Answered Questions Page6

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235 thoughts on “Answered Questions Page6

  1. I had a extraction on number 13. my wisdom tooth is growning in instead of getting a implant couldnt i get braces and have a dentist pull down number 16 and push number 15 and 14 over to full up the space? im only 20. they say get an implant but i dont feel it is needed if that procedure could be done. couldnt they use a chain during orthadontic treatment? it might take a long time but it also might be a good idea because im only 20. im a dental assistant. but i dont want to talk to my boss about this.

    1. Hi Katrina,

      There are a lot of factors involved in what you asking to be done. The problem with shifting the 1st and 2nd molar forward, only on one side, is that your maxillary midline will shift to the left of your facial midline. Moving molars mesial is hard to do. It takes a lot of time.

      If you find an orthodontist who will take on the challenge, they may have to use a TAD (temporary anchorage device) as an anchorage point to move the molars forward. TADs do not move and would keep your midline shift to a minimum.

      Thanks for the question.

  2. Hi,
    I was told that I was going to get my braces off in a few months, and I am in the final detailing now. While I was eating steak tonight, half my chain came loose, and I cut it, but now I’m realizing that probably should’ve just pulled the rest off. The left side of my mouth is now being affected by the chain and there isn’t anything we can do about it until my orthodontist is at my dentist friday. Should I find a way to pull the rest off (using a toothpick) or just wait for the orthodontist? Will this set back my time on the braces at all?
    Thank you.

    1. Hi Daniel,

      I’d leave the rest of the power chain alone. I don’t think it will set you back. Get in to see your orthodontist for repair. You should be fine.

      Thanks for the question.

  3. Hi,
    I had my braces removed many years ago and have been wearing retainers dutifully at night ever since. However I notice that each morning when I take off my retainers my bite has been altered, and I noticeably notice a few teeth shifting throughout the day. I also have quite recessed gums for my age (that are planned to be treated with gum grafts with my periodontist). In particular, one of the teeth that moves daily is also deeply recessed. Is there a problem with my retainers, and could my gum recession be connected to the moving teeth problem? or perhaps am I grinding my teeth at night without noticing?

    Thanks!

    1. Hi Cary,

      Gingival recession that you are describing is usually not caused by tooth movement from a retainer but from plaque or calculus causing inflammation of the gum tissue. Also, brushing too hard can cause gingival recession.

      Your retainer needs to be monitored by your orthodontist. It sounds like your recession is severe so your teeth will become mobile due to loss of bone support. If you grind your teeth at night, your retainers will keep your teeth from becoming very mobile. Continue consultations with your family dentist, orthodontist and periodontist about your tooth mobility.

      Thanks for the questions.

  4. What happens next after the chain and bracket surgery didn’t work on my “canine” tooth? What will they do?

    1. Hello,

      Sometimes an impacted cuspid will not erupt into the mouth via forces placed on it with a bracket & chain. In those circumstances the cuspid is removed and treatment is continued with a space in that area. Eventually, the braces are removed and a hawley retainer is made with a false tooth to keep the space open until a more permanent replacement is performed. That could be a bridge or an implant.

      Thanks for the question.

  5. I am going to be having clear retainers once my braces are off. I have been told I will have to wait one week to collect my retainers but I am worried my teeth may move slightly during this one week brace and retainer free. If the teeth do shift even very slightly will the retainers move the teeth back into place because the impressions were taken the day of the brace removal?

    1. Hi Nat,

      Yes, you are correct. Since the impressions were taken on the same day the braces were removed, the retainers will move the teeth back into position. I don’t like waiting a week so we make the retainers in-house so they can be seated the next day.

      Thanks for the question.

  6. I am wondering how teeth that have been intruded (I think that’s the correct word – basically teeth that have been pushed up into the gums to make the teeth shorter) during braces treatment are retained after the braces are taken off? I can see how a removable retainer (clear or hawley) will prevent the teeth from rotating or shifting sideways/forwards/backwards but how to stop a tooth moving down out of the gum? Would a bonded retainer be the only way to prevent this type of movement? or is it quite rare for the this type of relapse after braces?

    The reason I ask is because during my treatment both of my upper lateral incisors were moved up into the gum slightly to make them appear shorter and it was successful, but I will only be having an upper removable retainer (clear) and not a bonded retainer on the upper front teeth so I’m worried about this movement relapsing after braces.

    Thank you

    1. Hi,

      In most cases, it is very difficult to intrude teeth orthodontically. Most orthodontic movements are extrusive. All teeth have an eruptive force at all times. They erupt until they occlude with an opposing tooth. So basically I’m saying your central incisors extruded more during treatment than your lateral incisors intruded to make your lateral incisors look shorter. In regards to retaining the lateral incisors position, your clear plastic retainer should hold them in good positions. I would not recommend an upper bonded retainer since lower teeth occluding on it usually knocks it off.

