FAQ’s for Teens

Braces Improve Your Face Value (your smile).

You must have heard that the quickest way to improve your looks is to smile. It is hard to believe when you are going through it, but braces will improve your smile and make you look excellent. Your smile is the most striking part of your face. Look in the mirror. Do you like your smile now? Well, the orthodontist will make your smile look fabulous. You will end up looking great. Think about how looking great will improve your social life.

Braces Improve Your Health

• You will be able to chew your food better. Chewing is the first step in digestion. If your teeth are not straight, you will not be able to chew your food correctly so partially unchewed food will go down to your stomach. That could give you an upset stomach.
• You will avoid dental problems. If you do not get orthodontic treatment when you need it you could have problems with your teeth for years to come; your teeth will be hard to clean. Your gums will hurt. Your teeth will wear in ways that they should not. The effects are significant enough that many adults are now going back to the orthodontist for braces.
• You may avoid developing a breathing problem. As you get older the roof your mouth can sometimes partially block the air passages in your nose. That makes you snore loudly, and may contribute to a condition called “sleep apnea.” If you get braces you may avoid this possibility.

Besides, do you really think that your parents would pay for braces if you did not really need them?

It has been said that if babies use a pacifier (dummy) for too long, they can develop an incorrect bite. Orthodontic problems can also be caused by injuries to your mouth, or if you suck you thumb when you are older than five or six. Some orthodontists also say that fingernail biting, or lip biting can also cause orthodontic problems. Still, most people need braces because of genetics, that is, a mismatch between the sizes of their teeth and their jaws. Quite often, the teeth are too big for the jaws, leading to crowding.

About 70% of US teenagers need braces. Just look at your class at school. Probably, two out of three of the kids have braces or will have braces.

You usually think about your jaw as being solid like a rock, but when you are growing your jaw is really more like clay. If you apply pressure to your jaw, you can get your jaw to stretch. If you pull your jaw apart, your jaw will get wider. If you push your jaw back, your jaw will slowly move back. Your jaw does not actually stretch. Instead, when you pull on your jaw, your jaw grows in the direction you are pulling. Still, the important thing is that when your braces pull on your jaw, the braces change the shape of your jaw. In the same way, if you push on your teeth, your teeth will move around in your mouth. This is how orthodontics works.

The orthodontist pushes your jaw to stretch your mouth so all your teeth fit. The orthodontist then pushes on your teeth so they are all in the proper places. If your top jaw is too small, your orthodontist can install a special gadget called a “palatal expander” to get your jaw to grow wider. If your teeth stick out, your orthodontist can install another gadget called a “facebow” to push your back teeth back. In that way, your orthodontist is able to move around individual teeth and expand your jaw so that all of your teeth fit correctly in your mouth.

(At what age should I start orthodontic treatment, What happens if I wait?) You can get orthodontic treatment at any age. Kids as young as 4 are sometimes advised to start orthodontics early to avoid a problem later on. People as old as 90 sometimes get orthodontic treatment to fix crooked teeth. Still, orthodontic treatment works best and is the least painful when you are 8 to 14 so we advise that you start orthodontic treatment then.

Your jaw is growing the quickest when you are 8 or 9 so it is usually best to expand your jaw and reshape your mouth when you are 8 or 9. This is called “interceptive orthodontic treatment or Phase I treatment”. Then you should wait for most of your permanent teeth to come in. Usually, your permanent teeth come in when you are 12 or 13 and so that is the best time to start full orthodontic treatment (usually with braces) when you are 12, 13 or 14. Other kinds of interceptive treatment from the orthodontist includes treatment for habits like finger sucking, protruded teeth (teeth that stick out too far) or just simple space maintainers.

You can get braces at any age so if you are too afraid, you can wait a couple of years. However, as you get older the braces treatment takes longer and hurts more. Your jaw is growing fast when you are 8, so your jaw is easy to stretch. If you wait until you are 12, the orthodontist needs to push a lot harder to expand your jaw so it hurts. By time you are 20, you may need surgery to expand your jaw.

