the need for replacements over the years should be borne in mind there are definite limits to the amount of irregularity which can be tackled successfully in this way. Veneers can be become excessively thick, crowns can only be reshaped by a limited extent there may be adverse effects on the underlying gum tissues over the years from having the edges of the crowns or veneers close by.

There are three main types of food which can cause problems during your orthodontic appliance treatment. Hard foods, (e.g. pizza and bread crusts, biltong and dried sausage, ribs and steaks, whole fruits, nuts, rusks, popcorn and meat from the bone) sticky foods (e.g. chewing gums, caramel, toffees, fizzers and dried fruits) and foods/sweets with a high sugar content. Hard and sticky foods can damage the appliance that will in turn prevent the required tooth movement and prolong your treatment. A sugar rich diet can result in tooth decay (more readily whilst wearing appliances) and the development of permanent unsightly marks/spots on your teeth. These food types are best avoided during your treatment. A good habit would be to avoid in between meal snacking.

A soft diet is recommended after the placement of your appliances. This can include food types like pasta, egg, potatoes, porridge, fish, mince, chicken, soup and yoghurts. You can rusume a ?more normal diet? approximately two weeks after your braces have been fitted. Continue to avoid the above mentioned food types and never use your front teeth/incisors to bite or tear into food. Cut your food, especially steak and fruits, into small pieces and chew on your back/molar teeth.

Fizzy drinks is best avoided as it can readily cause damage to your teeth during brace treatment. Excessive and continuous intake of fruit juice (acidic) can cause a similar problem. Fruit juice is best enjoyed diluted during meal times. We recommend water, ice tea, milk and squash.

· Breakages – Orthodontic appliances are prone to break. Appliances that break cause problems:

· additional appointments (that may well be during school time)

· repair/replacement costs

· increasing the length of your treatment

Please be very careful with your habits (e.g. biting nails or chewing pens), dietary habits and food type selection. Should you find that the appliance is loose/broken contact us at your earliest convenience.

Root shorthening (resorption) – Resorption is a normal process associated with tooth movement. Fortunelately, root resorption because of brace treatment is of a mild nature without long term consequence. A small minority of patients may experience more aggresive resorption and the treatment aims will then be reviewed. Trauma, impaction, endocrine disorders or idiopathic (unknown) reasons also cause this.

Muscle Habits ? Breathing through the mouth, sucking of thumb, fingers or lips, thrusting of tongue (abnormal swallowing) and other unusual habits can prevent the teeth from moving to their corrected positions or cause a relapse after braces have been removed.

Facial Growth patterns ? Unusual skeletal patterns and insufficient or undesirable facial growth can compromise the dental results, affect facial change and cause shifting of teeth during retention. Surgical assistance may be recommended in these situations.

Temperomandibular (TM) joints ? Orthodontic treatment does not cause nor cure jaw joint problems. It may however be possible for some patient to develop jaw joint signs/symptoms during treatment but this is usually a co-incidental finding. TM problems should be reported immediately.

Ankylosis ? In exceptional cases, teeth that still need to erupt, fuse to the bone and will then fail to erupt or erupt no further. This condition is known as ankylosis. In most cases, ankylosed teeth will have to be removed. The gap that is left either has to be closed with braces or has to be handled prosthodontically (bridge and/or implants). Teeth most prone to ankylosis are impacted eyeteeth (canines) and primary molars.

Non-vital teeth ? Teeth sometimes become non-vital (dead nerve) during orthodontic treatment. This is usually caused by a pre-existing lesion (cavity) or trauma to the tooth concerned. Your dentist will then have to perform conventional root canal treatment on the tooth.

Discontinuation of treatment – Successful treatment depends on a well motivated patient. Failure to comply is never in the patients best interest. In such unfortunate circumstances we may need to review the agreed treatment aims and expectations with the patient and/or parent to decide on the best way forward.

Relapse ? All teeth that have been moved during treatment have a tendency to move back to their original positions. Retention appliances are required to maintain the teeth in their newly corrected positions. Retention is especially important during the first 6-9 months after completion of your active treatment. You will be advise to continue with your retention appliances for a two year period. Fixed and removable retention appliances are available. In most cases, some form of life-long retainer is the only guarantee that teeth will stay in their corrected positions. Relapse will not occur if retainers are worn as prescribed. Re-treatment due to relapse are charged for.