      Thanks for the question.

  7. Hello,
    So a few months ago, I got my first appliance in my mouth. I´m 13 btw in case thatś important. I had a nance appliance in. The first one, the top right metal piece broke so I got it replaced. With the new one, I feel a short yet sharp pain in my top right molar (furthest back) whenever pressure is put on it, like when chewing etc. Is this bad or what? and can you tell me why this is occuring and how I can stop it or at least ease it up a bit.

    1. Hi Jason,

      A sharp pain when chewing can be a variety of things. It could be a cavity. It could be tooth movement from the new nance arch or it could be a cracked tooth. You’ll need to see your orthodontist or family dentist if the symptoms continue past a week for an evaluation. Try not to chew on the tooth and use soft foods if it is getting worse. If the pain is from tooth movement, it will subside in a week.

      Thanks for the question.

  8. Hi!
    I have been wearing braces for about 7 months and I’m going to get them off in a month. But there is a noticable gap between my teeth on the side and you can see it when i smile. Will it close in a month or is it going to stay that way?

    1. Hi Anni,

      8 months of treatment is a very short period of time with braces, if you are having full treatment. You need to ask your orthodontist if the space will close before you have them removed. Some spaces will close in a month if they are small, about a millimeter or less.

      Thanks for the question.

  9. Hello, I would like to ask your opinion. I am planning to get my braces put in next week and suggested to remove 3 of my teeth (as I had my right 2nd lower premolar removed before). I has had my upper right premolar removed yesterday. But looking back at my teeth, the left side (both upper and lower) seems to be in good position and alignment. Is it possible for me to wear braces first and only remove the teeth over the left side if needed later on during treatment, as this will result me in unequal number of teeth between left and right side of the jaw

    1. Hi,

      There are a variety of reasons that extractions are needed to correct a malocclusion. One main reason is to releave crowding and create a stable occlusion. Another is to reduce protrusion or an overjet. Extractions can be performed before treatment begins or during treatment. You need to ask your orthodontist to explain why the extractions are needed and your concerns.

      Thanks for the question.

  10. Hi Dr. Thompson
    I had my upper wisdom teeth removed before getting braces for two years and everything seemed fine. However while wearing the retainer I noticed that the last upper molar (the second) on both sides turned facing the cheeks at around 45 degrees. As a result the bite is affected.
    Could you please tell me what is to be done?
    Thank you so much
    Karin

    1. Hi Karin,

      A small compliment of braces can be placed on the upper posterior teeth to align the second molars. Also, clear plastic aligners could be used to move the molars. This is a common problem when 2nd molars come in so slow due short jaw length. Consult your orthodontist for options. It can be fixed.

      Thanks for the question.

  11. My retainer keeps on cracking i have already been given another one for free but i know they will charge me this time ifi break this one again. For some reason it has cracked in the same place as last time. Is there a cause for this? also i am wondering if i don’t play with my retainer and only touch it to clean it or take it out to eat will it stop cracking and just stay in its current state or will it still crack and i will still have to get a new one

    Kindregards
    -B

    1. Hi Bella,

      The posterior region of a clear plastic retainer can crack in the same spot over and over. This is due to the cusp of some of your teeth hitting the plastic just right to break it. There is not much that can prevent it from cracking.

      If the crack is in the middle anterior section, that is due to flexing the plastic and playing with it. Clear plastic retainers are fragile and should not be stressed by chewing on them or squeezing them with your fingers.

      With my patients who have this problem, I switch to durable hawley retainers. They can withstand a lot of force and not break easily.

      Thanks for the questions.

  12. Hi,

    May I just ask?, My teeth are very crooked and I’m about 10 yrs. old turning 11 on Dec. 9. I think all of my teeth got out but I’m not sure, almost all my teeth are crooked and some didn’t grow.
    Do you think I need braces? if yes please tell me when do you think I might need it.

    1. Hello,

      If your teeth are crooked and the majority of them are coming in, you can start orthodontic treatment. You need a visit with an orthodontist so they can evaluate what needs to be done.

      Thanks for the questions.

  13. Just found out that my 12 year old is tongue tied. They want to put braces on him and wait on the surgery for the other. I am wondering if the tongue tying condition makes him need braces wouldn’t we want o fix that first the worry about braces. Our orthodontist said no. He wants to watch the tongue. May not need the surgery

    1. Hi,

      If your son is tongue tied (ankyloglossia), then surgery is indicated now. An oral surgeon or a periodontist can perform the surgery (frenulectomy). In my opinion, ankyloglossia doesn’t get better over time. It will stay the same. The reasons for a frenulectomy is to improve speech and to avoid the gum tissue from being pulled away from the back side (lingual) of the lower incisors. There is no connection between the tongue tie and the need to have orthodontic treatment, in my opinion.

      Thanks for the question.