Generally, teenagers do not find braces to be any big deal. Your mouth is usually sore for the first week after you get braces. Also, your mouth will be sore when the braces are tightened. However, with modern braces, you should get so used to the braces, that you should not notice the braces, except when the braces are being tightened or if you get hit in the mouth. If you start orthodontic treatment when you are 18 or older, it generally is more uncomfortable; your teeth feel like they are loose in your mouth. Still, the pain is worth the gain.

With most modern braces, they will not hurt except for the first few days when the orthodontist first puts them in or when your braces are tightened. Its more like and dull ache and its nothing that any pain medicine couldn’t fix!

Initially, when the orthodontist places your braces, there may be some sores on your 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 if you get into a fight. However, the sores should heal rather quickly. If your lips get too sore during the first week, you can put wax on the braces to prevent the braces from rubbing and irritating the sore.

It varies a lot according how much your jaw needs to stretch and how much the orthodontist will have to move your teeth. If you start interceptive orthodontic treatment when you are 8, it usually takes anywhere from 3 to 6 months to stretch your jaw. It takes longer if the orthodontist needs to reshape your jaw.

If you get braces when you are 12 years old, it usually takes the orthodontist a year and a half to two and a half years to move around your teeth. It will take longer if you do not do what the orthodontist tells you to do or if there is something unusual about your bite.

Only you know your friends. Most braces nowadays are pretty cool and most teenagers feel good about them. Most of your friends will be getting braces too. Wouldn’t it be excellent if you were a cool dude and your braces were funkier than all of your friends’ braces?

Yes. Standard braces should not affect how you talk or the sound of your voice. You can talk, sing, yell, make fun of people, and act just as you do now. Braces will not stop you from having fun. Just do not get punched in the mouth. It hurts! Occasionally the orthodontist needs to put in a gadget which gets in the way of your tongue. If so, you may have trouble talking clearly for a day or two, but then you will be able to talk fine.

Of course. Would a fun guy get braces if he could not play? You can still play football, baseball, basketball, soccer. You can still go bowling. You can still do everything. Just wear a mouthguard, and try to not get hit in the mouth. As orthodontists we recommend that you avoid sports where you will get hit in the face. Fighting, boxing, wrestling, karate, can be very painful when you have braces. If you get into a snowball fight, be sure to duck!

Be sure to mention your musical abilities to the orthodontist. The orthodontist will give you wax to cover your braces. It will protect your lips and will make it possible for you to still play musical instruments.

As your orthodontist we advise against you participating in activities where there will be many blows to a your mouth. Sports like boxing, karate, and wrestling should be avoided. Fighting should also be avoided. You should wear an orthodontic mouthguard whenever you participate in any sporting activity.

Yes! You can eat most of the good things that you can eat now. The one big limitation is that your mouth will get sore after you first get braces, so the orthodontist will recommend that you only eat softer foods for the first week. However, after that you should be able to eat normally.

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.

You probably should not eat hard sticky, gooey or crunchy foods. Caramel, taffy, peanut brittle can stick on your braces and pull the braces off your teeth. You also need to be careful with crunchy foods like carrots and apples and hard rolls so that you do not knock your braces off your teeth.

The orthodontist will attach them again. Usually, this is no big deal, although if it happens lots of times, your orthodontic treatment will take longer.

The orthodontist needs to take off your 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 orthodontic treatment. Wouldn’t it be strange if your braces never came off, so you would be stuck with them for the rest of your life?

I know you are concerned, but it is usually NOT a serious problem if you swallow parts of your braces. All braces are tested so they are completely safe. The parts just pass through your digestive system.

Inhaling a part from your braces is a problem however. If you inhale a part of your braces, and the part gets into your lungs, it could cause a problem. The orthodontist will then ask an MD to remove the part of your braces from your lungs.

