Monday, September 20, 2010

Braces are Coming Off, but Teeth are Still Crooked?

Braces are Coming Off, but Teeth are Still Crooked?

Typically, braces must be worn from anywhere between 12 and 24 months. Depending on the kinds of orthodontist problem you have, your dentist will set an estimated time frame by which time your teeth should have straightened. However, if your braces are to be removed soon, but your teeth still don’t look as straight as you would like them to be, it’s a good idea to raise your doubts with your orthodontist.

It’s also very important to remember that your orthodontist is a specialist with several years of straitening teeth behind him. He most likely knows what he is doing, and if he has decided that now is the time for you to have your braces off, then he’s most probably right. It’s also possible that you’re noticing flaws in your teeth that aren’t really there. Sometimes, it’s natural to be overly critical of the end result, and see issues or flaws that are not visible to others. It takes some time to get used to seeing your teeth without braces after months of barely being able to see them.

Most of the time, an orthodontist will prescribe a retainer to be worn for several weeks after the braces come off. These retainers must be worn exactly as your orthodontist recommends. Many people fail to wear these retainers after the braces come off because of negligence or laziness. They may soon find that their teeth, that had moved to the right position, are now slowly going back to their former crooked appearance. Retainers are meant to hold the teeth in their desired place, so that the effects of the orthodontic treatment permanent.

If you don’t wear your retainers even for a couple of weeks after you get your braces removed, then you will begin to see your teeth becoming crooked again. In rare cases, it may be possible that you need to wear braces for a little while longer, so if you have doubts about your teeth looking crooked, inform your dentist, so he can see if the braces need to be left on for a few more days.

Friday, September 17, 2010

Retainers What are the types of retainers?

Retainers
What are the types of retainers?
To retain means to keep in place; therefore, an orthodontic retainer is used to keep your teeth in their new positions after your braces come off. Most orthodontists use one of these three types of retainers:
A clear plastic retainer (also called an Essix Retainer) is sometimes  placed on the upper teeth one or two days after the braces are removed. It resembles the Invisalign appliance. It is normally worn only at night and lasts an average of 24 months. After it wears out the orthodontist may replace it with a traditional wire retainer. Some people have commented that this type of retainer can be uncomfortable.
A bonded retainer  is normally placed behind the lower teeth after the braces are removed. It is a wire "permanently" bonded to the teeth with composite material. Sometimes this type of retainer is used for the upper teeth, but usually this is not possible because it would interfere with your bite. A bonded retainer will remain in place for several years. 
A wire retainer (also called a Hawley Retainer) is normally placed after discontinuing use of either the clear retainer or bonded retainer. This type of retainer has the added benefit of being adjustable so that minor tooth movement is possible. Sometimes a wire retainer can be worn full time instead of braces to correct mild crowding. As you can see, the plastic part of the retainer can be made in a variety of colors and patterns.
Do I have to wear a retainer after my braces come off?
The short answer is: YES, absolutely!
The long answer is: It takes many months for your periodontal ligaments and bone to "remember" the new position of your teeth and keep them in place. The retainer helps keep them in their proper new positions. It's important to wear the retainer exactly as your dentist/orthodontist recommends. Otherwise, your teeth may shift, especially if you stop wearing your retainer in the first two years after your braces come off.
Most people wear their retainer 24/7 for at least 6 months to a year after the braces first come off. Of course, you must take your retainer out to eat or to to brush your teeth. Be sure to carry a retainer case with you to store your retainer when it is not in your mouth. Keep a few handy -- in your car, your purse, at work, etc. Many retainers have been lost in napkins at restaurants or school and thrown in the trash. A new retainer can cost as much as $300! There are also special "Retainer Maintainer" plastic bags with a "don't throw this out" symbol to use in a pinch. These are easy to stuff in your pocket, purse, or backpack "just in case."
After the initial period is over, your orthodontist will probably tell you that you can switch to wearing your retainer only at night. Be sure to wear it EVERY night for at least 4 to 6 additional months. After that, if everything seems stable, you can probably switch to wearing it only several nights per week (always be sure to ask your orthodontist what he or she recommends).
If you totally stop wearing your retainer, even after a few years, your teeth may begin to move and shift. This is especially true if you have tongue thrust issues or have had extractions. Unless you want crooked teeth again, or want to go back into braces, wear your retainer regularly for the rest of your life -- at least a couple of nights each week! This isn't as bad as it sounds. It just becomes part of your life -- another way to ensure that your smile stays beautiful and healthy!
If your retainer breaks, call your orthodontist immediately to have another one made. If you can't afford a new one, discuss this with your orthodontist and try to set up a payment plan or work out a financial arrangement.
How do I keep my retainer clean?
You should clean your retainer each night as directed by your orthodontist. If you are wearing your retainer around the clock, rinse it with warm water after taking it out of your mouth, and also before putting it back in later! This will help prevent bacterial buildup.
You can brush a Hawley retainer with a toothbrush and a tiny bit of toothpaste, but that is not recommended for a clear Essix retainer, as it can get scratched. Brushing also gets tiresome after a while. The most convenient way to keep your retainer clean is to use a product made for this purpose, or to use denture cleaner.
Several great specialty products are available to help keep your retainers clean and free of odor. Four such products are SonicBrite, Retainer Brite, DentaSoak, and Cleanse.Freshen.Go. They work great on all types of retainers and even clear Invisalign -type aligners. SonicBrite includes a portable sonic cleaner. Retainer Brite is a tablet which can be used with or without a sonic cleaner (sold separately). In both these products, the sonic cleaner helps the product to reach all the little crevices in your retainer, cleaning out all the bacteria and dissolving all of the white buildup.