  14. I just got my braces yesterday they are hurting so much. I can’t really bite anything I feel like I am starving. What can I do? I have tried wax on but it really isn’t working out good. I’m not sure if I should put more…It’s a really discomfort I want to get used to them. I sometimes feel like if my bottom teeth are itching and has pain at the same time. What can I do to stop the pain from my braces???

    1. Hi Stephanie,

      Newly placed braces is difficult. It will take a week to get over the initial discomfort. You can use lots of wax and eat very soft foods. Over time you will get use to your braces and the following appointments won’t be as painful. There is no way to stop the pain except over time. Make sure that even though your teeth are hurting that you brush your teeth very well during this time. Most patients feel better after three or four days.

      Thanks for the questions.

  15. Hello,

    I am in the process of getting Invisalign and have already gotten my impressions done. I had braces previously and a fixed retainer was placed on the bottom set of my teeth only. I am happy with the bottoms so they are not being moved during the invisalign treatment… my top teeth will be doing the shifting. The dentist took molds of both my top and bottom teeth so I am assuming I will still be wearing a bottom set of trays… my fixed retainer was not removed so i’m wondering if I’ll be experiencing discomfort with the retainer tray being place on top of my fixed retainer ? Is it okay to wear invisalign retainers over a fixed retainer?
    Thanks,
    Carolina.

    1. Hi Carolina,

      It is ok to wear a clear plastic retainer over a fixed retainer. The teeth that are attached to the fixed wire retainer will not be moved. To move the lower anterior teeth, the fixed retainer has to be removed. Your orthodontist may want to move the lower posterior teeth and not the anterior teeth. Talk to your orthodontist and ask why you are going to wear a lower aligner over a fixed retainer.

      Thanks for the questions.

  16. Hi , i have braces over 1 year , 2 months ago my dentist gave me the elastics , and wanted me to use them , but i cant use them because they ache a lot during using them , he said its very necesarry but i cant , also i have one more problem , i had injuries at lower inner lip , it looks like a saw cut it(my sister says that).i dont know how can i treat it , dentist gave me wax to put it on the braces but they r not healthy i think and didnt work.and one last question 🙂 , i saw the colorful elastics and i really like it , but im from Turkey and i dont know where can i get it , can everybody use it to make braces more fun :)?

    1. Hi,
      You have to wear your elastics for a good result. They come in different strengths and lengths. You may need a different elastic so talk to your orthodontist.

      On the inner lip that is cut, use a lot of wax and don’t sleep on your face. When you sleep on your face, you push your lip into your braces and the braces irritate the inside of the lip.

      For the colored elastics, your orthodontist can order colored elastics from the same company that they get the plain ones. Just ask them about it.

      Thanks for the questions.

  17. I wear my retainer all the time and I have had them for four months now. A couple of months ago my gap came back a little bit but then my retainers broke and it got bigger because my orthodontist took my retainer away for a day and they said that my new retainer would make my gap smaller (but it didn’t). Also my front tooth has become wonky

    But I was just wondering if my orthodontist would be able to put my braces back on or will I not be able to because I have already had my braces.What would you do if you had a patient in his situation?
    Sorry for the long question
    Thank you

    1. Dear Natasha,

      If the gap between your central incisors is large, then braces are needed again to close the gap. Some patients are more prone to this type of relapse.

      If the gap is small, a retainer can be used to close the gap. Since the gap is trying to open, once it is closed, you need a fixed retainer. A fixed retainer is a wire bonded to the back side of the central incisors. This keeps the gap from opening back up.

      Thanks for the question.

  18. Hi am am very bothered and not getting straight answers from my orthodontist… I have had braces for almost five years and I just got rubber bands the fourth year. My mouth is a little crowded because i have large teeth so my teeth move slow. When i first got my rubber bands they had me wear them the way i see online, Top front to bottom back. But a few months ago, they had me change it to top-inside-back to bottom-outside-front. Ever since then, my overbite has been getting bigger… My rubber bands have broken a lot also since they are being bitten every time i close my jaw. It took me asking them three times before they gave me better rubber bands that wouldn’t break every single time i bit down. I asked early January if there was anyway to get my braces off before i go into my senior year (i play a brass instrument and it is very hard to play high notes without hurting my lips- wax just makes it even harder to make notes on my instrument). It would be nice to have one year in high school without braces (considering i have had them since the end of seventh grade). My orthodontist said that would really be pushing it and i can only get them off if my parents request it. I even asked them about my rubber bands making my overbite bigger, they just said if i wore my rubber bands every day i wouldn’t be having these problems. I will let you know that i have been wearing my rubber bands. My older brother had similar issues but they never made him wear rubber bands like they are having me wear. I have even asked my friends who had had braces. They never wore their rubber bands they way i am wearing them either… I am very frustrated. I would like some straight answers if you could give them…. I also have not broken anything in my years of wearing braces.