A cool dude is still a dude with or without braces. Years ago, when glasses (eyeglasses) were old and clunky, people used to worry about going to the dance in glasses. Now it is no big deal. In the same way, years ago when braces were all big and clunky, people worried about going to a dance in braces. Now you can get cool-looking braces so there is nothing to worry about.

Braces come in lots of different sizes and colors. First there are old fashioned braces. Old fashioned braces are big and clunky. They can cut your lips, and are generally uncomfortable. Then there are modern braces. Modern braces are smaller and more comfortable than old fashioned braces. They have what is called a low profile design, which is less irritating to your lips. They also have special contours to make your orthodontic treatment go faster and be less painful.

No. Modern braces are made with three different manufacturing processes, “machining,” “metal injection molding,” and “casting.” Then one has to consider the style of the braces. Braces come in a series of styles and colors. There are tooth colored braces which blend in so they barely can be seen.

There are two parts to orthodontic treatment, interceptive orthodontic treatment (Phase I) and Regular or Phase II or Class I orthodontic treatment. Do not worry about the big words. Just follow the links and see what each of the parts of orthodontic treatment does.

The objective of interceptive orthodontic treatment is to make your jaw wider and reshape your mouth so there is room for your permanent teeth. Your orthodontist may install a gadget called a “palatal expander” to make your mouth bigger. The orthodontist may also use a facebow to try to start to correct overbites and underbites. If you start interceptive orthodontic treatment when you are 8, it usually takes less than a year, and avoids painful treatment later on.Generally, you should wear the facebow for about 12 hours a day. The facebow should be inserted into the two holes on the tubes at the back of your mouth. The facebow should then be connected to the breakaways, and on to the neckpad or other headgear. A facebow should never be worn without a safety strap or breakaway.

A little. The palatial expander is stretching your mouth, and you know the old saying, “No Pain, No Gain.”

Most kids finish interceptive orthodontic treatment by time they are 9. Then they usually wait until they are 12 and ready for braces.

The objective of full orthodontic treatment is to continue to stretch your mouth, and move around your teeth so that your teeth are in the right places.

First there are a series of appointments where the orthodontist examines your mouth and figures out what is needed.

Next the orthodontist installs your braces. You usually keep your braces in for two to two and a half years. During that time, your orthodontist’s assistant will “tighten” or adjust your braces every four to six weeks.

The orthodontist may tell you to wear a facebow during that time. Then your orthodontist will remove your braces and give you a retainer. You will need to wear the retainer 24 hours a day for about 6 months, then a few nights a week until you stop growing.

Generally, full orthodontic treatment takes 18-30 months for a typical case. It will take longer with a complicated case or if your do not follow the orthodontist’s instructions.

Generally, it takes several visits to the orthodontist for you to start your treatment. On your first visit the orthodontist’s assistant will take a medical history. The orthodontist will then examine your mouth to see if you need orthodontic treatment. Generally, the orthodontist will look at your mouth to see if everything is ok. Is your mouth big enough to hold all of your teeth?

When you close your mouth, are the top teeth lined up with your bottom teeth? Are any of your teeth crooked or not in the right place? Are there any missing teeth? Are there any other problems like a breathing problem, or a problem with the joint in your jaw? I know that you are afraid. NOTHING THAT THE ORTHODONTIST DOES ON THE FIRST EXAM HURTS

After the orthodontist looks at you, he will determine you need braces. About 70% of the teenagers in the US need braces.

