First-Time Patient?

Before you come to see the orthodontist you may have some questions you would like answered.

Frequently Asked Questions

What is Orthodontic Treatment?

Orthodontic treatment is concerned with the position of your teeth. We move teeth to make your smile more beautiful and attractive. Improving the position of your teeth also benefits your bite (function) and makes it easier to clean your teeth. We can move teeth using a variety of orthodontic appliances at our disposal.

How to keep your your teeth and gums healthy during brace treatment?

Can I play sports while wearing braces?

Yes, but make sure you wear a protective mouth guard. Ask your orthodontist to recommend the right kind of mouth guard while you are having orthodontic treatment. Keep your smile beautiful after treatment and wear a mouth guard at every practice and every game.

Can I play musical instruments while wearing braces?

With practice and a period of adjustment, braces typically do not interfere with the playing of wind or brass instruments.

When should I have my first appointment?

Most children begin treatment around the age of 11 – 13, once all their permanent teeth have erupted. In a few instances treatment is better started early and your dentist may want to make an earlier referral. But age is not a barrier to treatment and the number of adults seeking treatment is on the increase.

What happens at my first visit?

The orthodontist will examine your mouth to assess the problem. You may well have X-rays and/or photographs taken. Impressions or “moulds” of your teeth will also be needed before treatment starts. The orthodontist will then want to discuss the possibilities for treatment with you and agree how to proceed. It is very unlikely that you would have braces fitted at the first appointment.

How much is my treatment likely to cost?

The cost of treatment depends on several factors. Orthodontics for adults tends to be cost more than for children. The overall cost will be affected by the complexity of the case, the type of brace to be used, the experience and training of the orthodontist, the locality and the facilities of the practice etc.

To obtain a definite figure you will need to arrange a consultation with the orthodontist – this will not involve you in any commitment to proceed with treatment. The orthodontist will then be able to assess the problem, discuss the options with you and set out the costs.

How is treatment paid for?

Treatment cost – or part there off – is usually paid for by your medical aid. Usually and where appropriate we assist patients to obtain prior treatment approval. Alternatively patients can elect to privately fund the proposed treatment.

You will receive a written quotation that explains costs (initial consultation and diagnostic records, treatment fees and retainer costs) that you are likely to incur. Treatment expenses are usually spread over equal monthly payment as part of a payment plan/arrangement.

Will I need extractions?

Correcting the teeth often needs additional space. Extractions may well be needed if sufficent space cannot satisfactorily be created in other ways. This decision is taken as part of the orthodontic assessment. The extractions are normally carried out by your own dentist rather than the orthodontist.Advances in treatment methods mean that extractions are actually needed less frequently than in the past.

How often will I need an appointment?

You will usually need to have appointments every 4-8 weeks. If you are not able to attend regularly your treatment will take longer to complete. It is not advisable to start treatment if you know you will not be able to keep regular appointments.

How long will I need to wear my braces?

Generally orthodontic treatment will last for a minimum of 18-24 months. Treatment times vary according to individual treatment plans. Your orthodontist will give you an estimate of the anticipated treatment time. This will be influenced by your treatment complexity, broken appliances, missed appointments, unfavourable growth… Retention (holding the teeth in their corrected positions) follows active orthodontic treatment and involves wearing retention appliances

I don't want to wear the metal braces. What are my options?