Day-to-day Living with Braces and Orthodontics

Day-to-day Living with Braces and Orthodontics

What is an adjustment and how is it done?
In a nutshell, the elastic ligatures are changed, and sometimes the arch wire is also changed. For a detailed description of the procedure, read About Tightening/ Adjustment.
I seem to be drooling more, now that I have braces. Why?
Excess saliva (drool) is actually very common. Apparently your mouth mistakes the feeling of the brackets on the inside of your cheeks for food, and sometimes produces extra saliva to help digest it. 
Suddenly I've developed gaps between teeth which never had gaps before. Should I be worried?
It is very common for your teeth shift and develop gaps while treatment is underway. Your bite will change many times during your treatment. Remember than any strange gaps or bite problems will be resolved by the time your treatment is finished. If you are really concerned, mention it to your orthodontist.
Do I really need to brush my teeth after every meal when I'm wearing braces? What a pain!
Yes and no. Yes, you should, because depending on what you eat, food gets stuck in and around the brackets. Besides looking gross, it causes tooth decay and bad breath. It also feels yucky. Some people can't stand the feeling of food stuck in their brackets. You wouldn't believe how much food can get stuck -- often more than you'd imagine!
However, if you let the brushing slide every so often, it's not the end of the world. Just try to be as diligent as possible on a regular basis. At the very least, swish your mouth with water and try to pick out any food that is stuck in your brackets. It's also a good idea to floss each night, or at least a few times per week. Sometimes food gets stuck between teeth and you don't realize it until you floss it out.
Some dentists also recommend a fluoride mouth rinse, such as ACT, which is available in most supermarkets and pharmacies, and comes in many flavors (including bubblegum and mint).
My teeth really hurt! What can I do to ease the pain?
In the first weeks after you get your braces on, your mouth will be sore and your teeth will hurt. Most people take ibuprofen (Motrin/Advil) or acetaminophen (Tylenol) to help ease the pain. Cold drinks or cold foods (such as frozen yogurt, milkshakes, ice cream, or just plain ice water) may also help.
What can I eat? Should I really avoid the foods on my orthodontist's "don't eat" list?
It is best to eat only soft foods that are easy to chew. Do not take big mouthfuls. Chew carefully and slowly so that you don't gag or choke. Avoid stringy foods like melted cheese that forms big strings, and long stringy pasta -- they will get stuck in your brackets and may cause you to gag. Cut your food into small pieces. No biting into large sandwiches -- use a knife and fork until you get the hang of wearing braces! I ate hamburgers with a knife and fork the entire 3 years I was in braces!
Read our pages of Soft Food Suggestions to get some insight on what types of foods you can manage. This stage will probably only last for a few weeks, until you get used to your braces and your gums "toughen up."
Your orthodontist may have given you a list of foods that should be avoided. These include gummy sticky foods (like Gummy Bears), and very hard foods (like nuts or hard chips). But it can also include things like ice cream and popcorn. Why? Because many flavors of ice cream can include hard chunks. The unpopped shell of popcorn can get stuck in your brackets. Biting into any hard food might cause your brackets to break or your wires to bend, so you must be careful.
Will my brackets pop off?
Sometimes a bracket will spontaneously pop off. There are a number of reasons this can happen. Remember that your brackets are glued on, so if the glue bond is broken, the bracket will come off. If this happens to you, call your orthodontist immediately to get it re-glued. It is normal for a bracket to pop off occasionally. But if a bunch of brackets keep popping off by no fault of your own, speak to your orthodontist about it. Gluing on brackets can be tricky and it may take a few tries to get it exactly right.
I don't want to wear my headgear during the day. Why can't I wear my it only at night?
Nobody likes to wear headgear, but it serves a specific purpose in your treatment. If you don't wear it as many hours as your dentist recommends, your treatment won't progress as fast, and you might wind up wearing the headgear additional months. It's best to just go along with what your dentist recommends and get it over with sooner.  Read A Few Words About Headgear for more information.
Why do I need to wear elastics?
Elastics help fine-tune the alignment of your teeth and your bite. There are many different ways that you can wear elastics for specific reasons.  You should wear the elastics the number of hours that your dentist recommends to help your treatment progress properly. (Wearing them "double time" or "double strength" to make up for time you spent without them is NOT advisable -- that could harm your teeth). Most people take elastics out before a meal, brush, then replace them after a meal.
How can I cope with canker sores when I have braces?
There are many ways to cope with canker sores. If the sore is near a bracket, you  can put some dental wax or dental silicone on the bracket to create a barrier, then apply some canker sore medication to the sore area. For more detailed information, read Ouch! I Have a Canker Sore!
Do ceramic (non-metal) braces stain?
The brackets themselves usually do not stain. It's the elastic ligatures that hold the arch wire to the bracket that stains. These are changed at each adjustment, when you get fresh clean ones. So, if your ligatures or power chains stain, you'll only have to live with it for a short time.
What foods stain the ligatures of your braces the worst?
Foods like curry, mustard, black coffee, and red wine create the worst stains. For more details, read Help! Did I Stain My Braces?
What colors of ligatures or power chains resist stains the best?
Clear or white ligatures show yellow stains the worst. The best colors, according to ArchWired readers (and my own personal experience) are: smoke, pearlescent, glow-in-the-dark, and any dark vibrant colors. I have also worn light blue, which turn a pleasant teal color when stained by curry (i.e., blue ligatures plus yellow curry make greenish blue ligatures).
Can I change my elastic ligatures ("o rings") myself at home?
Unless your orthodontist has given you the go-ahead to do this, it is NOT recommended! Yes, there are places on the web where you can buy elastic ligatures and power chains, but even THEY do not recommend that you change them yourself at home. The reason is: putting extra pressure on your teeth at inappropriate intervals can interfere with your treatment. Read Changing Your Own Ligatures for more information on why it is a bad idea to change your own ligatures.
Can I smoke cigarettes, cigars, or pipes with braces on my teeth?
Yes, you can smoke or chew tobacco, but both of these habits will stain your ligatures and may possibly stain ceramic brackets.
Is it OK to have braces if you are pregnant, or plan to become pregnant?
Yes, many pregnant women have had orthodontic treatment. Your teeth may be a bit looser than average because of the hormonal changes and the effect on your periodontal ligaments. But as long as you maintain good periodontal health, it shouldn't be a problem to wear braces if you're pregnant. For a reader's perspective on the subject, read Braces and Pregnancy.
Can you wear braces if you snorkel or scuba dive?
Yes, you can. It's probably best to have the braces on for a few months before snorkeling or scuba diving, so you can get used to the extra hardware in your mouth. For a reader's perspective on the subject, read Braces and Snorkeling/Scuba.
Can you wear braces if you play a wind instrument?
Yes, you can. Several companies make mouth guards and lip protectors specifically for this purpose. Ask your orthodontist for one that he/she recommends. Some orthodontists can make a custom lip guard for you.
How can I keep my braces clean after eating at a restaurant or traveling?
Most people who have braces carry a little dental kit to help them in such situations. A dental kit should contain a dental pick, some floss and floss threaders, a toothbrush, and some toothpaste. A travel cup is also a good idea. All these items are compactly offered in a product called DentaKit Braces Survival Kit.
A wire at the end of my braces is poking my cheek. What should I do?
This is always an annoying and tricky situation. If possible, gob a bunch of dental wax at the end of the wire to stop it from poking you. You can also try a bit of cotton. Call your dentist or orthodontist and ask to come in ASAP so they can clip the wire. Please don't suffer needlessly with a poking wire. After a day or two it can really painfully tear up the inside of your cheek, so don't wait to get it clipped! Some orthodontists let you come in "as needed" for a clipping without an appointment.
By the way, the wire pokes you because your teeth have moved, displacing the end of the arch wire. Although this is annoying, it's a good sign that your treatment is progressing!
What about braces and sports?
Depending on the sport, it is probably a good idea to wear some sort of lip protector or mouth guard so the braces don't cut up the insides of your mouth (and also to protect your teeth and braces). Light contact sports will be made safer with a simple lip protector. Many heavy contact sports require a larger mouth guard. If you are not sure what is appropriate for you, ask your orthodontist. Sometimes, orthodontists make custom-fitted mouth guards and lip protectors.
How often should I get my teeth cleaned when I have braces?
Most dentists recommend that people get their teeth cleaned twice per year. For people with braces, this is especially important. Even if you brush and floss very well, a professional cleaning will ensure that you don't develop decay. When you have braces, you should consider getting one or two extra cleanings per year. They do not take off your arch wires or brackets to do a cleaning. They usually work around your braces, or use a device called a Cavitron, which is like a high-powered Waterpik.