The next step is called the “records appointment”. You will come in for half an hour and the orthodontist’s assistant will take a number of measurements of your mouth. During this appointment the orthodontist’s assistant will take:

• Panoramic X-Rays: You stand or sit in a special chair with your head very still, while a special x-ray machine sweeps around your head. The x-ray machine produces an image of all of your teeth and your jaw and parks of your skull. This x-ray tells the orthodontist if the roots of you teeth are OK, whether your jaw is OK, whether the joint is OK and whether there are any other complications such as extra teeth. We have been told that about 5% of people, including Count Dracula, have extra teeth. Extra teeth are hereditary; they come from your ancestors.
• Cephalometric X-Rays You go to a second x-ray machine, and the orthodontist’s assistant takes additional x-rays of your head. These x-rays tell the orthodontist if your bite is OK and if your mouth is growing normally.
• Bite Registration You bite down on some special paper or wax, so the orthodontist can see if your top teeth line up with your bottom teeth.
• Impressions: The orthodontist’s assistant will place a container containing something called “alginate” in your mouth and ask you to bite down. The alginate is like putty; it allows your orthodontist to build a model of your mouth so he can see exactly how your teeth come together. You will need to bite into the alginate twice, so the orthodontist can make a model of both your top and bottom jaw. Old fashioned alginate tasted awful so the alginate was the worst part of the records exam. However, people make flavor drops to make the alginate taste better. Flavor drops come in many different flavors: strawberry, mint, pina colada. If you do not like the taste of the alginate your orthodontist is using, be sure to ask him to add flavor drops.
• Pictures of your face and teeth The orthodontist uses the pictures to keep track of how your smile is changing. The orthodontist’s job is to make your mouth look excellent, and the photo’s help.Once the records appointment is done, the orthodontist will be able to figure out what he needs to do to fix your mouth. The orthodontist will then schedule a meeting with you and your parents called a “consultation” to discuss what the orthodontist needs to do to make your smile perfect and how much it will cost.

Discuss things with your parents, to make sure that they know what you want. Your parents will be committing a lot of money for your orthodontic treatment, and it is a little scary for them and you. Make sure that you discuss everything with your parents before you start treatment. Also, remember that your parents are doing this because they love you. If they did not love you, they would not spend money on your treatment.

You should ask any questions that you have: Will there be anything you cannot do while you have braces? How will braces change you? What fun things can you do with your braces? Does the orthodontist offer the styles and colors of braces that you want? Is he going to provide you fun braces or old clunky ones? Will he provide flavored materials if you want? It is your mouth and the orthodontist will need you to help him so the orthodontist should be happy to answer your questions.

If you and your parents decide to accept the orthodontist’s treatment plan, then the orthodontist may either put your braces on that very day or install “separators” between the teeth in the back of your mouth. The separators could either be little springs, or little plastic pieces to create space for bands on your back teeth. You usually leave the separators on for a week or two, and then come back to the orthodontist’s office to have your braces put on.

I know it sounds bad, but nothing bad should happen if you swallow a separator. The separator just passes through your digestive system.

Generally, the orthodontist needs to attach bands and buccal tubes to your back teeth, brackets to your front and side teeth, and then attaches an archwire.

The first step is get your teeth ready for the bands. The orthodontist’s assistant will remove the separators from your mouth and polish your teeth until your teeth are perfectly clean. It takes a few minutes, but the orthodontist’s assistant needs to do this carefully, so that you do not get any cavities under your bands. Once your teeth are clean, the orthodontist’s assistant will measure your teeth and try to determine what size bands you need. Bands, though, are like shoes. Even if the bands are the right size, the assistant needs to try them on to make sure they fit. It usually takes several tries before the orthodontist’s assistant finds a band that exactly fits your teeth. Do not worry though. Bands come in 50 different sizes, so there is sure to be one that fits.

