Frequently Asked Questions: Parents Of Orthodontic Patients (tm) Part 3
Contents: Parents Response To A Child's Concerns About Braces
- What is having braces like for my child?
- How can I prevent my child from being embarrassed by wearing braces?
- Do Braces Hurt?
- Should my children do anything special during their first week in braces?
- Will braces cause sores in my child's mouth?
- How long do the braces take to put on?
- Will it hurt to put the braces on?
- What holds the braces on?
- Will my child have any limitations with braces?
- What happens if my child swallows a part from their braces?
- How Do I Convince My Child To Brush Their Teeth With braces?
- All about Orthodontic Rubber bands
- Ligating modules
- Dangers in orthodontics: facebows snapping
- allergic reactions
- Can my child hear the radio on their braces?
- What is having braces like for my
Generally, most patients do not find braces to be any big deal. Patients mouth's are usually sore for the first week after they get braces. Also, their mouth's are sore when the braces are tightened. However, with modern braces, most children get so used to the braces, that the children do not notice the braces, except when the braces are being tightened or if the child is hit in the mouth.
Peer pressure is sometimes a problem, especially if your child gets old fashioned, clunky braces. However, stylish braces(tm) are now available, and most children feel good about them.
Certainly, it is much easier for your child to get braces when they are twelve than to go through life with buck teeth.
- My son/daughter does not want to get
braces because they are afraid that the braces will make him/her look like
a geek. Any ideas?
This is hard because some teens are so worried about their appearance. One thing to try is to point out is that most people who need orthodontic treatment look like a geek even before they get braces. How would you like to go through life with buck teeth and a jaw that is too big or too small? If your child is really concerned about their appearance, then braces will really help them. Your smile is the most striking feature on your face, and at the end of orthodontic treatment you child's smile will look fabulous. Doesn't your child want to look fabulous?
The other thing is that braces have changed a lot since the days when we had braces. Braces now come in a series of styles and colors. There are orthocosmetic (tm) braces which blend in so they barely can be seen. Designer braces (tm) in gold and sapphire to add a touch of class. Even Outrageous Braces (tm) in bright purple, pink, green and black for a decidedly outrageous look. Your child can add sparkles(tm) in their school colors.
- Do Braces Hurt?
Braces have changed a lot in the last 20 years so they are a lot less painful than they were 20 years ago. At present, we do not know how to avoid the pain when the braces are first put in, or when the braces are being tightened. However, modern, cast, low profile brackets are designed to minimize your children's pain between visits to the orthodontist. Most children experience some soreness during their first week in braces and occasional pain when their braces are being tightened. However, after the first week, most children hardly notice the braces at all.
- What happens if my child's braces continue to hurt?
Talk to your orthodontist. Some patients continue to complain for the sake of complaining. However, if your child continues to hurt, it could be a sign of the start of a problem. If your child is allergicto something in their braces, their gums would be inflamed and sore. Your orthodontist can check for this. Your childs mouth will also be sore if he or she is not thoroughly brushing their teeth. Again, your orthodontist can help.
If your child hurts, be sure to tell your orthodontist. He or she can help.
- Should my children do anything special
during their first week in braces?
We generally recommend that patients be especially careful about what they eat during the first week after getting braces. Usually, patients are advised to only eat softer foods and to be very careful with their mouth.
- Will braces cause sores in my child's
Initially, there will be some sores on your child's lips. If you rinse the sores in warm salt water, the sores will heal within a week or two. Thereafter there will be an occasional sore when, for example your child gets into a fight. However, the sores should heal rather quickly.
If your child's lips get too sore during the first week, you can put wax on the braces to prevent the braces from rubbing and hurting your child's lips.
- How long do the braces take to put on ?
Depending on the case, two to two and a half hours.
- Will it hurt to put the braces on?
Not usually. The orthodontist is usually just attaching the braces to your child's teeth. The pain comes later, when the braces first begin to rub up against your child's lips.
- What holds the braces on?
Generally, the brackets are bonded directly to your child's teeth using a special FDA registered adhesive.
- My son/daughter does not want to get
braces because they are afraid that the braces will prevent them from
participating in sports. Any suggestions?
Years ago people who wore braces were advised to avoid sports. However, in 1981 people started using orthodontic mouthguards. The mouthguards have allowed patients to continue to participate in sports while they have braces. Therefore, there is nothing for your child to fear.
- My child plays the trumpet. Will his ability to play be affected by
Be sure to mention your child's musical abilities to the orthodontist. The orthodontist will install something called "lip protector" which will make it possible for your child to still play musical instruments. We have had reports of entire bands having orthodontia with no problems.