    1. Dear Henry,

      Patients who have braces for a long period of time usually have grown or are growing adversely. The growth that you are going through is too much for the elastics and braces to correct the relationships of the jaws. To get straight answers, you and your parents need to have a chair-side conference with the orthodontist. The orthodontist needs to be aware that this conference is going to take place in the future so that an evaluation of your growth and position of the jaws can be assessed. It may be that the treatment plan needs to be changed. Orthognathic surgery may be indicated to correct your malocclusion.

      Thanks for the question.

  19. Dear Dr.Joseph Thompson ,
    I want to thank you for answered my question , it was very helpful. thank you for opening this web-site , you are very kind to everybody. I will ask you everything whenever i have any problem , its very relaxing! I wish you were my orthodontist! 🙂 , thanks again , take care of yourself!
    -Edd

  20. Dear Dr Joseph
    My daughter aged 7 has just had a thumb crib put in as she sucked her thumb constantly and has a anterior overbite. This is the second night and she is really sad and saying it hurts. Is this just temporary or will it pass? If so how long. Eating food is really difficult will this get better? Our orthodontist said it shouldn’t hurt but I thought I’d get a second opinion. Thank you Kate.

    1. Hi Kate,

      When a thumb crib is placed, it can make the teeth sore and it can be harder to chew food. This will last for about a week with everyday that passes being easier. If she is still having problems during the second week, then call your orthodontist. There may be something that needs to be adjusted.

      Thanks for the questions.

  21. Hello Doctor,

    My son wore braces for three years and at the end of treatment I was advised that he suffered from root shortening that was not noticed on the x-rays. He now has permanent retainers on both top and bottom because of the risk of movement. My son wants to be a jazz musician. His primary instrument is the tenor saxophone. Will the number of hours he will have to put in practice in a day affect the mobility of his four front teeth that suffer from root shortening? I am having difficulty getting an answer from his orthodontist or dentist. Your insight would be appreciated.

    1. Dear Luann,

      In my opinion, I do not believe that intermittent forces placed by playing a saxiphone is enough to cause more loss of bone increasing mobility of the teeth. Usually, root resorption from orthodontic treatment is not severe. While the upper teeth rest on the mouth piece of the sax, the muscles of the lips support the teeth and reduce the forces on them. Root resoprtion from orthodontic treatment happens when there are constant heavy forces usually associated with root torque. I’d also mention that idiopathic root resoprtion does happen randomly in the population with or without orthodontic treatment.

      Thanks for the question.

  22. So I just got my rubberbands on and was wondering what’s after them and when do you think I get them off. I have had them for a 1 1/2.

    1. Hi Bailee,

      Rubberbands are used to move whole segments of teeth or to modify the growth of the jaws. Sometimes a patient will wear rubberbands for months or even years. Make sure that you wear them as instructed to get the best results from your treatment.

      Thanks for the question.

  23. I get my braces off in two days but my teeth are still moving. Do you think that they will stop moving by then or will my orthodontist cancel the appointment and I will have to wear my braces longer.

    1. Hi Jack,

      It all depends on how far they move. If it is just a little, then the retainer can handle it. If not, then there could be a delay on getting your braces removed.

      Thanks for the question.

  24. If I wear two rubberbands on one side of my mouth is it going to do the same thing as wearing one but instead faster and more powerful?

    1. Hi,

      Orthodontists use elastics for a variety of movements. You should not change what your orthodontist has instructed you to do with your elastics. To answer your question, sometimes heavier elastics are needed for movement. We do ask some of our patients to wear more than one elastic at a time. Talk to your orthodontist about your elastic wear at your next visit.

      Thanks for the question.

  25. I don’t like the way my teeth look right now (after braces) and I don’t want braces again. My orthodontist told me to wear a retainer so, is it going to be okay if I only wear it 3 times a week because I want them to move forward? Will they be crooked again? Also, what do rubber bands do? Do they move your teeth back or forward? Thanks!

    1. Hi Angel,

      You need to discuss with your orthodontist any changes in your retainer wear first before you do so. You and your orthodontist need to discuss the way changes in tooth positions can be made with or without retainer wear. Discuss with them what you don’t like about the esthetics.

      Elastics are used to move teeth in a variety of ways. They can be used to move teeth forward, backwards or to the sides.

      Thanks for the questions.

  26. Hi!

    I just wanted to ask you if there might be any complications if I am going to have braces on my upper teeth 2 months longer then I was supposed to have. I have missed the appointment today for taking my braces off. The new date for appointment I got is 11th and 12th of September. What do you think of the effects the braces are going to have on my teeth now? Is it going to ruin what we have been working on for almost 2 years? The treatment has cost us quite a lot. What I should do? Should I just wait for the September´s appointments and hope that everything is going to be OK? Or the work of braces is now finished and I dont need to worry about it? What do you think?