Next the orthodontist or his assistant will attach the bands to your teeth. First, your teeth must be dried completely. The orthodontist or the orthodontist’s assistant will place cotton rolls on both sides of your teeth. They will also put a tube into your mouth that looks like a straw. The tube is attached to a small wet-dry vacuum to suck up all of the liquid from your mouth. Next the orthodontist or the orthodontist’s assistant will put some special cement onto the band and push the band onto your tooth. The orthodontist will usually ask you to help him get the band on, by you biting down on a special “bite stick” to help push the band on the tooth. The orthodontist or his assistant will repeat this process until they have installed bands on four of your teeth. Then you will be asked to bite down on cotton rolls for approximately 5 to 10 minutes to hold the bands in place until the cement hardens. After the cement hardens the orthodontic assistant or orthodontist will take a special tool called a scaler to remove the excess cement from around the band. The scaler looks sharp, but do not be afraid. It does not hurt.

The next part of the process is called “bonding”. In bonding, the orthodontist attaches little “brackets” to your teeth. The brackets are used to hold the wires onto your teeth.

First big plastic things, called cheek retractors are used to draw back your lips. You make a funny face, like you did in the mirror when you were little. Then your teeth are dried and a tube like a straw is put in your mouth to remove all of the liquid from your mouth. Once, your teeth are perfectly dry, a liquid called “etchant” is placed on the teeth for 30 to 60 seconds. The teeth are then rinsed and dried. Next the orthodontist uses a special glue to attach the brackets to your teeth. Most orthodontists use a special glue called “light cure” which only hardens under ultraviolet light. It usually takes the orthodontist about an hour to attach all of the brackets to your teeth. The light cure hardens in about a minute, so it will not be sticky in your mouth. Do not be afraid of this part of the procedure. Your cheeks sometimes get a little uncomfortable from the cheek retractor, but the bonding process should not hurt.

Uh, yes. You orthodontist’s assistant still has to put on your arch wire. Usually, the assistant sticks the wires through the buccal tubes on the bands at the back of your mouth, pulls them tight, cuts off the end of the wire, and then uses little rings called “ligating modules” to hold the wires into the brackets. This process only takes 15 minutes, but it is at the end of the process, so it seems longer. Just remember that it is almost over.

Depending on the case, one to two hours.

Not usually. The orthodontist is usually just attaching the braces to your teeth. The pain comes later, when the braces first begin to rub up against your lips and your teeth begin to move. Generally, your mouth will hurt the first night you get braces. Ask the orthodontist to give you wax in case the braces begin to rub and be sure to ask your mom for some Advil or Tylenol if your mouth hurts. Advil or Tylenol really helps the pain. Putting salt or salt water on you gums can also lessen the pain.

Generally, the brackets are attached directly to your teeth using a special glue. The glue is completely edible and will not hurt you.

Your mouth will hurt for your first week in braces. You should be careful about what you eat. You need to only eat softer foods and to be very careful with your mouth.

Hmm. This is a hard question. In the beginning part of orthodontic treatment, your 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 if you notice a sharp wire you go back to the orthodontist and ask the orthodontist’s assistant to trim the sharp edge before the wire before it cuts your cheeks.

Your orthodontist will usually tell you to come back in 4-6 weeks after your initial visit.

Sometimes the orthodontist just looks at your mouth. Sometimes your braces are “tightened” and sometimes the orthodontist changes wires. Each time the braces are tightened your teeth are pushed a little closer to where your teeth need to be. The orthodontist may install rubber bands sometime during your treatment or ask you to wear a facebow. Rubber bands and facebows are used to make your teeth in your lower jaw line up with your teeth in your upper jaw.

During orthodontic treatment, the orthodontist stretches your jaw and moves around your teeth so that everything fits. If the orthodontist would try to move your teeth all at once, it would hurt too much, and it might damage the roots of your teeth. Generally, the orthodontist moves your teeth slowly to avoid hurting you too badly. Still, the orthodontist does have to move your teeth. Every time the orthodontist tightens your braces, the orthodontist moves your teeth a little bit. Then the orthodontists waits for your teeth, jaw and gums to shift, before the orthodontist tries moving your teeth again.

Unfortunately, tightening hurts but the pain does not last long. You know the old saying “No Pain, No Gain.” Don’t be a Friday Cat.