- Can my child still chew gum with braces?
Gum is usually not recommended. The gum can get caught on the braces and pull the braces off. Also the sugar in the gum can get trapped behind the braces and cause cavities.
Still, you might want to talk to your orthodontist if your child really wants gum. In some cases, it may be possible for your child to chew a sugar free, non stick gum such as Freedent ® or Wrigley's Extra®. A study in the American Journal Of Orthodontics 107(1995)497 indicates that the xylitol in the Freedent® or Wrigley's Extra® prevents cavities, and the gum does not stick to some styles of braces. It is difficult to know if your child can safely chew Freedent® or Wrigley's Extra®. Check with your Orthodontist to be sure.
- Are there other foods that my child should avoid?
We generally recommend that your child avoid hard sticky, gooey or crunchy foods. Caramel and taffy can stick on your child's braces. Crunchy foods like carrots and apples and hard rolls can occasionally knock off a bracket.
- What happens if a bracket comes off?
The orthodontist will attach another bracket. However, every time the orthodontist has to replace a bracket, it delays the orthodontic treatment.
- What happens if my child swallows a
It is usually NOT a serious problem if your child swallows a bracket. Bracket are usually made of a medical grade stainless steel which should not have any adverse effects on your child if the bracket is swallowed. The bracket just passes through your child's digestive system and leaves in your child's feces.
Inhaling a bracket is a different matter however. If your child inhales a bracket, and the bracket gets into your child's lungs, it could cause a problem. Therefore, the orthodontist will normally ask an MD to use a bronchoscope to remove the bracket.
- Why cannot the orthodontist attach the braces strongly enough that
the braces cannot come off during eating?
The orthodontist needs to remove your child's braces at the end of the orthodontic treatment. If the orthodontist attaches your braces too firmly, the braces will not come off again at the end of your child's orthodontic treatment.
- Are there any other activities that my child should avoid
when they have braces?
We advise against patients participating in activities where there will be many blows to a patient's mouth. Sports like boxing and wrestling should be avoided. Fighting should also be avoided. Your child should wear an orthodontic mouthguard whenever they participate in any sporting activity.
- How often should my child brush their teeth
when my child has braces?
We recommend that your child continue to brush and floss their teeth after every meal and before they go to bed. Brushing and flossing is especially important when your children have braces because food can get caught in the braces and cause cavities. Many orthodontists also recommend that your child brush with a fluoride gel in a further attempt to avoid cavities.
- How Do I Convince My Child To Brush Their Teeth When The
child has braces?
This is hard because teenagers are so rebellious. However, if they do not brush their teeth, food will get caught in their braces and their breath will smell awful. One parent said that she started calling her son Mr Yuch Mouth. It was amazing how fast her son started to brush his teeth.
- I have noticed that some children have
rubber bands in their braces. What do the rubber bands do?
The rubber bands are used to move teeth forward or back in your child's mouth. For example, they could be used to move your child's lower teeth forward or back, to move a tooth that is far our of alignment, or to close a space in your child's mouth. The rubber bands are often used in the final stages of the orthodontic treatment
- How often should my child change their rubber bands?
Orthodontic rubber bands break after they have been chewed a few times. Usually, the rubber bands snap when the child opens their mouth, with painful results. The only way to avoid the pain is for your child to change their rubber bands frequently. We recommend that orthodontic patients take off their rubber bands before each meal and put in new ones after they are done eating. It also is helpful for your child to change the rubber bands before the child goes to bed.
- What happens if my child leaves off their rubber bands?
The orthodontic treatment will take up to a year longer and be more painful.
- What happens if my child swallows a rubber band?
Orthodontic rubber bands are made of a medical grade latex rubber which is similar to the grade of rubber used in medical implants. The rubber is thought to be safe for human consumption. If your child swallows an orthodontic rubber band, the rubber band just passes through your child's digestive system and leaves in your child's feces.
Your child will get indigestion, and may have a bad allergic reaction if the child swallows a bag of rubber bands. Please make sure that your child does not eat a pag of rubber bands.
- What does a retainer do?
The objective of a retainer is to keep your child's teeth in perfect alignment after braces are removed?
- Why is a retainer needed?, Do teeth move after orthodontic
Usually, when braces are first removed, your child's teeth will all be in perfect alignment, but your child's gums, bones, etc will not have completely shifted into their new positions. The retainer holds your child's teeth in position until their gums, bones etc settle in to their new positions.