    Thank You,

    Tomas

    1. Hi,

      There should be no problems waiting the extra two months to get your braces off. Usually at the end of treatment, very little active movement is occuring with the braces. Keep your teeth clean. If you see tooth movements that you are concerned about during this time, phone your orthodontist and ask them if you need to be seen sooner.

      Thanks for the questions.

  27. I had gaps between my teeth before I had braces, but the biggest gap was between the two front teeth. I then had braces for around 18 months and all the gaps were closed. A few days or so after getting my braces off however, the gap between my two front teeth slightly started to open up. I have been wearing my retainer every night but it is just keeping my teeth in place and not closing the small gap. I have had my braces off for just over a month now and the small gap is still there. What should I do? Is there anything I can get done without having to go through brace treatment again or wearing my retainer permanently?

    1. Hello,

      This is common in some patients who start with the gaps between their teeth before braces. An orthodontist can make you a Hawley retainer with extra wires to push the central incisors back together. Once they are together, a fixed wire retainer is placed on the backside of the centrals to keep the space closed. You don’t need braces again if caught early.

      Thanks for the question.

  28. I am supposed to get my braces off in 10 days. I am more than excited! However today after biting into a few foods I got a gap in between my right central insicor, and my right lateral inscisor. I am heartbroken. Is there anyway the gap will close? Or is there a retainer i can get to fix it? Its really important to me that I get my braces off in 10 days, I will be crushed if i can’t. Can you please tell me what will happen because of this new gap?
    thanks in advance!

    1. Hi,

      Spaces can open up at unfortunate times. It can keep you from getting your braces removed. I’d advise that you see your orthodontist for an appointment before your braces off date. They may be able to close the space before that appointment. Then you can get your braces removed as scheduled. It is much easier to close the space with the braces than with a retainer.

      Thanks for the question.

  29. How long does it take for a space permanetly to close while your braces are on? (how many days, weeks, etc.)

    1. Hi Hailey,

      No. I can’t think of any foods that would cause gaps to open up while you are in treatment.

      Thanks for the question.

  30. I was a patient of yours around 2000-2004 when i was 30. about three years ago my home was destroyed in a fire. i was concerned about not having my retainers; however, my dentist stated that with it being so long my teeth should be fine and if they moved it wouldn’t be much. my bottom teeth have moved and the two center teeth are pushing against each other and i’m having chipping (small pieces of my teeth breaking off around the top and corners). What are your suggestions on fixing this as I am worried that this will worsen over time. I love my new smile and want to keep it. thank you.

    1. Hi Katherine,

      Please set up an appointment for a consultation (304) 697-4110. Tell the receptionist that you are a former patient. Chances are, we can move the teeth back and prevent chipping by using upper and lower standard Hawley retainers.

      See you soon.

  31. I recently got a permanent retainer removed because I couldn’t floss around it. I went to the orthodontist and got fitted for a removable one. He told me I had two choices, a regular Hawley and a Spring one. I chose the Spring One because he told me that I wouldn’t have to wear it at all time just at night because my teeth didnt have to move much. I went to pick the retainer up today weeks later, and he tells me I need to wear it 24/7 for 8 weeks. What should I do follow his first or last instructions. I don’t want to wear it all the time because I’m at an age now where I’ve had braces in the past years ago and don’t want to go through that again.

    1. Hi Justin,

      Spring retainers are active retainers that places pressure on your teeth to move them. You should try to wear the spring retainer 24/7 for the 8 weeks as your orthodontist instructed. Your teeth will move quickly and then you can go part time. Your orthodontist has evaluated the type of pressure needed to move the teeth and has decided full time is best. It won’t be long and you can adapt to the spring retainer easily. Some adults can’t wear their retainer full time because if effects their speech too much at work. If that is the case, wear it as best as you can. I hope that helps and at your next appointment, ask your orthodontist if you can start part time wear.

  32. I’m finally getting my braces off tomorrow! I got permanent retainers on both my top and bottom teeth last week, plus I’m getting removable retainers. Is it normal to have two? I actually wanted the top perm retainer removed because it feels like its grinding my bottom teeth and its hard to floss. I don’t want my teeth to move, but its likely since I started out with crooked overcrowded teeth that was corrected without extractions (even my dentist thought it was a miracle!). Would it be okay without the top perm retainers and just the removable ones?
    Also, just out of curiosity, do retainers correct misaligned crossbite teeth?
    Thanks so much.

    1. Hi Joyce,

      You can use a fixed lingual retainer and a removable retainer at the same time. Possibly the reason is that the fixed retainer just holds six anterior teeth whereas the removable retainer will retain all teeth that it covers.

      Standard Hawley retainers with finger springs or a spring retainer are active retainers that can jump anterior cross bites and eliminate them.

      Thanks for the question.

  33. hi! i just wanna ask if it is normal that the lock of my braces in the lower part was easily off, even if I dont eat.! my braces is only 10days from now but the lock was easily off 5 times now. I am so disappointed to my dentist coz she didn’t do anything.. she only put it again and then in the morning when i woke up the lock again is off. Is it impossible that it is local?