People just started selling new wires which are designed to minimize the pain of tightening. The orthodontist installs the wire, and the wire slowly moves by itself. The result is that the orthodontist is able to move your teeth without having to tighten your braces so often.

Eventually, your orthodontist will remove your braces, give you a retainer and tell you that you are done. You should wear the retainer 24 hours a day for the first 6 months, and then a few nights a week until your orthodontist tells you to stop or cut back. Don’t stop wearing the retainers until your orthodontist says so.

Do not worry, it should not hurt to remove your braces. The brackets are easy to remove. They just twist off. Sometimes, removing the bands at the back of your mouth is painful. If so, please tell the orthodontist. He can cut the bands so it does not hurt.

Brushing and flossing is really important when you have braces because food can get caught in the braces and cause cavities. Also you will have terribly bad breath so no one will want to talk to you. You should brush and floss your teeth after every meal and before you go to bed. You may want to brush with a special fluoride jell to make sure that you do not get any cavities.

Brushing might hurt the first week after you get braces but then everything might hurt your first week in braces. Fortunately, you can get through it. After the first week, brushing should be fine. Flossing is a little harder. However, a water pik works great. There are also special brushes and floss designed to clean around your braces. Be sure to ask your orthodontist for some. Also, please ask your orthodontist’s assistant for help flossing every time you get your braces tightened. The orthodontist’s assistant can do a great job cleaning your teeth.

Your breath will smell terrible and you will get cavities.

It is hard to say. If it is a normal cavity, your regular dentist will just fill it. If the cavity is underneath your braces, your orthodontist will have to remove your braces first. I have noticed that some of my friends have rubber bands in their braces.

The rubber bands are used to move teeth forward or back in your mouth. For example, they could be used to move your lower teeth forward or back, to move a tooth that is in the wrong place, or to close a gap between your teeth.

Orthodontic rubber bands break after they have been chewed a few times. Usually, the rubber bands will snap suddenly when you open your mouth wide. The rubber bands will hurt your jaw. The only way to avoid the pain is to change your rubber bands frequently, usually about twice a day.

If you leave the rubber bands in too long, they will snap and hurt you. Be sure to change your rubber bands before every meal, and before you go to bed.

Your braces will need to stay on for up to a year longer and your teeth will hurt more. Changing rubber bands is not hard, so there is no reason not to change them.

Nothing; the rubber band is safe unless you are allergic to it. The rubber band just passes through your digestive system. Just do not swallow a whole pack of rubber bands. They will give you indigestion and you might have a bad allergic reaction.

The retainer keeps your teeth in perfect alignment after braces are removed so you keep an excellent smile as your mouth grows.

Usually, when braces are first removed, your teeth will all be in perfect alignment, and your smile is excellent. However, your gums, bones, etc will not have completely shifted into their new positions.

The retainer holds your teeth in position until your gums, bones etc settle in to their new positions. At the end of your orthodontic treatment, your smile will be wonderful and your will look excellent. You need to wear your retainer to keep yourself looking excellent. Also, you are still growing after your braces are removed. Sometimes, your mouth will grow unevenly. If so a retainer can be used to make sure your teeth stay perfect as you grow.

Your gums and bones will not settle into their new positions so your teeth will move part way back to their old positions. Your fabulous smile will dwindle. You may even need to get your braces put on again. Don’t let that happen! Wear your retainer.

It should not. If your retainer hurts after the first week, it may be that the retainer may need some adjusting. Go back to your orthodontist.

You will need to initially wear the retainer 24 hours a day as prescribed by the orthodontist, gradually cutting back to 1 or 2 nights a week.

A well-made retainer should last for years. If your retainer breaks ask your orthodontist for a new one. What happens if I swallow a part of the retainer. Nothing. The part will just pass through your digestive system. Tell me about fixed retainers Fixed retainers are an alternative that is sometimes used when you keep “forgetting” to wear your retainer. The orthodontist cements a retainer in your mouth and you cannot take the retainer off for a year. If this happens, be sure to clean the retainer every night or else your breath will smell awful. I notice that some braces have little colored rings around the brackets.