Keeping Your Braces Clean and Comfortable

Keeping Your Braces Clean and Comfortable

Do I need to use a special toothbrush or other gadgets when I have braces?
Yes and no. You  can use a regular soft toothbrush, but most orthodontists recommend an orthodontic-cut toothbrush, where the bristles in the middle are lower than the bristles on the edges and cut into a "v" shape. You can also use any electric toothbrush, such as a Sonicare or Oral-B Braun. These do an especially good job of cleaning your teeth.
To floss your teeth, you don't necessarily need special floss. You can use any type of floss with a plastic threader needle such as BridgeAid. The plastic threader helps you bring the floss under the arch wire for each bracket.
To make things easier, there are also several types of "threader floss" which is a length of floss that has a built-in stiff threader end. Some popular brands of threader floss are Thornton 3-in-1 Floss, SuperFloss, Crest Glide Threader Floss, and SturdyFloss which was created by a dental hygienist. An enterprising orthodontic patient even invented a tool he calls "FlossFish" to help you floss under your brackets with any type of regular dental floss. Many of these flossing tools can be found at DentaKit.com or many online drugstores.
You might also want to get a small spiral dental brush (sometimes called an "interproximal brush" or a "proxi-brush") or a rubber-tipped stimulator to help clean food debris out from between the brackets before you brush. A WaterPik or a device like Oral Breeze's QuickBreeze (which attaches to your sink faucet) or ShowerPik (which attaches in your shower) are also helpful.
And finally, you will need some dental wax, because inevitably, the brackets will irritate the insides of your cheeks at first and you will want some relief from the irritation.
Why do you need to use wax when you have braces?
Wax helps to create a barrier between the bracket and the inside of your cheeks and lips. It helps prevent the bracket from irritating your cheeks or gums. At first you will probably use a lot of dental wax, but as your get used to your braces and the insides of your cheeks "toughen up" you may wind up using less.
How do you use orthodontic dental wax on your braces?
To use dental wax, break off a tiny bit of wax from the container, smoosh it with your fingers a bit to mold it, then place it directly on the bracket that is causing the irritation, as shown in this photo. Dental wax is non-toxic, so it's ok if you swallow it. Wax tends to break down over time, so you'll probably have to apply more after eating a meal. Take off the wax before you brush your teeth, or it will gunk up your toothbrush.
Dental silicone, such as Ortho-Sil is a little different. It lasts longer than regular dental wax. Your brackets must be extremely dry when you apply dental silicone, or it will not stick to them. Some people love dental silicone and some prefer regular wax. If you have never used OrthoSil, ask your orthodontist for a small packet, or buy just one container to try before buying a large quantity.
Usually your dentist/orthodontist gives you some dental wax after you get your braces put on. Most pharmacies (both online and local) carry dental wax. DentaKit.com also carries silicone dental wax, as well as several types of lip protectors which are alternatives to wax.
What else can you use to ease irritations inside your mouth in the first weeks of braces?
A warm salt water rinse, several times per day, can be very soothing. But if that isn't enough, try a mouth rinse called Rincinol PRN, which helps to heal mouth sores. You can find this product at many stores online, or at your local drugstore or pharmacy. You may also want to read our page of suggestions about canker sore remedies, which contains many suggestions.
How do you brush your teeth with braces on?
First, rinse with warm water a couple of times to dislodge any food particles. You can also use a rubber-tipped gum massager to dislodge any particularly stubborn particles that are badly stuck in your brackets. Now you can use a small amount of toothpaste and brush your teeth.
It is best to use circular, vibrating motions around the gum line. Angle your toothbrush above and below the brackets. Scrub each surface of every tooth with 10 strokes of the toothbrush. This should take several minutes -- be as thorough as possible. Don't forget to also clean the surfaces of the molars and to also brush your tongue!
Can you use whitening toothpaste when you wear braces?
It's probably best not to use a whitening toothpaste until after your braces come off. If you use a whitening toothpaste on a daily basis, the teeth underneath the brackets may not be as white as the rest of your teeth when your braces come off!
How do you floss your teeth with braces on?
It's a little tricky at first. You must thread the floss under the arch wire between each tooth, floss under the gumline, then remove it. Repeat for each tooth. At first it will take about 15 minutes to floss all of your teeth, but with practice you will get faster and more efficient at doing it. It is important to floss EVERY NIGHT. Even if you use a Waterpik device, you should still floss. Braces are notorious for hiding tiny pieces of food you could have sworn were rinsed away!
You can use any type of floss that is comfortable. Most people attach the floss to a plastic needle called a Floss Threader, or use floss that has a stiff end, such as SturdyFloss or Glide Threader Floss, as mentioned a few paragraphs earlier. 
How can I keep my braces clean after eating at a restaurant or traveling?
Most people who have braces carry a little dental kit to help them in such situations. A dental kit should contain a dental pick, some floss and floss threaders, a toothbrush, and some toothpaste. A travel cup is also a good idea. It is easy to put one together yourself.