    1. Hello,

      I’m not exactly sure by what you mean by “lock”. If you have self ligating brackets, then the bracket needs to be replaced. If you have edgewise brackets then adhesive probably needs to be removed around the wings of the bracket so the elastic tie stays on.

      I hope that helps.

  34. I have braces and im using toothpaste whitning to help my teeth. Is it a bad idea because most people that i will have squars but i havent nocited a diffrent in shades of my teeth

    1. Amelia,

      Using tooth whitening toothpaste is ok during orthodontic treatment and will not cause white marks around the brackets. The white marks are usually decalcification of the enamel by the plaque that is not removed on a daily basis. If you keep your teeth very clean during treatment, you lessen your chances of decalcification.

      Be aggressive when brushing your teeth by tipping your toothbrush around the brackets and wires. Also, massage your gum tissue with the bristles of your brush as you are brushing. Don’t forget to floss.

      Thanks for the question.

  35. hi 🙂 I got my braces off two days ago and got two hawley retainers my top one is fine and fits snugly but my bottom one feels a bit loose and I can easily remove it with my tongue also sometimes when I laugh or talk it will pop out is this normal or should I go back to my ortho to have it tightened I have an appointment in three weeks anyways but should I go sooner. thanks

    1. Hi Leslie,

      It is normal for both retainers and particularly the lower retainer to become loose. Some patient’s teeth have no undercuts and the retainer is not very tight to begin with. As long as it stays in your mouth, it will be ok. I’d wait until your next appointment to have it tightened. If you are in doubt, call your orthodontist and find out what they advise.

  36. I have a lot of gaps between my teeth and I was wondering if it could be fixed by just a retainer and not braces

    1. Hi,

      Since you stated that you have a lot of spaces between your teeth, you will need something more than a retainer to close the spaces. Retainers are only good for closing a small space between the central incisors, not multiple spaces. They don’t have enough force or control to close a lot of spaces. You will need braces or clear plastic aligners to close the space.

      Thanks for the question.

  37. Hello. I recently got my braces off, maybe a week and a half ago. I was given the metal retainer and was told to wear it everyday 24/7 except when eating or brushing my teeth. Although I have been following through with wearing it as much as possible, I noticed today that one of the little triangles (made of that plastic material as well) that come off to fit in between your teeth broke off. I’m not sure if that makes sense. You know how the top retainer looks, with the plastic part fitting the roof of your mouth and the little triangles that come off as well that fit between your teeth and upper molars. Well one of those broke off, just the top of the little triangle shaped part. I honestly don’t think it’s a big deal, but I just want to make sure that it will make no difference. I just really don’t want to have to get new retainers because they cost so much. I don’t know if it happened because I tend to take them on and off too much. None of the wire is damaged, just that little piece of the plastic material in my top retainer. Once again I hope that makes sense, I apologize if it doesn’t. Another quick question if how to properly take care of my metal retainers and what is the longest time in a day that I can not wear my retainers? Thank You.

    1. Hi Diana,

      Yes, I know exactly what you are describing. That triangle of plastic can be very thin and can break. I do not believe it is a problem. There is plenty of plastic to hold the teeth in place. Show your orthodontist the area that has broken at your next visit. If it is sharp, your orthodontist can smooth it out.

      When you take your retainers out of your mouth, rinse off the saliva. Don’t let saliva dry on your retainers. If saliva is left on your retainers, it will dry on them and your retainers will start having a white hard crust to develop on them that will not come off easily.

      Don’t place water in your retainer box. A lot of bacteria and germs can grow in your retainer box. Yuck. Let your retainers dry out. If you want to disinfect them, use 10% bleach solution for 10 minutes. That kills bacteria. Aggressively brush your retainer with your toothbrush and toothpaste everyday. You can also look under Products for Braces Tab for ultrasonic cleaners that can be used to clean your retainers.

      When starting your retention phase of treatment, you should wear them 24/7. Only take your retainers out when eating a meal or brushing your teeth. You should not go hours with out them. The teeth try to move the most right after braces are removed. Wear them as your orthodontist instructed.

      Do not chew gum with your retainers. You will work harden the wires and they will break. And don’t take your retainers out to chew gum. Later your orthodontist will tell you when you can start wearing your retainers part time. You can chew gum then. Here is an article on How to Clean Your Retainers.

      Good questions.

  38. Hi,
    2 weeks ago I had my gold chain attached to the tooth to be pulled down.
    However yesterday I looked in the mirror and saw the stich that was holding the chain to the gum was gone and that the chain was a lot longer than usual.
    I’m really scared and have no idea what to do.
    Our next appointment isnt till the 18th of september with our orthodontist

    Please help….
    Thanks

    1. Hi Veronica,

      The oral surgeon may have used a resorbable suture which slowly dissolves over time and disappears. You should be ok. The loose end can dangle without any problems. Don’t pull on the chain and keep the area clean. Call your orthodontist and tell them what has happen. They may want to shorten the chain and reattach it to your braces.