The colored rings are called ligating modules. They hold the wires into the brackets. Ligating modules can be fun. You can get them in all the colors of the rainbow and more! There are orange and black ligating modules for Halloween, red and green for Christmas and red or pink for Valentines day. Red, white and blue for the fourth of july. You can get ligating modules in your favorite colors, your school colors, your favorite teams colors or even your mom’s least favorite colors. Ligating modules allow you to make your braces match your personality. We even have glow-in-the-dark modules. Enjoy!

I know it is scary, but orthodontic ligating modules are safe. Orthodontic ligating modules are made of a medical grade polyurethane which is similar to the grade of polyurethane used for medical implants. The polyurethane is safe to eat. If you swallow a ligating module, the ligating using just passes through your digestive system.

Lingual braces are a technique where braces are mounted behind a patient’s teeth. These types of braces can be effective with certain types of crowding. We often use these types of braces for parents of our patients who have lower incisor crowding. However, not everybody is a candidate for lingual braces. We can help you know if this might be an option for you.

A facebow is designed to push your rear teeth back so that there is space for the teeth in the front of your mouth. It is also used to correct jaw positions.

If you do not wear your facebow, your orthodontist will not be able to stretch your mouth so all of your teeth fit. Treatment will take much longer. The orthodontist may have to extract (pull) teeth or even surgically move your jaws into their correct positions. You need to wear your facebow! Your braces will not work unless you wear them.

Generally, you should wear the facebow for about 12 hours a day. The facebow should be inserted into the two holes on the tubes at the back of your mouth. The facebow should then be connected to the breakaways, and on to the neckpad or other headgear. A facebow should never be worn without a safety strap or breakaway.

A facebow uses headgear to provide the force needed to move your jaw. There is so called “high pull” headgear, which has straps over the top of your head, and around your neck, and “cervical headgear” which only have straps around your neck.

In rare cases, the parts from the facebow have been known to go into a person’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 facebows. Be sure that the facebow is inserted properly. Be sure you wear a safety strap. Be very cautious to make sure that the facebow does not come loose and hurt you.

If you find your facebow coming loose at night be sure to tell your orthodontist about it immediately. If the facebow comes loose, it could hurt you or even poke you in the eye (If that does happen, see a physician immediately). If the facebow comes loose, ask the orthodontist to adjust your safety strap. The safety strap needs to be tight enough that the facebow cannot come out of your buccal tubes. Use the tightest hole possible. Try out the facebow to make sure that it cannot come loose and hurt you.

Cervical headgear is less risky than high pull headgear but still not 100% safe. Some kids 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. DO NOT BEND YOUR FACEBOW – IT COULD SNAP AND HURT YOU. Insist that the orthodontist give you 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 you do not bend the facebow, and uses the break away modules or safety strap whenever you are wearing the facebow.

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 that is resistant to breakage. However, all wire will break if the wire is bent enough times. I have lots of allergies.

There are always special concerns with an allergic patient, so your parents will need to discuss your allergies with your orthodontist. You can be allergic to something in the orthodontist’s office, or allergic to the orthodontic materials. There are two kinds of allergies to orthodontic materials: allergies to chrome and copper and allergies to latex. Allergies to nickel, chromium, or copper happen a lot, but are not very dangerous. Latex allergy is very rare but can be life threatening. Further details about latex allergy, and nickel, chrome and copper allergy are given later in this document. If you are worried about allergic reactions your orthodontist can provide you with latex, nickel, chrome and copper free orthodontic materials.

About 40% of spina bifida patients can develop class I latex allergy. Class I latex allergy is very dangerous. People occasionally die from it. Be sure to inform your orthodontist that you have spina bifida before you start orthodontic treatment and make sure that he uses latex free products. Also ask the orthodontist to make your appointment the first appointment of the day so there is no latex dust in the air when you are treated. For further information about latex allergy and Spina Bifida, consult the Spina Bifida Association of America.

