Healthy Mouth and a Healthier You

Orthodontics and Braces: Ask the Dentist

Dentist Steven E. Roth, DMD, answers your additional questions about braces and orthodontics.

Question:

How can I find a good orthodontist or oral surgeon for my daughter?

Answer:

First, I would ask your pediatric dentist for a referral.  If that doesn’t work, contact the local dental society in your area.

Question:

I am 54 years-old. For the past 8 months, I have noticed that the space between my two front teeth is getting wider. The dentist I recently saw said that the tooth next to one of my front teeth is pushing it, and that my front teeth are shifting. He suggested I see an orthodontist and look into getting braces. Are braces the answer for me as a 54 year-old? Could this be happening as a result of bone loss?

Answer:

If your teeth are shifting in your 50s, it is usually as a result of either poor periodontal condition with bone loss, severe tooth-grinding, bite problems, or the loss of a tooth.  Orthodontics may be the answer. But I would definitely have a periodontist or gum specialist take a look, as well.

Question:

Is there a cure for a child with a severe under bite?

Answer:

Orthodontics can help. I would schedule your child for a consultation with your orthodontist as soon as possible.

Question:

I am 23 years old and my dentist said that I need braces for my top teeth. I’m wondering if this is a good idea.

Answer:

Treating someone in their early 20s would not be a problem for an orthodontist.  The goal for orthodontics is to straighten teeth in order to make them easier to clean, and to make them function in the ways that they’re supposed to.  Teeth function better when they are straight up and down, and not at an angle. It sounds to me like your dentist has only your best intentions in mind.

Question:

If my baby sucks her thumb, will she need braces?

Answer:

Not necessarily.  Frequently, when thumb-sucking stops, any teeth that have shifted will go back into their proper place.  I would see the pediatric dentist for an evaluation and for help with stopping the habit.

Question:

My little girl is 8. We were told today that her bottom jaw isn't growing fast enough and there were some stimulant things that could be done to help it grow. What are they talking about?

Answer:

There are many great orthodontic appliances that can change the growth patterns of the jaws in order to align them better.  Eight years of age is a great time to have an orthodontic consultation.

Question:

Can you get cavities under your braces? What happens then?

Answer:

With braces, teeth can decay just as easily as they would without them. Your oral hygiene, including frequent brushing, water picking, fluoride rinses and supplements, and frequent cleanings during orthodontics treatment is imperative. Usually cavities can be fixed while braces are still on. But sometimes, they do have to be removed first.

Question:

I'm 19 years old, and my braces were removed when I was 17. Although they are visible, my wisdom teeth are not coming in. They aren't hurting me, but I'm concerned that if I don't have them removed, the dental work from my braces may be affected. Should I get my wisdom teeth removed?

Answer:

The jury is out on whether wisdom teeth growing in can move other teeth.  Age 19 is the perfect time to see an oral surgeon for an evaluation for wisdom teeth removal.

Question:

What is the right age for children to get braces?

Answer:

Age 7 or 8 is a good time to have an orthodontic screening exam.  Frequently, younger children can wear retainer-type appliances, which will mold the jaws properly, and make it possible for braces to be worn for a shorter amount of time.

Question:

What is an apexification procedure?

Answer:

This is a root canal for teeth that haven’t finished forming.

Question:

I'm 45 years old. In the last 6 months my 4 bottom front teeth have shifted and are now crooked. I can see that they are very crowded. Is it worth going to an orthodontist or is it something that I should just accept with age?

Answer:

Although it’s completely up to you, I would recommend having a comprehensive exam with your general dentist to rule out a periodontal or gum and bone problem. Then you can see the orthodontist. 

Question:

My jaw pops, which makes it difficult when I’m eating certain foods. Some of my back teeth do not touch, and my front teeth stick out a bit. I also feel a greater amount of pressure on some of my side teeth. Can braces help me?

Answer:

Braces might help. However, you will need a comprehensive exam to diagnose the cause(s) of all your dental and bite problems. 

Question:

Are metal braces a better option than Invisalign? Which braces are cheaper?

Answer:

Every case is different.  There are cases that are appropriate for Invisalign, and others that need the kind of movement that is only available with regular braces.  Whichever treatment works best in your own case is the best one for you to go with.

Question:

I’ve noticed that my kids grit their teeth, just like I do. How do I prevent them from doing this while they sleep?

Answer:

Grinding, clenching, and gritting teeth are habitual and part of normal growth patterns.  We don’t have a fixed way to stop it.  However, nighttime appliances can protect the teeth and relax the jaw muscles. You can obtain an appliance from your general dentist, your pediatric dentist, or an orthodontist.

Question:

I have braces. About two days before I went to get my braces tightened, I noticed my front tooth was very sensitive to cold drinks. It is very painful! I told my orthodontist and he said only to worry if it is sensitive to hot and cold. Still, I am concerned that I may have a cavity on my front tooth. I don't want a silver front tooth. What are my options?

Answer:

Silver front teeth are a thing of the past.  If you do have a cavity it can be repaired with white restoration.  More than likely, the sensitivity is transient and will go away soon.

Question:

My daughter just had dental floss stuck between her 2nd to last molar and when I pulled on it, the tooth popped out.  It looks like it broke off instead of coming all the way out.  Is this a baby tooth or is this a permanent tooth?  She is 10, almost 11.

Answer:

I would get your daughter to a dentist ASAP, for an examination.  It’s possible that the tooth was ready to come out. It’s also possible that it is a permanent tooth with a bigger pre-existing problem.  The only way to find out is by having her see the dentist.

Question:

Can a tooth die due to rapid orthodontics treatment a month after braces were put on?

Answer:

There is no scientific evidence that orthodontics can “kill teeth.”  If there was an endodontic, or root canal problem, it’s more than likely that it’s been caused by a previous cavity or trauma.

Question:

What will happen if a teenager with braces misses his periodic checkup or evaluation for 10 months?

Answer:

Missing checkups means a lack of progress, because the teeth will not have moved for 9 of those 10 months. This also means that the teeth may have stabilized. So getting them to move may be a little tougher.  Most importantly, get the teenager in for an evaluation ASAP.

Question:

My orthodontist wants to remove some of my son’s teeth to get a better orthodontic result. The other option I was given included having surgery for his jaw. We could just get braces without doing any preparation beforehand. But then he may need braces again -- or surgery -- as an adult. My son suffers from Asperger's syndrome. Should I get a second opinion?

Answer:

It sounds like you don’t like something that you’ve heard, or like there may be a trust issue between you and your son’s orthodontist.  I think a second opinion is always a good idea in that case.

Question:

Every time the rubber bands on my braces are tightened, my teeth ache. Is there anything I can do to prevent this?

Answer:

The aching is related to the movement of your teeth.  If there is no pain, none of the teeth’s movement will be apparent.

Question:

What can you do if your teeth have stains after your braces are removed?

Answer:

The best thing to do is get a cleaning and have any residual stains looked at by your general dentist.  Many stains may need further polishing or whitening in order for them to be removed.

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