The Braces: How They Work and How They Feel

The Braces: How They Work and How They Feel


common parts of braces
What is an arch wire?
The arch wire is the metal wire that goes across your braces, from one end of your mouth to the other. You have two arch wires; one on top and one on bottom. The pressure from the arch wire is what helps to move your teeth.
What is a ligature?
A ligature (also called an "o-ring") is a tiny elastic that holds the arch wire onto each bracket of your braces. Ligatures come in a variety of colors. Some brackets are "self-ligating," which means that they do not need the little elastics to hold the arch wire onto the brackets -- instead they have a "sliding door" system for keeping the arch wire attached to the bracket.
Why do I need to have spacers put in before braces?
Sometimes there isn't enough space between certain teeth to insert a metal band or other appliance. Spacers help move the teeth slightly to create space that is needed for your treatment. For more information, read What are Orthodontic Spacers?
How do braces work?
In a nutshell, the ligament surrounding the teeth is loosened, allowing the teeth to move. For a more detailed explanation, and illustrations of the parts of braces, read How Do Braces Work?
Is there a big difference between metal and ceramic braces? 
All the pros and cons are outlined in What Type of Braces are Best? Also, visit ArchWired's Links page.
Why are there hooks on my brackets? 
Hooks are for attaching elastics (rubber bands). At some point in your treatment, your orthodontist may tell you to wear rubber bands that attach from a hook on the top brackets to a hook on the bottom brackets. Elastics help to close up your bite and correct things like midline problems. This all refers to the way your top and bottom teeth meet and align with each other.
Why are there little tubes on my molar brackets? 
The tubes (often called "buccal tubes") on your molar brackets may be used for attaching an appliance like headgear or a facebow. Don't be alarmed -- just because you have them, it doesn't mean that you are going to get headgear or a facebow! Some molar brackets have the tubes "by default." My molar brackets had tubes but they were never used for anything in the three years I had my braces!   (picture from braces.org)
How long have braces been around?  
Braces, in one form or another, have been around since ancient times! For an interesting article about the history of braces, read A Short History of Braces and Orthodontics.
Do braces hurt when they are on your teeth?
Yes, at first they do. For me, it felt like I had been hit in the teeth with a baseball -- but everyone's experience is different. Your teeth will ache to some extent and your gums will probably get sore in specific places. This is because your teeth are not used to the pressure, and your cheeks are not used to the metal or ceramic rubbing against them. 
After wearing braces for a few weeks, the pain and discomfort begin to diminish. You can use dental wax and topical anesthetic to help create a barrier between the braces and any sores that develop on your gums (the sores usually heal within a few weeks). You can also use a lip protector.
In a few months, pain is less of an issue, and it goes away. You sometimes even forget that you're wearing braces! Your teeth may also hurt again for several days after your monthly adjustment, but by then you're used to it and it doesn't bother you as much.
How long will braces cause pain and discomfort?
When you first get braces on, your teeth will hurt or you may be in some amount of discomfort for several weeks. After about a month, it is better. In a few months, you may even forget that you are wearing them. Within 3 months you will be able to eat almost anything you like. In six months, you might even be biting into hard cookies, chips, and crusty bread once again. Eat these things in moderation and always be careful. "Forbidden" foods and soft foods are mentioned in the next section.
I just got my braces recently and my teeth feel loose. Why? Is it OK?
The periodontal ligament, which helps to hold your teeth in place, is loosening up. Yes, this is perfectly normal, although it is very disconcerting. The teeth should stop feeling loose after a few weeks. If you're very concerned about it, or if the teeth feel loose for months on end, talk to your dentist about it.

GETTING FRIENDLY WITH BRACES!!

Thinking About Getting Braces

Can you be too old for braces?
There is no age limit for braces. As long as you have good periodontal health, braces can be used to straighten your teeth and correct your bite. More people over age 30 are getting braces today than ever before. Most ArchWired.com readers are between the ages of 25 to 55! However, if you have been on a Bisphosphonate drug for osteoporosis (such as Fosamax or Boniva) you need to talk to your orthodontist or dentist first. Read this article to find out why this is very important.
I wore my retainer for a while when I was younger, but then I stopped wearing it and my teeth shifted years later.  Is this common?
Yes, it is more common than you think. The teeth are actually more dynamic than you'd expect. Sometimes, when wisdom teeth erupt, your bite can change in adulthood. A large percentage of adults in braces are in them for a second time!
My kids just got braces and now I'm thinking of getting them, too. 
Many adults "finally get their teeth done" when their kids go in for orthodontic treatment. It's more common than you think! Several ArchWired.com readers have an entire family in braces!
What is it like to have braces put on your teeth? Does it hurt?
Getting braces put on your teeth does not hurt, and does not require Novocain injections or anything painful. For a full description of the process, read Braces Basics: When the Braces Go On.
How much do braces cost?
The average cost for a full set of braces in a typical two-year treatment is about $5,000 US. The cost varies depending on where you live. Major metropolitan areas tend to be slightly higher in cost than rural areas. Generally, metal braces cost less than ceramic ones. Invisalign treatment can be just as costly as traditional braces, and sometimes is even slightly more expensive. Here is a survey we did on the subject a few years ago.
Does dental insurance cover the cost of braces?
Many people in the U.S. have dental insurance through their employers or as individuals/families. This insurance usually cover orthodontic treatment for children up to age 18, but does not cover adult orthodontics -- or only covers it up to a certain dollar amount. If your plan covers adult braces, consider yourself in the lucky minority. I can't speak for dental plans offered overseas, as I know very little about them, and some are government-run (such as the NHS in the United Kingdom).
Remember, most insurance plans and discount dental plans do not cover treatment that is already in progress. So, if you are going to sign up for a dental plan or insurance plan, do it before any treatment begins. Also, beware of any waiting periods your dental plan may enforce. And by the way, jaw surgery or extraction is sometimes covered under your medical plan, so be sure to look into this, too.
How can I find an orthodontist or a discount dental plan?
To help find an orthodontist near you, it's best to get personal recommendations. Ask friends who have braces (or whose kids have braces). If your insurance covers orthodontics, see if it is limited to specific dentists/orthodontists. Or, post a query on ArchWired's Metal Mouth Message Board; our readers are all over the US and around the world, and are very helpful!  
Dental plans come and go; some are better than others. Please read the fine print carefully before you sign up for anything and check with the Better Business Bureau. If you don't have dental insurance, you can sign up for a discount dental plan. A discount dental plan is not insurance -- it is a cooperative of dental professionals who have contracted with a company to offer their services at a discounted rate. Many are available, offered by different companies. You can search for discount dental plans on Google or DentalPlans.com. Or, ask a trusted insurance agent or your own dentist.
I can't afford dental insurance or a dental plan. What can I do?
If you don't have dental insurance and can't afford a a discount dental plan, there is still an alternative. If there is a dental school in your area, call them and ask if they have a clinic. Often orthodontists and dentists in training will practice on patients in the school clinic, under the watchful eye of experienced teachers who are themselves dentists and orthodontists. This service is offered to the public at a minimal cost.
Can I get those invisible braces (Invisalign) instead of traditional ones?
That depends on your specific case. Invisalign braces are usually not recommended for very complicated cases, or cases that involve extractions. Only a qualified dental professional who has examined your mouth can decide whether Invisalign is right for you. If you are very concerned about your appearance with braces, another thing to consider is lingual braces, which are behind the teeth (such as iBraces). An orthodontist must take special training to do lingual braces -- not every orthodontist does them.
What is the difference between a dentist and an orthodontist?
An orthodontist is a dentist who has taken several years of extra training beyond the basic dental degree. Here is what the American Association of Orthodontists (AAO) says:
"It takes many years to become an orthodontist. As in medicine, the educational requirements are demanding.

