Your Guide to Braces, Spacers and Retainers

If you need orthodontics, then you’ve probably got questions.  Here, we tackle some of the more common ones.

If there’s one thing that can dramatically improve your appearance, health and even your psyche, it would be orthodontics.  Most people who undergo treatment are very happy with their improved appearance and increased self-confidence.

Kids and adults can get braces at any age.  “Early preteens and teens would be the easiest time for treatment, when bone is still actively growing – but treatment in older individuals is also very effective,” says Dr. Rick Caldwell, ODA President (2013-14), who maintains a dental practice in New Liskeard, Ont.  Start by talking to your dentist, who may refer you to an orthodontist.  But one thing’s for sure: once you do make the decision, you’ll have questions about your braces, spacers and retainers.  Here’s what you need to know.

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Why do I need braces?

Most recommendations for orthodontic care involve a combination of improved function or improved esthetics, says Dr. Ian McConnachie, a pediatric dentist in Ottawa and ODA Past President.  Problems with function can result in further damage to teeth, gums or bone supporting the teeth, or can result in problems related to jaw functions, he explains.  And problems with esthetics may arise from teeth that are crowded and overlapping, or teeth with spacing between them.

Am I too old to wear braces?

No.  Age is no longer a factor, and these days orthodontics for adults are particularly popular.  “A large percentage of the patients in our office are in the 40- to 70-year-old age group,” says Dr. Jeff Berger, an orthodontist in Windsor, Ont.

Where can I find more information?

Patients should only start treatment after a thorough assessment of the benefits and risks – and a thorough discussion with your oral health-care provider.  Check out these websites for more information:

• Ontario Association of Orthodontists (www.oao.on.ca)
• Canadian Association of Orthodontists (www.cao-aco.org)
• American Association of Orthodontists (www.mylifemysmile.org)

And, of course, ask your dentist or orthodontist if you have any questions.

What’s new compared to 20 years ago?

These days, braces are much smaller and many no longer require metal ties or coloured rings to hold the wire in the brace.  And arch wires are much more flexible with lighter force levels, which all add up to greater patient comfort.  Invisalign™ has become a popular way to move teeth.  “These clear, transparent, removable tooth aligners are a welcome alternative to braces for some of our teenage and adult patients,” reports Dr. Berger.  One of the latest innovations is the use of laser-scanning technology to create extremely precise images of the teeth, which avoids the need for dental impressions.

If I’m seeing an orthodontist, I don’t need to see a dentist, right?

Wrong!  “All orthodontic patients need to see their dentist on a regular basis for tooth cleaning and routine checkups,” emphasizes Dr. Berger.  “This is really a group effort, and it is important that patients also participate by maintaining good oral hygiene, so that teeth and gums are kept in peak condition.”

Dental-Retainer

My son took his retainer out, then forgot about it and stepped on it.  Do I need to replace it?

Retention is a lifelong process.  That is a change in recommendation as a result of newer science on this issue, says Dr. McConnachie.  Why?  As with the rest of the body, the mouth and the bite change with age.  If you wear the retainer, the teeth won’t shift; it’s that simple.  The bottom line for broken of lost retainers is that new ones are needed.

The goal of orthodontic treatment is a good bite – meaning straight teeth that mesh well with the teeth in the opposite jaw.  A good bite makes it easier for you to bite, chew and speak.  This can enhance your dental health and your overall health, and may improve self-esteem.

Glossary

Aligners, braces, retainers and spacers: A Glossary

Orthodontics involves different treatments and procedures, depending upon the problem.  The recommendation may include one of the following types of appliances:

Aligners: Aligners are made of a clear plastic or acrylic material and are custom-shaped to your teeth.  A series of aligners progressively move teeth toward their desired positions.  They must be removed to eat, brush and floss.  Because they are removable, patients must be sure to follow their orthodontist’s instructions for daily wear.

Braces: Braces generally have two components: brackets, made of metal or tooth-coloured ceramic, and wires, which are threaded through slots in the brackets and do the actual work of moving the teeth.  An orthodontist needs to adjust the wires periodically.

Retainers: These “retain” teeth in their position.  This is done most often after a period of orthodontic treatment and can be either removable or fixed in place with orthodontic cement.  Retainers preserve and stabilize the results of orthodontic treatment – and must be worn as prescribed.

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Spacers: A space maintainer (either a removable appliance or attached into position as a “fixed” appliance) holds certain teeth in position while waiting for further development of the bite.  Often used when a primary or baby tooth has been lost prematurely, due to accident or decay, and to hold the space until the permanent tooth comes in.

Written by Donna Paris.  Reprinted with permission of the Ontario Dental Association and YourOralHealth.ca Magazine, 2013.

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