Tuesday 16 February 2021

Answers to Most Common Questions Regarding Orthodontic Mobile and Fixed Appliances


Nowadays, a beautiful smile is an imperative and the best first impression we can leave. Straight and beautiful teeth are what an increasing number of patients want, and our task is to help them achieve that. The branch of dental medicine that deals with correcting the position and relationship of the teeth in the jaw, and the relationship between the upper and lower jaws is called ORTHODONTICS. The goal of orthodontics is not only aesthetics in terms of having "straight teeth", but properly placed teeth are important for the health of the whole organism, jaw joint, muscles and surrounding tooth tissue. Properly placed teeth in the jaw and mutual relations, enable even transmission of masticatory force, which protects the supporting tissues of the teeth, the teeth themselves from the load, excessive wear and decay by reducing and eliminating joint problems. Straight teeth are easier to follow and maintain their hygiene, thus reducing the possibility of caries and periodontal problems. In addition, we should mention that there are two types of orthodontic appliances: mobile and fixed. The former are usually worn by younger patients for 14 to 16 hours and they can be easily removed by the patient himself/herself and adjusted as per the orthodontist evaluation. The latter, are worn by older patients and they can not be removed independently, however their result is much higher on a long term basis. There is no age limit for orthodontic therapy especially when wearing a fixed prosthesis. Here are some of the most common questions regarding orthodontic appliances:

How long does the therapy duration last when wearing a fixed appliance? 

On average, it lasts about 18 months ± 6 months from the date of installation yet, the wearing period depends on several factors:

  • types of anomaly (if teeth were extracted, for example) 
  • patient age - the younger the patient is the shorter the the therapy duration 
  • regular orthodontic control
  • bracket - each dropout prolongs the therapy for 4-6 weeks, so we have to go back one wire. Therefore, follow the orthodontist's instructions on how to behave during therapy. 
  • wearing additional elements - rubber band, headgear, etc.
How long will I wear the retention device? 

The wearing time of the retention device depends on the anomaly and the age of the patient. Patients that completed the growth and development stage, the therapy lasts for a LIFETIME! Teeth change position during life and we cannot expect them to stay that way after a fixed appliance. The retention device is worn following the orthodontist's advice. Initially, it is worn constantly for the first 4 months, then for the next 2 months 16 hours (half a day and all night), then only at night, then every other night, etc. The patient continues to come for an orthodontic control, which is less frequent. In addition, there are two types of retainers: fixed and mobile. As per the orthodontic evaluation and patient's teeth positioning the correct type is accordingly recommended. 

How long does it take to install a fixed device and is it painful? 

The placement of the fixed device takes about 40 minutes per jaw and you may relax - it is not painful. The worst thing for patients is that they have to keep their mouths open for a while longer without a break and rinsing. It is usually placed first in the upper jaw, and after some time in the lower, depending on the anomaly. The soreness begins 6-8h after placement. It is more of an inconvenience and lasts for 3-4 days. We advise the patient to drink something for pain. Wounds can form on the mucous membranes of the cheeks and lips, and this passes after 4-6 weeks until the mucous membranes get used to it.

Why do I need a fixed appliance for both jaws?

 It is extremely rare to wear an appliance in only one jaw, this happens only when small corrections are involved and the bite is normal. In most cases, it is needed in both jaws in order to correct all irregularities, the malocclusion (incorrect bite) and to get the most out of the therapy. After the orthodontic therapy, the patient must have a normal occlusion (ratio of the upper and lower jaw), which is necessary for a successful result.

Why are teeth sometimes extracted as part of orthodontic therapy, and sometimes not?

Whether teeth will be extracted or not, depends on how much space there is for a proper tooth placement in the jaw. If the lack of space is insignificant then extraction is not required and the other way round. However, after a detailed examination, the orthodontist will evaluate whether the space in the jaw demands extraction or not. 

How is therapy progress monitored?

The progress is monitored by both the patient and the orthodontist. During the initial check up, a plaster cast impression is created which depicts the patients teeth positioning. Later, the same is used to compare and measure the progress. In addition, professional dental photography helps in monitoring the progress of the orthodontic therapy.

How are orthodontic appliances worn?

 Mobile appliances have to be worn 14-16 hours a day to have an effect. Before visiting the orthodontist, place them in a box. Do not wear the appliance at school, sports or playing games. Be sure to wear it at night and during the day, while you are at home, studying and watching TV… Wash it with a toothpaste and a brush or use dissolvable tablets. the right way to wear the appliance is to make sure it is clean before putting it and have your teeth brushed and flossed. Fixed appliances require more time and effort because the elements (brackets) glued to teeth make it difficult to maintain proper oral hygiene. Teeth should be brushed after each meal because food is retained on the tubes and braces. In addition to the classic toothbrush, use interdental brushes that are small so they can clean the spaces between the teeth and braces. There are a large number of products on the market intended for orthodontic patients. After placing the fixed appliance, the teeth are more sensitive and you can feel discomfort for a few days. This is completely normal and occurs as a result of the force action on teeth.

Should you need any further advice on mobile/fixed appliances do not hesitate to contact us.

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