First, an orthodontist must complete college.
Next is a three- to four-year graduate program at a dental school in a university or other institution accredited by the American Dental Association (ADA).
Finally, there are at least two or three years of advanced specialty education in an ADA-accredited orthodontic residency program. The program is difficult. It includes advanced knowledge in biomedical, behavioral and basic sciences. The orthodontic resident learns the complex skills required to both manage tooth movement (orthodontics) and guide facial development (dentofacial orthopedics).

Only dentists who have successfully completed this advanced specialty education may call themselves orthodontists."
Should I get braces done by a dentist or by an orthodontist?
My personal opinion leans toward orthodontists.
Some dentists incorporate orthodontics into their practices. They have probably completed some extra coursework in tooth movement management and facial development. Some dentists who practice orthodontics have completed more coursework than others. Don't feel shy about asking a dentist about his orthodontic qualifications -- what extra training he has completed, and how many orthodontic patients he has seen. Just because a dentist says he or she "can do braces for you" doesn't mean that they have all the training necessary to successfully handle complicated treatments. Some dentists confer with their their orthodontic colleagues to ensure that they're doing things optimally. If you have minor orthodontic problems, your dentist might be able to handle your case. Complicated cases are probably best handled by an orthodontist who has more training.
If you're considering getting braces, you should probably get at least one opinion from an orthodontist to ensure that you are getting the correct type of treatment.
How many orthodontic consultations should I get?
You can get as many orthodontic consultations as you want. In a consultation, an orthodontist looks at the alignment of your teeth and your facial aesthetics and gives you a general opinion of what he or she would do to correct your problems.
Usually the consultations are free or of minimal cost. While an orthodontist can look at your teeth and give you a general opinion, he or she can't put together a comprehensive treatment plan for you until teeth molds and panoramic x-rays have been done.
There is usually no one right way to correct orthodontic problems -- there are many ways, and different orthodontists may give you different opinions. That is why it's a good idea to consult with two or three orthodontist before you start treatment, especially if they recommend extractions, headgear, or jaw surgery.
What are some of the risks of getting braces as an adult?
Just like any medical or dental procedure, there are some risks involved in orthodontic treatment, no matter your age.  The forces involved in braces can cause some amount of trauma to the dental tissues and structures. However, most adults successfully complete their treatment without any major complications. Orthodontists often give their patients a booklet outlining some of the risks that may be involved and make them sign a waiver that they understand these risks, which include:
  • Root resorption - The structure of the tooth's root may break down, causing its destruction.
  • Gum recession - The loss of gum tissue around the tooth, which in severe cases can expose the tooth's root. The "triangle" of gum tissue surrounding some teeth may also recede.
  • Allergic reactions - If you are already allergic to nickel or latex, tell your orthodontist. There are alternative brackets and bands which are nickel and latex free. You may be sensitive to these substances and not realize it until you get braces. If you develop unusual swelling or tenderness in your gums during your treatment, or any sort of hives or rash on your face and mouth, allergy may be the culprit.
What is a "bite" and what is malocclusion?
Occlusion is another word for your bite -- how the teeth in your top and bottom jaw meet with each other. Mal comes from the Latin root meaning "bad." So, a malocclusion means a bad bite -- a bite with problems. It means that your top teeth do not line up properly with your bottom teeth.
What are the "classes" of malocclusion?
Malocclusion is most often caused by hereditary factors such as an abnormal relationship between the size of the teeth and the size of the jaws. Malocclusion may also result from missing teeth or habits such as thumb sucking or tongue thrusting.
Malocclusions are classified based on the relationship of the maxillary (upper jaw) and mandibular (lower jaw) first permanent molars. 
There are three basic classes of malocclusion, Class I, Class II, and Class III:
Class I malocclusion involves crowding, spacing, or overlapping of the teeth. In this classification the upper jaw is in a normal relationship to the lower jaw; that is, neither jaw protrudes.

Class II malocclusion occurs when the bottom jaw is in a more posterior (backward) position than normal. The top teeth appear to protrude out over the lower teeth. One example of this type of malocclusion is often referred to as "buck" teeth.

Class III malocclusion occurs when the lower jaw is in a more anterior (forward) position than normal. The lower teeth protrude out beyond the upper teeth. This is often the most difficult type of malocclusion to correct.


What are the "types of bite" and what do they mean?
The most common types of bite problems are:
  • Overbite. Patients with overbites appear "bucktoothed" and have a receding chin. The lower front teeth are positioned too far behind the upper front teeth. This condition can result from a horizontal overdevelopment of the upper jaw or an underdevelopment of the lower jaw or a combination of both. 
  • Underbite. Patients with underbites have a strong jaw with a chin that juts straight out. The lower front teeth are positioned in front of the upper front teeth. This condition is caused by the horizontal underdevelopment of the upper jaw, the horizontal overdevelopment of the lower jaw, or most frequently a combination of both.
  • Crossbite. This occurs when the upper teeth are biting inside the lower teeth. This is frequently the result of a narrow upper jaw. Crossbites also occur because of a mismatch in jaw size and position between the upper and lower jaw. Some crossbites also lead to asymmetry of the lower jaw by causing the jaw to be abnormally deflected to one side when closing the teeth together. Proper diagnosis determines how and when a crossbite needs correction.
  • Open bite. This occurs when the upper front teeth cannot meet or overlap the lower front teeth even though the back teeth have closed together. Sometimes this this makes eating difficult. Open bites are caused by the overdevelopment of the back portion of the upper jaw in a vertical direction. As the back portion of the upper jaw grows vertically downward, the lower jaw will open in a clockwise direction. This explains why open bite patients have a long facial appearance. 
Can I get braces just on the top or bottom?
That depends on your case. Orthodontics isn't just about making your teeth straight or making them look better. Most dentists and orthodontists take a lot of things into consideration when recommending treatment, such as:
  • how the top and bottom teeth meet with each other (i.e., your bite)
  • how well you can chew your food
  • whether you have a tongue thrust problem
  • whether extraction or surgery will be necessary to correct your problems
  • whether you will need any appliances in your treatment, such as a palate expander or headgear (yes, some adults do wear headgear)
So you see, it isn't just a matter of making your teeth look pretty. There are lot of other factors to take into consideration. This is why you sometimes need a full set of braces, even if you think that you only need them on top or bottom. Of course, some people are lucky. Their bites are good and perhaps they only need a bit of straightening. People in this position often can get braces only on top or bottom  
When will I begin to see changes in my teeth after the braces are put on?
According to a recent ArchWired.com poll, most people begin see changes in their teeth in the first 2 to 6 weeks of treatment.
Are people going to think I look geeky or weird with braces on my teeth?
Of course you're self-conscious because it is YOUR mouth, but frankly most people don't give a hoot. Your braces are a conversation piece for about 3 minutes; after that, nobody pays much attention. Really. And most people don't think you look geeky. In fact, they probably think you look cute, or applaud that you are doing something positive to improve your appearance and your dental health. Whenever you become self-conscious about your braces, think about how great you'll look after they come off!

