Frequently Asked Questions

orthodontist

How much do braces cost?

This is a question best answered by your orthodontist after a full assessment. The cost of braces will depend on many factors: how long the treatment is going to take, your preference on brace types, any additional braces/procedure needed, what is included in the aftercare, whether the person treating you is a specialist orthodontist or a dentist. In Ireland, orthodontic treatment is tax deductible at a rate of 20% which means you can claim back 20% of the cost of your treatment or the cost of your children’s treatment. Most orthodontic clinics offer finance options so the cost of the treatment can be paid over the duration of care.

What is the best age to have braces at?

Every patient is different so there is no exact answer to this. Braces can be done at any age but are definitely easier when you are younger and growing taller. It is advantageous to have some baby teeth left as they tend to be bigger than adult teeth and can be used to relieve dental crowding. Also, certain braces are better accepted when you are in primary school so 10 to 12 years can be a great age to start. Some simple treatment can be done at a younger age (age 8) such as correction of crossbites or narrow/small upper jaws. This is called interceptive treatment and usually involves a short course of brace treatment to alleviate dental problems and make future treatment easier. Your dentist should be able to pick up on this and refer you to an orthodontist or if you have any concerns you can make an appointment with an orthodontist yourself. You do not need a referral. To find an orthodontist near you, click here.

Do I need to have lost my baby teeth to have braces?

No, it is actually good to have some baby teeth in your mouth when starting braces. Baby teeth are bigger teeth compared to their adult tooth underneath and this extra space can be used to alleviate dental crowding. Also, the severity of some orthodontic problems, like upper canine teeth going off course, can be reduced by early removal of baby canine teeth. Your dentist should be able to pick up on this and refer you to an orthodontist. Or you can go directly to an orthodontist for them to check. To find an orthodontist near you, click here.

What is the difference between aligning and straightening teeth?

Straightening teeth and aligning teeth appear similar but they serve different functions. Both are needed to improve ones’ smile.

Straightening teeth involves moving teeth by tipping and rotating them into their correct position in line with adjacent teeth. The 6 front teeth are very important for aesthetics.

Alignment of the teeth means getting the teeth and roots into alignment to achieve a comfortable functional bite between the upper and lower jaws ensuring the best fit between the upper and lower teeth.

Most Orthodontic treatment takes 18-24 months to achieve a proper stable result by getting the crowns and roots of teeth correct. It is important to realise short treatment of 6 months duration only tip the crowns of teeth and do not result in root positioning and therefore the result is not stable and teeth may all move back to their original positions. Some treatments take longer ( 3-4 years)  if Orthognathic surgery is required to reposition the Jaws.

How is Invisalign different to braces?

Braces are fixed permanently to the teeth for the duration of Orthodontic treatment. There are many types: metal/silver, ceramic/tooth coloured, and lingual positioned on the tongue side of the teeth so you can’t see them.

Advantages of fixed braces:

  1. No patient compliance required to remember to wear them.
  2. Braces may be quicker treating more difficult/complex  cases.

Disadvantages of Fixed braces:

  1. Difficult to clean and floss around.
  2. Avoid hard sticky foods.
  3. Risk of white marks on teeth if excessive sugar, plaque and poor brushing habits.
  4. Elastic modules may stain and look unaesthetic.
  5. Discomfort/ulceration of lips and cheeks for which wax may be applied.

Invisalign involves the use of clear plastic aligners which are typically changed every 7-10 days and they are aesthetic and removable by the patient. The teeth will have small white attachments on them to assist with moving teeth. In some cases treatment may take longer that fixed braces and for other cases treatment may be quicker. Your Specialist Orthodontist will be able to advise you.

Advantages of Invisalign:

  1. The aligners are aesthetic.
  2. Removable for eating so there are no dietary restrictions.
  3. May remove for special occasions.
  4. Remove for brushing and flossing.
  5. May be more comfortable
  6. Invisalign may be better than fixed to treat some cases.

Disadvantages of Invisalign:

  1. Good patient compliance is required to wear the aligners 22-23 hours per day and also not to lose the aligners.
  2. May be more expensive.
  3. If refinements needed treatment may take longer than fixed appliances

How can I find a specialist orthodontist?

All members of the Orthodontic Society of Ireland are Registered Specialist Orthodontists. You can search for a Specialist in your area here

There are a few ways to check if a dentist offering treatment with braces is a Specialist Orthodontist:

  1. They will be on the Dental Council Register of Specialists in Orthodontics here
  2. In Ireland, Specialists gain the qualification DClinDent or MDentCh and will also hold qualifications for the Royal Colleges such as MOrth or FFD(ortho) Check an Orthodontist’s qualification BEFORE you start treatment.
  3. They won’t offer other types of dental treatment such as restorations and extractions.

Is my orthodontist registered on the Irish dental specialist register:

When a dentist completes Specialist training in Orthodontics, they can join the Register of Specialists in Orthodontics with the Dental Council. You can check the Dental Council Register here

This is  the only level of training in orthodontics that is recognised by the Dental Council of Ireland.

