Do you think you may need help with your crooked smile?  You may be surprised at how young your child should be when you first need to start checking it out.

The first consultation
During this visit the patient is examined clinically. This enables the orthodontist to give advice on the treatment options available, when treatment should commence, and the duration of treatment.

If the patient decides to proceed with treatment, an appointment is made to collect records.

Records include:
	Impressions from which plaster models of the teeth are constructed.
	Photographs of the teeth and face.
	X-rays of the teeth and jaws.   Click here for more info about x-rays.
	Records allow the orthodontist to analyse each case accurately. They are also used to record the existing malocclusion for future reference.

Treatment Planning
At this visit the orthodontist discusses the treatment plan(s) which have been formulated using information obtained from the first consultation and records.

Then, arrangements are made to commence treatment or, if it is too early, to review the patient periodically until it is an appropriate time to commence treatment.

Extractions and other preliminary procedures
Sometimes it is necessary to remove teeth to gain sufficient space to align the remaining teeth. Any decayed teeth should be filled and the teeth sometimes need to be cleaned before orthodontic treatment is started. The patient is referred back to the family dentist to have these preliminary procedures carried out.

Braces
Braces are the most efficient and accurate way of moving teeth. They are usually made of stainless steel although clear brackets are available, usually at extra cost. Fitting the braces usually involves two visits. Braces remain on the teeth for the entire duration of treatment. Patients then attend approximately every 4-8 weeks for adjustments, wire changes, etc.  For more information on the different types of brace available, click here.

Rubber Bands and Headgear
During treatment, patients may need to wear such items as rubber bands and/or headgear with their braces. These items provide important extra forces for the correction of the bite.

How Long?
Orthodontic treatment usually takes 18 - 24 months. Some cases may be finished earlier and others may take longer to complete. The total treatment time depends on the severity of the original malocclusion, the type of treatment carried out, and the co-operation of the patient.

Dental check-ups
Orthodontic patients should continue to attend their family dentist for regular check-ups during the course of orthodontic treatment.

Retention
At the completion of the active part of orthodontic treatment, the braces are removed and retaining appliances (retainers) are fitted to hold the teeth steady in their new position. These appliances may be removable plates or wires fitted behind the teeth. Retainers play an important role in orthodontic treatment for, if they are not worn according to instructions, the teeth may move back towards their original position.

The retaining appliances are usually worn:
	Full-time for up to one year
	Just at night for a further year
	Phased out altogether over one more year

The corrected teeth are observed periodically for up to five years after the retainers have been phased out. During retention and the subsequent observation period, patients are expected to attend once or twice a year.

Are there particular foods to avoid with braces?
Orthodontists attach braces to your teeth with a small amount of cement (Braces are not bolted, riveted, nailed, welded, or chemically melted to your teeth; a less permanent method is usually preferred). This cement is designed to hold the brackets and bands against your teeth during normal orthodontic treatment, and, when it's time to remove the braces, scrapes off your teeth easily without leaving any permanent marks . It doesn't take much force to remove or "break" the braces off your teeth. That's good because it allows for easy removal when the time is right. However, it's also bad for you because any heavy force put on your braces could break them off and extend the treatment time.

Hard and sticky foods will break off brackets, bend wires and loosen bands, which , in turn, will extend your treatment time. Foods high in sugar content could cause cavities, calculus build up, and ugly stains on your teeth.  So what can you do?   Well, you must limit your diet to soft and healthy foods.

Things to avoid:
	Hard foods - Anything that is hard cannot be chewed with braces on. Remember, braces are fragile, and strong forces from hard foods will break them off. Damaged appliances will extend treatment time. Extended treatment time will increase the risk of cavities and stains on your teeth.
	Sticky foods - Braces can be pulled apart with sticky foods. Again, this could extend your treatment time.
	Anything high in sugar - Braces make it harder to keep your teeth clean. Sugar will feed the bacteria that cause cavities. If you do eat any foods high in sugar, brush your teeth immediately.