      Thanks for the question.

  39. hi!

    i have a question about the fixed wire on my bottom teeth, i had this wire put in after my bottom braces came off. i was just wondering, some of the glue keeping the wire on my teeth has worn off, and although its still stuck to my teeth there is no glue covering the wire like my other teeth, is this okay do u think? its a bit rough on the edges but usually this is not a problem, im just wondering if i should contact my orthodontist bout this as i will be away next week and will be unable to see him if the wire comes off or anything? do u think the remaining glue keeping the wire on will wear off soon?

    thanks so much and sorry if that was confusing!
    Eva

    1. Hi Eva,

      It is normal for the fixed retainer adhesive to slowly wear off. It is not urgent, however if you are concerned, have your orthodontist examine it. They can prepare the tooth surface and add more adhesive before the wire comes out. Biting pressures can be pounds of pressure so adhesive can break and come off at any time.

      Thanks for the question.

  40. Hi,

    Whenever I floss it creates a gap on the two bottom tooth please tell me why is that? Is it just because my teeth are shifting into place? It’s becoming bigger every time a floss though.

    1. Dear Jennifer,

      It is unusual for a space between the teeth to get larger every time you floss. I’m not quite sure why that is happening. I’d advise that you have your family dentist examine it.

  41. Dear Dr. Thompson,

    The orthodontist has proposed three possible treatment plans for our two daughters, ages 18 and 20. Option one involves jaw surgery, extractions, and braces, option two is extractions, Herbst device, and braces, and option three is extractions and braces. We have ruled out surgical interventions and we are wondering what kind of effectiveness may be expected from the Herbst device for patients of these ages vs. treatment without this device. Thanks for any information you can provide.

    1. Dear Brenda,

      A herbst appliance is usually used in a growing child to enhance the growth of the lower jaw. The patients have a retrognathic mandible and an excessive overjet. It is used when the mandible is deficient in its forward growth.

      When a Herbst appliance is used in an older non-growing patient, it tends to move the teeth more than the jaws. I would rely on your orthodontists judgment whether the herbst appliance would help with treatment objectives since I don’t have records to evaluate your daughter’s cases. There could be some benefit achieved with the Herbst device at this age.

  42. Dr. Thompson,

    Thanks for your prompt response and for the valuable service you are providing.
    We’ll definitely return to your site and will recommend it to others!

    Brenda

  43. Hi,

    i take calcium 500 mg and vitamin C 500 – 1,000 mg per day if this would benefit to bone and gum while i have braces.

    Can i use salt with water for mouthwash instead of brand name mouthwash while have braces in mouth (self ligating braces)

    1. Hi Renee,

      A skeletal open bite is when the upper and lower jaws do not grow in harmony due to genetic disposition of the patient. Your back molars touch, but your front teeth do not. If you observe a series of x-rays from the right side of the face, in a growing child, both jaws will grow in a downward and forward, counter-clockwise direction. With a skeletal open bite, this does not occur. Either the lower jaw grows in a more downward clockwise direction and/or the posterior region of the upper jaw (maxilla) grows too much in a straight downward direction. In either case, the patient will hit their posterior teeth first when biting down.

      Correction of a skeletal open bite can be difficult depending on the severity of the open bite. Some treatment plans to correct a skeletal open bite include impaction of the posterior region of the upper jaw (maxilla) by high pull headgear, extractions, the use of temporary anchorage devices (TADs) or orthognathic surgery by an oral surgeon. Sometimes two jaw surgery is indicated. After a complete workup with your orthodontist, they can tell you the best course of treatment.

      I hope that helps you in understanding skeletal open bites.

  44. I got braces over a year and a half ago and since I got them, I noticed some swelling of the gums. I really want it to go away but i need help. Any home remedies?

    1. Hi Mackenzie,

      It is not unusual for gum tissue to swell during treatment. Sometimes this is due to closing a space or not flossing enough. Once your braces are removed, the gum tissue swelling usually goes down. While the braces are in place, brush and floss the area well everyday and some of the swelling should reduce.

      Thanks for the question.

    1. Hi,

      It is best that you not whiten your teeth with braces in place. The whitening will not get under the brackets and may result in an uneven shading of the enamel. Wait until your braces are removed and then use the whitening solutions.

      Thanks for the question.

  45. Hi, My 16year old son was a late bloomer when it came to his teeth. He got his 1st tooth after turning 1yr. old, and he didn’t lose his first tooth until about age 10. His second molars have not yet erupted. He has been wearing braces for almost 2 yrs now and they are just about ready to come off. After taking a panoramic xray My orthodontist confirmed that his molars are coming in straight. My question is that if his second molars erupt after the braces are removed, will that cause his teeth to shift?