Is my dentist registered on the Irish orthodontic specialist register?

Some dentists may have completed other short courses and offer orthodontic appliances. This training is not accredited by the Dental Council of Ireland. If you want to check if your dentist has completed accredited training, you can check the Dental Council Register here

How do braces work?

There are 3 main types of braces:

  1. Fixed appliances with orthodontic brackets and archwires
  2. Removable appliances with an acrylic base
  3. Removable appliances that are vacuum formed clear acrylic that fits around the teeth.

These all work in different ways. Some are better at different types of tooth movement than others or more suitable for different age groups. Whilst you may have a preference, it’s worth getting advice from a Specialist in Orthodontics before you start any treatment.

There are 2 major misconceptions about orthodontic appliances:

  1. Some appliances are marketed to patients as better than traditional braces or faster than traditional braces, but the truth is that there’s no such thing as traditional braces. The engineering and innovation that goes into product development is constantly improving. Members of the Orthodontic Society of Ireland attend regular meetings, listen to international speakers and meet all the major orthodontic suppliers to keep up to date with product development and techniques.
  2. Some marketing for orthodontic appliances suggests that it’s the brace that does all the work! It’s understandable that websites want to promote products like this. In reality, orthodontic appliances are like a car and it really matters who’s in the driving seat. The best outcomes come from understanding what the patient needs and then controlling and fine tuning the appliances and attachments at each visit. Specialists in Orthodontics have the expertise, training and experience to do this.

 What causes dental crowding?

Dental crowding happens when there isn’t enough space for all the adult teeth to be nicely aligned. Extra teeth are very rarely the reason behind this. Sometimes it’s due to early loss of baby teeth and this disrupts the normal development of a well aligned set of teeth, so we’d recommend every child have an orthodontic assessment around age 7 or earlier if there have been orthodontic or dental problem. Sometimes it’s a mismatch between tooth size and jaw size, and sometimes it’s related to the shape and development of the jaws. Your orthodontist will be able to examine and investigate the problem and advise you on options to prevent it, minimise it or resolve it.  Sometimes this is due to baby teeth being lost early and

I have an overbite; what causes an overbite?

“Overbite” is basically the amount of vertical overlap between the upper front teeth and the lower front teeth. A couple of millimetres of overbite is quite normal and that would be a typical target in orthodontic treatment. Sometimes overbites can be abnormally deep, or even completely absent and the teeth don’t overlap at all (an “open bite”) and there are a few different reasons that these things happen. This can be a combination of problems with the teeth, jawbones and the muscles around them. Your orthodontist can give you an indication of what the problem is, and the reasons behind it as well as the options for dealing with it.

Does thumb sucking effect my teeth?

Usually not. There are a few situations where thumb sucking (and it might be fingers other than the thumb) causes trouble to the ideal development of teeth and jaws, but fortunately they are pretty rare and your orthodontist will usually be able to advise you after a simple examination in the clinic – although sometimes, they might need to arrange an X-ray for your child.

Do I need jaw surgery?

Sometimes people have orthodontic problems that aren’t just caused by the positions of the teeth, but also the development, size and shape of their jawbones. When they happen to a severe extent then it’s unlikely that orthodontics alone (whether it’s braces or aligners or other forms of treatment) will fix all the problem. That sort of situation is rare, but in that case, the best result will probably require a combination of orthodontics and an operation to adjust the position of the jaws. This is almost always only done for adults or older teenagers when facial growth has slowed down

If your orthodontist thinks that this is what you require, they’ll be working in conjunction with a surgeon from a specialty called Oral and Maxillo Facial Surgery (OMFS).

How do I know I am seeing a specialist Orthodontist?

An Orthodontist is a qualified Specialist who has first trained to become a Dentist and then has undertaken a further 3 years of study on a Postgraduate course at Masters or Doctorate level.

Specialist Orthodontists only treat Orthodontic braces to provide braces, whereas dentists will do fillings, extractions, crowns, bridges, dentures and may do simple Orthodontics.

Dentists are unlikely to have the same level of experience in providing Orthodontic treatment as an Orthodontist. You can check if your brace provider is on the Orthodontic Specialist Register of the Dental council before you commence treatment by clicking here

If their name is not on this Register they are not and Orthodontist.You may also question your brace provider at consultation about their qualifications and experience and if they have completed a masters in Orthodontics.

What Questions do I ask to make sure my Brace provider is an Orthodontist?

Firstly you may question them about their training, experience and qualifications and if they have completed a full-time 3 years postgraduate training program in Orthodontics and not a short weekend course or night time course.

Ask if you brace provider provides other treatments ie fillings, crowns, extractions and dentures as well as Orthodontics…? If they do they are Dentists as Orthodontists only provide Orthodontics. You can also check if their name is on the Orthodontic Specialist Register in the Dental Council by clicking here

Why are straight teeth important?