Ceramic brackets are relatively inconspicuous on the teeth. Ceramic brackets ( are tooth coloured or translucent. They are less conspicuous than metal brackets and therefore often favoured by adults. However they do have a number of drawbacks which need to be taken into account. The brackets are more prone to breakage than metal brackets; the wires slide through the slots less freely so treatment may take longer; the brackets tend to be abrasive and may cause wear to teeth in the opposite jaw if they should make contact when biting; the brackets can sometimes be difficult to remove with a slightly higher risk of damage to the tooth surface. The brackets are also more costly than metal brackets, and with all the associated problems the overall treatment can be expected cost significantly more. Having said all this, if appearance is at a premium, ceramic brackets may still be the first choice for many patients. Lingual braces are placed out of sight on the inner surface of the teeth. Lingual appliances are attached to the lingual surface of the teeth, i.e. the surface towards the tongue. In this position they are virtually invisible. The technique involves special skills and needs considerable experience on the part of the orthodontist to achieve acceptable results. Only a limited number of orthodontists offer this technique and you may need to search for a suitable practitioner who has the requisite experience. The main drawbacks are that it can cause soreness of the tongue and affect speech. Fees are always much higher than for conventional fixed braces because of the higher material costs, greater surgery time involved and the extra training needed. Aligners are clear plastic splints which fit over the teeth and progressively move them to the desired position. These are often known by their commercial names such as Invisalign and Clearstep. They blend modern technology with the long-standing concept of using clear flexible splints to ease teeth into line. A succession of splints is worn, each splint bringing the teeth a little closer to the desired position. The splints are effectively invisible and are therefore an attractive option from the standpoint of appearance. Aligners can be very effective if all that is required is to align mildly irregular teeth. However there are several drawbacks. In the more severe cases, notably those where extractions are required, aligners lack the necessary control of the teeth to give consistently good results and often lead to disappointment. Likewise they are not well suited to correcting problems like prominent upper incisor teeth. The cost is much higher than for conventional fixed braces owing to the high laboratory costs in making the aligners. In selected cases they they are very effective but their scope is limited.

What can be done without wearing braces?

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.

Can I have "colours"?

The “colours” are tiny elastic rings which are mostly used to hold the wires into the brackets on your teeth. They are readily available in many different colours so you can personalise your brace. We offer the colour of your choice at no additional costs.

Will treatment be painful?

Fitting a brace is not painful, at the most a little discomfort is involved. However for a few days afterwards the teeth and gums will almost certainly ache as the teeth start to move. This is to be expected and is not a cause for concern. Your cheeks can also get sore until they are used to the brace. There may also be some aching after the brace is adjusted from time to time. If necessary take your usual painkillers until things settle down.

How will braces affect what I can eat?

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.

Should I visit my own dentist during orthodontic treatment?

Yes definitely; the orthodontist only looks after the braces. Your teeth are actually at greater health risk during orthodontic treatment. It is particularly important that you keep up regular contact with your own dentist.

How do I keep my teeth healthy whilst wearing braces?

A high standard of toothbrushing is essential throughout your treatment. Your teeth need brushing after every meal. Ensure that you are using a proper toothbrush and appropriate brushing technique. Daily use of an interdental brush and fluoride mouthwash, in addition to your regular toothbrush, is recommended. It is good practice to visit your family dentist regularly (4-6 monthly) to ensure optimal oral health.

What can possibly go wrong?

· 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.

Will I need retainers?

Most probably yes. The tissues around the roots take time to adjust to the new tooth positions and there is a particular risk of relapse in the early months after the brace is removed. Even in the longer term some risk remains and the best advice is to continue retention indefinitely if at all possible.

Retainers may be removable or fixed, and there are advantages and disadvantages to both.

· Removable retainers are usually worn full time initially, but reduced to night times only later. They are effective but obviously depend on the patient remembering to wear them. They will need occasional repair or replacement, a relatively simple task.

· Fixed retainers are usually bonded to the back of the teeth. They are therefore in place all the time and are highly effective. A high standard of tooth cleaning in the vicinity of the retainer is essential to avoid gum problems. They do need regular inspection because if any of the bonds fails, the tooth in question may start to drift out of position. For this reason it is essential for the patient to contact the orthodontist at once if there is a breakage. Many general dentists are unhappy about repairing a fixed retainer and a visit to an orthodontist will be needed.

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012 348 7108 – Pretoria
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Atterbury Rd 504
Menlo Park

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201 Kemston Ave

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