Also, your child is still growing after your child's braces are removed. Sometimes, your child's mouth will grow unevenly. If so a retainer can be used to make sure the child's teeth stay in perfect alignment as your child grows.
- What happens if my child does not use the retainer?
If your child does not wear a retainer, your child's gums and bones will not fully settle into their new positions. Eventually, the incorrectly shaped bones will push your child's teeth causing the teeth to out of perfect alignment.
- How long should my child use a retainer?
Generally, patients are advised to keep wearing a retainer 24 hours a day for at least a year after their braces are removed. Then it is recommended that a child continue to wear a retainer a few nights a week until your child stops growing at age 24.
- I notice that some braces have little colored
rings around the brackets. What do the colored rings do?
The colored rings are called ligating modules. They hold the wires into the brackets.
- What happens if my child swallows a ligating module?
Orthodontic ligating modules are made of a medical grade polyurethane which is similar to the grade of polyurethane used in medical implants. The polyurethane is thought to be safe for human consumption. If your child swallows a ligating module, the ligating using just passes through your child's digestive system and leaves in your child's feces.
- Is there any chance that the sharp edges at the ends of the braces
will hurt the insides of my child's cheeks.
Hmm. This is a hard question. In the beginning part of orthodontic treatment, your child's teeth will move a lot. Sometimes the end of the wire will stick out past the end of the tube, and create a sharp edge. We recommend that you ask the orthodontist to trim the sharp edge before the edge cuts your child.
- What is the purpose of a facebow?
A facebow is used to push your child's molars distally (back) creating room for the teeth in the front of your child's mouth.
- How does my child use a facebow?
Generally, your child should wear the facebow for about 12 hours a day. The face bow should be inserted into the two holes on the buccal tubes at the back of your child's mouth. The facebow should then be connected to the breakaways, and on to the neckpad or other headgear. We also recommend a facebow safety strap.
- Are there any dangers with a facebow?
A facebow uses headgear to provide the force needed to move your child's jaw. There is so called high pull headgear, which has straps over the top of a child's head, and around his neck, and cervical headgear which only have straps around a child's neck.
Many Manufacturers do not sell high pull headgear because we consider high pull headgear risky. High pull headgear has been known to snap a facebow. In rare cases, the parts from the facebow have been known to go into a child's eye. Sometimes, high pull headgear is the only alternative to surgery, and so an orthodontist will prescribe it. Still, we recommend that parents and children be very cautious around high pull headgear. Be sure that the facebow is inserted properly. Be sure your child wears a safety strap. Be very cautious to make sure that the facebow does not come loose and hurt your child.
If your childs finds their facebow coming loose at night be sure to tell your orthodontist about it immediately. If the facebow comes loose in the middle of the night, it could cause a face or eye injury. Ask the orthodontist to adjust your child's safety strap. The safety strap needs to be tight enough that the facebow cannot come out. Make sure your child uses the tightest hole possible. Try out the facebow to make sure that it cannot come loose and hurt your child.
Cervical headgear is less risky than high pull headgear but still not 100% safe. Children often try to bend their facebows to make them more comfortable. They can weaken the facebow as they bend it which can cause the facebow to snap. Therefore, you need to be cautious around a standard facebow. We recommend that you insist that the orthodontist give your child a facebow with breakaway modules and/or a safety strap. Ask the orthodontist's assistant to carefully instruct you on the use of the facebow. Make sure that your child does not bend the facebow, and uses the break away modules or safety strap whenever he or she os wearing the facebow.
- What causes the facebow to snap?
Something called "metal fatigue". When you bend a wire enough times, the wire will break. You can see this with a solid copper wire like the wires in the wall in your house. If you take a piece of solid (unstranded) copper wire and bend it several times, the wire will break. Facebows are made of a special stainless steel wire which is resistant to breakage. However, all wire will break if the wire is bent enough times.
- Are there any other dangers in orthodontics?
There are some concerns about sterilization of orthodontic materials, taking orthodontic materials our of one patients mouth and "recycling" them to a second patient's mouth, and allergic reactions to orthodontic materials. These issues are discussed in the next section.
- Is there any chance that my child will be able
to hear the radio on their braces?
Well, we do not think so, but you never know. Years ago people used to build crystal radios, where the radio receivers consisted of a insulator much like a tooth covered by a metal piece which was like a bracket. Crystal radios could pick up AM signals in they were close to the AM antenna. We have never heard of a report of someone hearing the radio on their braces, but it is theoretically possible.