What is a Tightening or Adjustment?


What is a Tightening or Adjustment?
It's not as Medieval as it sounds!
Every 4 to 6 weeks, you go to your orthodontist to get your braces "tightened" or "adjusted." Sounds awful, doesn't it? Well, cast aside your visions of Medieval torture devices. Nothing is really "tightened." It's really very simple.
This is usually what happens during an orthodontic adjustment:

  • The orthodontic assistant removes your elastic ligatures (the little rubber bands that hold each bracket to the arch wire). 

  • Then the arch wire is removed.

  • At this point, you can brush and floss almost sans braces.

  • The orthodontist may come over to examine your teeth's progress. Depending on the situation, a new arch wire may be needed. If you need anything new (such as power chains or elastics), the orthodontist should tell you.

  • The arch wire (new or previous) is put back onto your brackets. New elastic ligatures are put on. If this is one of the first times you're getting an adjustment, this may hurt a little because of the pressure placed on the teeth. Don't worry, in future months, it won't hurt anywhere near as much! This is why they call it "tightening;" the braces feel tighter when the new ligatures are put on because of the renewed pressure on the teeth.

  • If the arch wire pokes your cheek at all, tell your orthodontist immediately! The arch wire should not poke you! If it does, the orthodontist or assistant must shorten the arch wire with clippers. Sometimes, the arch wire does not poke you immediately, but suddenly starts poking after one or two meals. This is good -- it means your teeth have moved! See your orthodontist ASAP to get the wire clipped. Otherwise, the arch wire will tear up the inside of your cheek, which is very uncomfortable.
That's it! Do your teeth hurt? Take some pain reliever to help you deal with it. The discomfort will probably last a few days, then dissipate. You may need to eat only soft foods for a few days. Protein shakes, such as the Atkins or Slim Fast shakes, made ideal meal replacements if chewing even soft food is uncomfortable. Within a week, most people an usually eat normal food again. After a few months, adjustments won't hurt as much (really!)
After you have had braces for more than 6 months, your teeth get used to the extra pressure. At this point, an adjustment might not hurt at all, but your teeth usually feel sore for about a week afterwards. For some people, the teeth don't feel sore again until the next adjustment. But for others, the pain dissipates for a week or two, and then a week before the next adjustment, the teeth are sore again. Why is this?
The cell regeneration process occurs after an adjustment. Your teeth are under force and move and causes some cells (bone, tissue) to break down and new cells to regenerate. After the regeneration happens the teeth and supporting structures begin giving and moving again and the cycle continues. This is why most orthodontists see patients every 4-5 weeks. The cell regeneration process typically takes about 3 weeks and that gives patients enough time after an adjustment to be ready for another one.
Because today's wires move teeth slowly over a long period of time, the whole cell regeneration doesn't stop/go/stop/go as it used to with older style wires, now it just moves your teeth continually. Movement continues until the wire is fully back to the original size and shape, at which time you are ready for a stiffer and larger arch wire.

What are Orthodontic Spacers?

What are Orthodontic Spacers?
...and why do you need them?
Your orthodontist may have told you that you need to have spacers before your braces go on. What does this mean?
Some of your teeth may need brackets that are attached to metal bands that go all the way around the tooth.* Usually, the bands are used only on molars. If the space between your molars is very tight, it will be difficult for the orthodontist to put the bands on the teeth. Therefore, space must be opened up to fit the bands in. This is where spacers come in.
Spacers are little rubber nodules that fit between the teeth. In some cases, your orthodontist may use a metal spacer, which looks like a tiny metal hinge. The spacers stay between your teeth for several days and move the teeth apart slightly. You wear the spacers 24/7 until your orthodontist removes them. Do not floss teeth that have spacers between them (it will be impossible)!
Are spacers uncomfortable? Yes, they usually are. It feels like you have something stuck between your teeth -- and you do! In some cases it may be more than just uncomfortable; it may ache. If so, take pain reliever (such as ibuprofen) as needed. 
Spacers usually stay between your teeth for several days; sometimes for as long as 10 days. The spacers are taken out before your braces are put on. The braces don't hurt like the spacers; in fact, when the spacers are removed, it feels so much better, even after the braces are put on!
Many people on Metal Mouth Forum have remarked that spacers were the worst part of the entire process. Perhaps that's not very encouraging, but remember, they're only in your mouth for a short period of time. You can deal with it. They'll be in, then they'll be out, and you'll be done with it. Hang in there, you're on your way to a better smile!  And if those spacers really bug you, drop in to the Metal Mouth Forum and spill your guts. We love to commiserate! :-)

*Why do some teeth need metal bands instead of regular brackets? Fillings. If you have a filling that protrudes to the outside of your tooth, brackets cannot be glued to these fillings. Therefore, a metal band must be wrapped around the tooth instead. The bracket is attached to the metal band.

HEADGEAR?? FACTS!