Nickel, copper and chromium allergy occur in 30% of orthodontic patients with pierced ears, 1-3% of all other orthodontic patients. The symptoms are generally an inflammation of the mouth, and possibly inflammation at points where metal such as a watchband comes in contact with your skin. If you mouth stays sore for more than 2 weeks after you get braces, or if you notice stuffy ears, you probably have an allergy to the metals in your braces.

It has been found that patients sometimes develop sensitivity to nickel, chrome or copper during the orthodontic treatments. Fortunately, a recent article in an allergy magazine Contact Dermatitis 30(1994) 210 suggests that the allergic reaction will go away when your orthodontist switches to nickel, copper or chrome free materials. If you are concerned about nickel, chrome or copper allergies, talk to your orthodontist.

How common is it, and do I have anything to fear? There are two kinds of latex allergies, a so called class IV allergy, which is not very serious, and a so called class I allergy, which can be life threatening.

The class IV allergy causes a slight inflammation of the patients mouth, but it goes away after the latex is removed. Class IV latex allergy is fairly common, affecting perhaps 1% of the orthodontic patients. The Class I allergy is much more insidious. Class I latex allergy is quite similar to penicillin allergy. You get the allergy from continued exposure to natural latex rubber. You usually do not have any symptoms when you are first exposed to latex. After you are exposed to latex for a long time, you get sensitized to it. First break out in a rash. Then you become very sensitive to latex. You might break into hives when exposed to a rubber glove or a condom. We have even heard of a case where a dentist became so sensitive to latex that she cannot be in the same room as a rubber glove. When she walks into a hospital or doctors office or airplane that contained a rubber glove an hour earlier, she goes into shock.

The estimates of how common Class I latex allergies are varies considerably. The US Food and Drug Administration (FDA) estimates that approximately 14% of dentists, 6% of physicians and 2% of other health workers will eventually get latex allergy. Latex allergy is said to be less prevalent in orthodontic patients. Still the FDA estimates that 1% of the general population eventually gets latex allergy. Orthodontic rubber bands can contribute to your developing latex allergy, although class I latex allergy will normally take many years to develop. If you are worried about this, insist that your orthodontist use all latex free materials.

There can be several different symptoms. Some patients with class I latex allergy develop hives and/or swelling in their face and hands perhaps 20 to 50 minutes after being exposed to latex. Other patients have difficulty breathing. Occasionally, there are no visible symptoms. IF YOU BREAK OUT INTO HIVES SOON AFTER CHANGING YOUR ORTHODONTIC RUBBER BANDS, OR IF YOUR HANDS OR FACE SWELL UP, OR IF YOU HAVE DIFFICULTY BREATHING, GO IMMEDIATELY TO AN URGENT CARE FACILITY OR A HOSPITAL EMERGENCY ROOM. DO NOT WAIT HOPING THAT THE SYMPTOMS WILL GO AWAY.

Ask your orthodontist to use only Latex free materials.

Orthodontic materials can be sterilized in dry heat sterilizers, autoclaves, or a solution called “glutaraldehyde.” A recent study shows that when used properly, dry heat sterilizers and autoclaves kill all known infectious agents. However, the glutaraldehyde solution does not always kill the Aids virus. The chances of you catching AIDS in the orthodontist’s office are slim. Our office sterilizes everything that goes in your mouth, and the sterilization is monitored by an independent outside company.

In the December 1995 issue of the AJO there was an article about a guy who HAD BRACES FOR 20 YEARS. It seems that he started orthodontic treatment and stopped after his orthodontist had put the braces on. He did not see a dentist for the next 20 years, and kept the braces on. He finally came in to see a dentist and the braces were removed. How would you like to have braces for 20 years?