Straight teeth are important for a number of reasons. Straight teeth have an impact on our oral health. Crooked or crowded teeth may contribute to food and plaque becoming trapped in hard to reach areas; this makes toothbrushing more difficult. Inadequate oral hygiene is the main cause of gum disease. Poor oral hygiene in conjunction with a sugary or acidic diet causes tooth decay. Both tooth decay and gum disease can result in dental pain and, if left untreated, tooth loss. Straight teeth also helps to boost self-esteem and confidence. Smiling makes us feel happier!

What are the benefits of braces?

The benefits of braces include improved oral health and dental appearance. Improved oral health occurs due to straight teeth providing easier access to clean around all of the tooth surfaces and gum margins. Correcting the position of prominent upper front teeth can reduce the risk of trauma to these teeth in the event of a bang or fall. Bite correction can also reduce the likelihood of wear to the front teeth if they bite edge to edge. Good tooth contact can improve the function of our teeth allowing better chewing and if there are large spaces where the teeth do not contact, space closure can improve speech. In those patients with missing or small teeth, braces can be used to close spaces or create adequate space in the correct position for replacement teeth in the form of implants or bridges. Specialist orthodontists often work with other dental specialists, for example prosthodontists, implantologists, oral surgeons or orthognathic surgeons. The aim is to achieve the best and most stable results possible.

How do I clean my braces?

Cleaning around your braces is super important. The orthodontic team will provide instructions when you have your braces fitted. However, if at any point you find yourself struggling to keep your teeth and braces clean then always ask your orthodontic team for guidance. You don’t want to end up with perfectly straight teeth that are discoloured or decayed! Cleaning your teeth during brace treatment involves some additional brushes and time. Allow 3-4 minutes for thorough cleaning; the equivalent of listening to your favourite tune on Spotify or YouTube.

Cleaning Around Fixed Braces (train-tracks) or Fixed Retainers (wire glued behind the front teeth to keep them straight after train-tracks) you will need the following:

  1. a regular toothbrush with a small sized head and medium to soft bristles
  2. a single-tufted brush
  3. interproximal brushes in at least 2 different sizes (small and large)
  4. superfloss is an alternative to the small interproximal brush
  5. a daily fluoridated mouthwash.

You will need to brush thoroughly in the morning, before bed and approximately 20 minutes after every meal. 20 minutes is suggested to allow the acid that forms after eating to be neutralized before brushing, this reduces the risk of damaging the enamel.

The regular toothbrush is used, unsurprisingly, in the regular way. The end tufted brush is useful for removing larger pieces of food/debris from around the brackets and is especially good at cleaning partially erupted teeth and wisdom teeth. The small interdental brush (or superfloss) is the equivalent to regular floss and is used to clean between each tooth. The large interdental brush is placed under the wire and used to clean either side of the vertical portion of the bracket. The fluoridated mouthwash is a useful addition to reduce the risk of dental decay and is best used last thing at night and/or during the day when a more thorough toothbrushing is not possible due to location or time constraints. Make life easier for yourself and have 2 sets of all of the above – one set stays at home in your bathroom and the other set is portable e.g. in a pencil case.

Cleaning Around Removable Braces and Retainers

For removable braces, you will need two regular toothbrushes, and either a small interdental brush or floss. The cleaning of your teeth is carried out a minimum of twice daily and entails thorough toothbrushing and cleaning in between the teeth with either floss or an interdental brush. Sizing of the interdental brush can be established by ensuring that the brush fits tightly between the teeth. If the brush passes between the teeth and does not contact the teeth in the process then it will be ineffective. The second toothbrush can be any size and the bristles hard – a cheap and cheerful toothbrush – this one is used to clean the removable brace. Toothpaste can be used with it to clean the removable brace and rinse the brace with COLD water. A daily fluoridated mouthwash can also be added to this regime.

If you are cleaning clear removable retainers (Essix retainers) after completing fixed brace (train-tracks) treatment, please do NOT use toothpaste as the abrasive nature of toothpaste will scratch the surface of your Essix retainer causing it to discolour and appear dirty when in fact it is clean. Instead a tiny amount of washing up liquid or liquid hand soap with COLD water is preferable. Please ensure that you rinse your Essix retainers thoroughly before putting them back in your mouth. There are also commercially available retainer cleaning products available to purchase in pharmacies.

What do I do if my brace breaks?

If your brace breaks, you should contact your orthodontic practice as soon as possible. Your orthodontic team are best placed to offer you advice based on the type of brace that you are wearing and the tooth movements that are occurring. Your orthodontic team will advise you if an emergency appointment is required to repair the breakage and/or any additional measures that you could carry out in the interim eg, using wax to prevent the broken piece rubbing against your cheek. Take note of all of the instructions that your orthodontic team provide as adhering to this will reduce the probability of problems eg, it is important to avoid eating hard and sticky foods to reduce the risk of breakages.