A Few Words About Headgear
by Adrian Vogt, DDS
Headgear is typically used in growing patients to correct overbites by holding back the growth of the upper jaw, allowing the lower jaw to catch up. Headgear needs to be worn approximately 10-14 hrs to be effective in correcting the overbite, usually anywhere from 6 -18 months depending on the severity of the overbite and how much a patient is growing.
Headgear is also used in adults, but for a different reason. A typical scenario is a case where some teeth are extracted, and front teeth are being retracted (pulled backward). When extraction spaces are being closed, the teeth behind the extraction space slide forward and the teeth in front of the space slide backward. In some situations, to maintain the bite, the orthodontist will not want the back teeth to come forward. The headgear serves to hold them back (maintain anchorage). Orthodontists will want those patients to wear the headgear as much as they can. Realistically for most adults this might only be 8-10 hours per day, but the more the better; even 24 hours would be acceptable.
Soreness of teeth when chewing, or when the teeth touch, is typical. Adults usually feel the soreness 12-24 hours later, but younger patients tend to react sooner, (e.g., 2-6 hours).
The soreness/tenderness may persist for several days. Usually, the second and third days are the most severe, with reduction in soreness over the next couple of days. Ibuprofen and soft diet are helpful. There is also a device called a "bite wafer," which is a soft U-shaped piece of rubber which patients can gently squeeze their teeth into. The bite wafer keeps the blood circulating around the teeth and lessens the time teeth might be sore.
Typically, soreness from the headgear and elastics will attenuate and disappear after a few days, but it may persist for as long as a couple of weeks. Very few patients complain of having sore teeth essentially the whole time. Once the soreness is gone, it is not uncommon for soreness to flare up again, usually just involving a few teeth. Then the soreness disappears again. Soreness tends to leapfrog among different teeth at different times as a result of tooth movement.
The key to the fastest relief of tenderness is to continue the wear headgear/elastics even though the teeth are sore. If you stop wearing the headgear or elastics, your teeth will feel better temporarily, but as soon as you resume wearing your headgear, the symptoms will start all over again.

HISTORY OF BRACES

A Brief History of Braces
when Metal Mouth really described it...
If you think the desire for straight teeth is a trapping of modern society, think again! Extreme Makeovers may be new, but "braces" date as far back as ancient man! Early History
Even ancient people wanted straight teeth! According to the AAO (American Association of Orthodontists), archaeologists have discovered mummified ancients with crude metal bands wrapped around individual teeth. To close gaps, it has been surmised that catgut did the work now done by today's orthodontic wire! Later, in 400-500 BC, Hippocrates and Aristotle both ruminated about ways to straighten teeth and fix various dental conditions. Straight teeth have been on our minds a very long time!
While Greece was in its Golden Age, the Etruscans (the precursors of the Romans) were burying their dead with appliances that were used to maintain space and prevent collapse of the dentition during life. Then in a Roman tomb in Egypt, a researcher found a number of teeth bound with a gold wire -- the first documented ligature wire! At the time of Christ, Aurelius Cornelius Celsus first recorded the treatment of teeth by finger pressure. Despite all this evidence and experimentation, no significant events in orthodontics really occurred until the much later, in around the 1700s (although dentistry as a whole made great advancements in the interim). It should be noted that in Medieval times, specialized barbers often performed dental "operations", extractions, and procedures such as blood-letting. Let's be glad we live in the 21st Century!
Important Breakthroughs
Even before George Washington wore his famous wooden teeth, dentists were thinking about ways to correct bad bites. In 1728, French Dentist Pierre Fauchard published a book called the "The Surgeon Dentist" with an entire chapter on ways to straighten teeth. Fauchard used a device called a "Bandeau," a horseshoe-shaped piece of precious metal which helped expand the arch. French Dentist Ettienne Bourdet followed Fauchard in 1757 with his book "The Dentist's Art", also devoting a chapter to tooth alignment and appliances. Bourdet was the dentist to the King of France. He further perfected the Bandeau, and is also the first dentist (on record) who recommended extraction of premolars to alleviate crowding. He was also the first to scientifically prove jaw growth. Here's a link to a series of pages with some fascinating illustrations of early expansion devices.
Scottish surgeon John Hunter wrote (among other surgical books) "The Natural History of the Human Teeth" in 1771, clearly describing dental anatomy. Hunter coined the terms bicuspids, cuspids, incisors and molars.  His second book, "A Practical Treatise on the Diseases of Teeth", described dental pathology.  Although teeth straightening and extraction to improve alignment of remaining teeth has been practiced since early times, orthodontics as a science of its own did not really exist until the mid-1800s. 
In 1819 Delabarre introduced the wire crib, which marked the birth of contemporary orthodontics. The term orthodontia was coined by Joachim Lafoulon  in 1841. Gum elastics were first employed by Maynard in 1843. Tucker was the first to cut rubber bands from rubber tubing in 1850. And in the late 1800s, Eugene Solomon Talbot was the first person to use X-rays for orthodontic diagnosis. But all this was nothing compared to advances in orthodontics in the 20th Century.
Daddy-O (as in Orthodontic)
Historians claim that several men deserve the title of being called "The Father of Orthodontics." Fauchard certainly took orthodontics out of the dark ages, but these men really put maloclussion on the map. One man was Norman W. Kingsley, a dentist, writer, artist, and sculptor.  In 1858, he wrote the first article on orthodontics, and in 1880, his book "Treatise on Oral Deformities" was published. The second man who deserves credit was a dentist named J. N. Farrar who wrote two volumes entitled "A Treatise on the Irregularities of the Teeth and Their Corrections". Farrar was very good at designing brace appliances, and he was the first to suggest the use of mild force at timed intervals to move teeth. 
In America in the early 1900s, Edward H. Angle devised the first simple classification system for malocclusions, which is still used today (Class I, Class II, and so on). His classification system was a way for dentists to describe how crooked teeth are, what way teeth are pointing, and how teeth fit together. Angle contributed significantly to the design of orthodontic appliances, incorporating many simplifications. He founded the first school and college of orthodontics, organized the American Society of Orthodontia in 1901 (which became the AAO in the 1930s), and founded the first orthodontic journal in 1907. A journal and website bearing his name still thrive today. His highly praised reference book, "Malocclusion of the Teeth" went through seven editions. In the wake of all these advancements, the field of orthodontics and dentofacial orthopedics eventually became a respected dental specialty in its own right.
Other innovations in orthodontics in the late 1800s and early 1900s included the first textbook on orthodontics for students, published by J.J. Guilford in 1889, and the use of rubber elastics, pioneered by Calvin S. Case (some believe it was H. A. Baker).
The First Metal Mouths
What did braces look like a century ago? In the early 1900s, orthodontists used gold, platinum, silver, steel, gum rubber, vulcanite (and occasionally, wood, ivory, zinc, copper, and brass) to  form loops, hooks, spurs, and ligatures. Fourteen- to 18-karat gold was routinely used for wires, bands, clasps, ligatures, and spurs, as were iridium-platinum bands and arch wires, and platinized gold for brackets. Why gold? It is malleable and easy to shape. Gold had its drawbacks, however -- because of its softness it required frequent adjustments, and it was expensive! Anyway, you guessed it -- these bands wrapped entirely around the each tooth -- the original "metal mouth" was real gold or silver! How's that for bling?
In 1929, the first dental specialty board, the American Board of Orthodontics, was born. On a side note, the first synthetic (nylon)-bristle toothbrush was invented in 1938. Around this time, stainless steel became widely available, but using it for braces was considered somewhat controversial. It wasn't generally accepted as a material for orthodontic treatment until the late 1950s/early 1960s! In addition, you may be surprised to learn that x-rays were not routinely used in orthodontic treatment until the 1950s!
Advancements in the 1970s
Braces continued to wrap around the teeth until the mid 1970s, when direct bonding became a reality. Why did it take so long for dentists to invent the modern bonded bracket? The adhesive! The bonded bracket was actually invented earlier, but the formulation for the adhesive wasn't perfected until almost a decade later. At first, bonded brackets were (of course) made of metal. Like any new method, it took a while for the direct bond bracket to catch on -- which is why some people may remember wearing the old "wrap around" metal braces into the late 1970s.
Around this time, the self-ligating bracket also appeared on the scene. Self-ligating brackets don't need tie wires or elastic ligatures to hold the arch wire onto the bracket -- they are held on by a "trap door" built into each bracket. As early as 1935, the idea of a self-ligating brackets began to take shape. Over the years many designs were patented, but few were commercially available until Ormco created the Edgelock system in 1972. As the 1980s and 1990s progressed, many companies created their own versions of self-ligating brackets and improved upon the idea by offering both passive and active resistance on the arch wire. Nowadays, we have a number of self-ligating choices, such as Orec's Speed Braces, Ormco's Damon System, GAC's In-Ovation, and Adenta's Evolution.
In the 1970s, Earl Bergersen, DDS created the passive Ortho-Tain appliances, which guide jaw growth and help correct orthodontic problems and malocclusions in both children and adults. The Ortho-Tain appliances look like custom plastic mouthguards, and are worn mainly at night, or for only a few hours each day. In many cases, people have been able to correct (or greatly  diminish) many types of orthodontic problems with these removable custom-made appliances.
Around 1975, two orthodontists working independently in Japan and the United States started developing their own systems to place braces on the inside surfaces of the teeth -- lingual braces. These "invisible braces" offered people the results of bonded brackets with one big advantage -- they were on the inside of the teeth, so nobody else could see them!  In America,  the late Dr. Craven Kurz of Beverly Hills California developed the Kurz/Ormco lingual system. In Japan, Professor Kinya Fujita, of Kanagawa Dental University invented his own lingual system, and continues to make great advances in the lingual method. 
It takes special training to treat a patient with lingual braces, and many American orthodontists in the 1970s and 1980s were reluctant to use the method -- but orthodontists in other countries readily embraced it, and continued to make advancements with new techniques. Recently, lingual braces have become more popular because technology has made them more comfortable. One example is iBraces, a company which custom-fabricates brackets for a patient's teeth with the aid of digital computer imaging.
Lingual braces were the "invisible" braces of choice until the early 1980s, when "tooth colored" esthetic brackets made from single-crystal sapphire and ceramics came into vogue. Nowadays we also have brackets made from a combination of ceramic and metal -- giving the patient a strength of metal with esthetic look of less noticeable "tooth colored" braces. Recently, a European company even invented a ceramic bracket that is self-ligating!
Invisible Braces via Silicon Valley
As far back as 1945, orthodontists realized that a sequence of removable plastic appliances could move teeth toward a predetermined result. Some orthodontists even made simple plastic "aligner trays" in their offices for minor adjustments. But it took an adult who'd just had braces to take the concept a step further.
Invisalign was the brainchild of Zia Chishti and Kelsey Wirth, graduate students in Stanford University's MBA program. Wirth had traditional braces in high school (she reportedly hated them). Chishti had finished adult treatment with traditional braces and now wore a clear plastic retainer. He noticed that if he didn't wear his retainer for a few days, his teeth shifted slightly -- but the plastic retainer soon moved his teeth back the desired position. In 1997, he and Wirth applied 3-D computer imaging graphics to the field of orthodontics and created Align Technologies and the Invisalign method. With a boost from ample Silicon Valley venture funding, Align soon took the orthodontic industry by storm. Dentists and other dental companies were skeptical at first, because neither Chishti nor Wirth had any professional dental training. Invisalign braces were first made available to the public in May, 2000 and proved extremely popular with patients. Soon similar products began appearing on the market, made by GAC,
3-M Unitek, Ormco, OrthoClear, and others.

