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Getting Braces FAQ
By Stephen Yang, DMD, MS
Board Certified Orthodontist
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Do I need braces?
Need is a strong word. Very few people need dental braces. For example, a person who has a severely protrusive jaw, who cannot chew because of his underbite needs braces (in addition to jaw surgery procedures). For most people, orthodontics is an elective treatment to straighten teeth and correct mild to moderate bite problems.

Do braces hurt?
For the most part, braces do not hurt. The first time you get separators or new wires, your teeth may be sore for a few days. The soreness usually peaks during days 2-3, but should start getting better by days 4-5. Future adjustments may or may not cause you discomfort depending on what is being done to your teeth. To alleviate the discomfort, you can take whatever pain medications you would normally use for a headache.

Because your lips, cheeks and tongue are not accustomed to rubbing against the braces, you may experience sores or ulcerations inside your mouth. The sores may last for one to two weeks until your lips, cheeks, and tongue get used contacting your braces. If there is part of the braces that is irritating your mouth, you can place orthodontic wax to help smooth the rough area of the braces. After your lips, cheeks and tongue get used to the braces, you may even forget you have them on.  Read more about common orthodontic emergencies.

In the old days, only stiff wires were available so there was more discomfort associated with braces. Now, with new technology and flexible wires, there is significantly less discomfort associated with tooth movement. In fact, some patients complain about not having any pain because they think that without pain, their teeth are not moving. Remember, “It does not have to hurt to work!”

Do I need to have shots?
No shots are generally needed for orthodontic treatment. Having said that, you may need shots if your orthodontist refers you out for other procedures such as extractions, surgical exposure of teeth, or miniscrews.

Are there clear or less noticeable braces?
Yes. Compared to 30 years ago, braces have gotten smaller and can be directly bonded (glued) to teeth. The bands or metal rings that used to be placed on every tooth now only need to be placed on the back teeth. In some patients, the braces can be bonded to even the back teeth so no bands are needed!

Besides smaller braces, there are also non-metal, clear braces or even lingual braces that are bonded on the tongue-side of the teeth.  Another option to straighten teeth is not to use braces at all, but a series of clear trays such as Invisalign. Your orthodontist can determine which option would be best for you.

Can I get braces just on my top or bottom teeth?
That depends. Orthodontists are not only concerned with straightening your teeth, they are also concerned about correcting your bite if needed. Many times, if only one arch is treated, the bite will still be uncorrected. Over time, a malocclusion (bad bite) could cause damage to your teeth, tissues, and jaw joints.

With some bite problems, it may not be possible to treat just one arch. For example, some patients will come in with straight upper teeth, crooked lower teeth, and a deep bite. A deep bite means that the upper and lower front teeth overlap significantly, often preventing the lower teeth from moving forward. Straightening the lower front teeth often involves moving the lower teeth forward to create space. However, due to the deep bite in this case, the lower teeth would be prevented from moving forward, and it would be difficult to straighten the lower teeth. In this case, upper and lower braces would be needed to first open the bite so that the lower crowding could be corrected.

Can I get braces if I play sports?
Yes. Many orthodontic patients play sports. However, be sure to protect your braces from cutting the inside of your mouth by wearing a mouthguard. If you have questions on what protective guard is appropriate for you, ask your orthodontist. Your orthodontist will be able to tell you which mouthguard to get and wear to buy one. Some orthodontists will even make custom-fitted mouthguards for you.

Can I get braces if I snorkel or scuba dive?
Yes, but not being careful with the mouthpieces can lead to breakage of your braces and disruption of your treatment progress.

Can I get braces if I play a wind instrument?
Yes, but the braces may feel a little rough on your lips. Ask your orthodontist about lip protectors specifically designed for wind instrument players. Alternatively, you can use wax to cover your braces when playing.

Can I get braces and return to school or work the same day?
Yes.  Getting braces is not like getting a tooth extracted.  It is relatively painless and you should be able to return to school or work the same day.

Can I get braces if I am “too old”?
As long as your gums and bone surrounding your teeth are healthy, your teeth can be moved to new and straighter positions. No patient is “too old” for braces.  However, because adult bone is more mature than bone of a child, treatment may take slightly longer.

Can I go back to work the day I get braces?
Yes. Braces should not interfere with your ability to go back to school or work. That being said, your lips and cheeks may take some time to get adjusted to your braces. If you have an appliance inside your mouth, you may need some time to get used to talking with it.

Can I get braces if I am pregnant?
Yes, but you may need a letter from your obstetrician saying that it is ok to have X-rays taken. Because of hormonal changes during pregnancy, your gums may become swollen easier. However, as long as you practice good oral hygiene, you can still enjoy the benefits of orthodontic treatment when you are pregnant.

Can I get braces even though I have crowns and/or bridges?
Yes. Your orthodontist can put a band or bracket on the crowned tooth and move it just like any other tooth. Bridges, because they involve multiple joined teeth, will not move well with braces. If you need to move a bridged tooth, your orthodontist may have to section the bridge or have your dentist remove it.

Can I get braces even though I have missing teeth?
Yes, your orthodontist can align the remaining teeth and adjust the space of the missing teeth so that ideal restorations can be placed.

Can I get braces if I have my tongue pierced?
Wearing a tongue stud can cause breakage of orthodontic appliances and is not recommended.

Can I get braces if I have TMD or jaw joint problems?
It will depend on the severity of your TMD or jaw joint problems. Your treatment provider will first conduct a thorough clinical evaluation which may include taking a series of TMJ X-rays. For mild cases, your provider may choose to observe you or give you a splint to help stabilize your TMJ. For moderate to severe cases, your provider may refer you to a TMJ or Orofacial Pain specialist.

Do I still need to see the general dentist when I have braces?
Yes, you should continue to see your general dentist at least once every six months to have your teeth cleaned and checked.

Can I get braces if I am allergic to nickel?
Yes. If you have a nickel allergy, tell your orthodontist. There are nickel-free braces and appliances that your orthodontist can use. If the office does not stock nickel-free appliances, they can be ordered.

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