The Future: Technology Continues to Advance
As technology enhances our daily lives, it also continues to advance the science of orthodontics. More and more companies are utilizing digital computer imaging to make orthodontic treatment more precise. The SureSmile system by OraMetrix, for example, takes a detailed 3-D model of a patient’s teeth and helps the orthodontist develop a precise treatment plan for tooth movement. The orthodontist's treatment plan then drives a highly accurate robotic process to customize the arch wires needed for treatment. This often shortens treatment time and gives highly accurate results.
NASA developed one of the late 20th century's most dramatic orthodontic breakthroughs: heat-activated nickel-titanium alloy wires. At room temperature, heat-activated nickel-titanium arch wires are very flexible. As they warm to body temperature they become active and gradually move the teeth in the anticipated direction. Because of their high-tech properties, these wires retain their tooth-moving abilities longer than ordinary metal wires and need less frequent attention from the orthodontist. Many orthodontists now employ heat-activated wires in their treatment plans.
What does all this mean for the orthodontic patient of the future? As companies develop more precise, high-tech materials and methods, your braces will be on for a shorter period of time, be smaller and less visible, result in less discomfort, and give great results. We've sure come a long way from the wrap-around "metal mouth" -- and that's something we can all smile about!

The following references and websites provided information, images, (and in some cases, whole sentences)  for this article. Thanks to:
www.braces.org and the AAO staff
www.angle.org and the article Orthodontic Biomaterials: From the Past to the Present by Robert P. Kusy, PhD
 
The Journal of the Canadian Dental Association, Lingual Orthodontics:History, Misconceptions and Clarification by Paul H. Ling, DDS, MDS, MOrthRCS

The British Orthodontic Society's Journal of Orthodontics, Self-Ligating Brackets: Where Are We Now by N. W. T. Harradine
 
American Journal of Orthodontics and Dentalfacial Orthopedics, Orthodontics in 3 Millenia article series by Norman Wahl (special for the AAO Journal)
"Der Zahnbrecher von Gerard Honthorst" Lithograph by Franz Hanfstaegl after the painting by Gerard Honthorst
The National Museum of Dentistry in Baltimore, MD