    Thank you!

    1. Dear Deb,

      Most patients have space for their 2nd molars. As they are erupting, the retainers will hold the teeth in good positions and not allow them to move. Usually, the 2nd molars will not cause any movement of the teeth orthodontically positioned.

  46. I have two ankylosed teeth that are right next too each other. They are the lateral incisor and the Canine both on the right side of my mouth. The Lateral Incisor has come down after 3 surgery’s but the canine which was supposed to be the easier of the two the bring down has now stopped moving again after 2 years of treatment and 3 surgery’s. My doctor is saying i need surgery again a fourth time for the canine to come down completely because the rubber band’s and elastics in place aren’t doing the trick. I want to remove the tooth and have a fake one implanted but the doctors keep telling me no but I can’t make sense of their reasoning. I wanted to know weather it was a bad idea to remove it or not because honestly I just want the tooth gone and i don’t want to have to deal with potentially a fifth and sixth surgery if this one doesn’t work because it’s never guaranteed.

    1. Dear Michael,

      I’m a little confused by your treatment history. An ankylosed tooth will not move. It stays in the same position. The root and the bone are fused together and the tooth will not erupt no matter how long you put pressure on it. Most ankylosed teeth that are not in proper position are removed. If instead you mean an impacted tooth, then that makes sense. An impacted tooth is just a crowded tooth that will not erupt into the mouth.

      With an impacted tooth, an oral surgeon will uncover the tooth and place a bracket and chain. The tooth is covered back up with the gum tissue and the chain is coming through the gum tissue. Pressure is placed onto the tooth with the chain to guide the tooth into position. Sometimes the bracket comes off of the tooth requiring surgery again to place the bracket and chain because the adhesive didn’t attach well to the impacted tooth. I have had some patients have two surgeries to place a bracket and chain on to an impacted tooth but not fifth or sixth.

      All treatment decisions are yours to make if you are of legal age. If you don’t like the recommendations of your doctor, get a second opinion. I hope I was helpful.

      1. You’re right I’m sorry they are impacted teeth and the first surgery was to place the brackets and chains, the second was to repair one, and the third was because my orthodontist thought one of the teeth had become ankylosed I think… Thank you for the help I appreciate it a ton and you’re doing a great job by answering all these questions for people.

        1. The only way an orthodontist can tell if an impacted tooth is ankylosed is by watching the teeth you are pulling from. If they start to move towards the impacted tooth, then the impacted tooth may be ankylosed. Your smile line will start to have a cant, be asymmetrical. One side higher than the other. If it is ankylosed, there is nothing you can do except extract the ankylosed tooth. No surgery will remove the ankylosis or cause the tooth to erupt.

    1. Hello,

      There is not much that you need to do. A loose bracket is not an emergency. The bracket is still attached to the wire. It can slide forward and backwards and it can twist up and down. If it is bothering you, try to slide it until it is in the right position. That may make it feel better. You can also place wax on it.

      If it is the last bracket in the back of the mouth and it is really bothering you, you can take small wire cutters or fingernail clippers and cut the wire right behind the next forward bracket that is attached. Call your orthodontist on Monday and find out what they recommend or schedule an appointment for repair.

      I hope that helps.

  47. Hello there I asked a question a short while ago on June 5th about my orthodontist intruding my upper left lateral incisor to make it appear shorter so that it would match my short upper right lateral incisor. Well I got my braces off 4 days ago and since then I can see the teeth have moved a bit, my left lateral incisor no longer looks shorter anymore, it is looking longer again so since having the braces removed either my left lateral has moved down out of the gum or my centrals have moved back up into the gum… either way I cannot see how my essix retainer will put these teeth back into the position they were the day my braces were removed (and retainer impressions were taken).
    You mentioned in your response to my other question that the retainers will move the teeth back into place if there has been some movement since the brace was removed but what about this type of movement where the teeth have moved up into the gum or down out of the gum??
    I collect my retainers in a few days (1 week from having my brace removed) and as well as worrying my retainer wont put my teeth (lateral/centrals) back into position I’m also really worried that the essix (clear) retainer will not fit properly with how the teeth have moved. Of course I will surely talk to my orthodontist about this but I just wondered what your thoughts were on this? My orthodontist is not open until Wednesday and I’m worrying myself after being in braces 3 years and spending a lot of money on them to have something go wrong. TIA

    1. Hi Nat,

      Retainers are not good at moving teeth that have intruded out of position. In other words, a retainer can keep teeth from moving except for intrusion. Retainers can move a tooth back into position that has extruded. In your case, you need to wear the retainers when you get them and see the results.

      If it is a tooth that has intruded, the adjacent teeth may need to be reduced in size. Sometimes the pressure from adjacent teeth can intrude a tooth. This reduction in pressure can allow a tooth to erupt again into position.

      If, having worn your retainers and the teeth are still not aligned, the edge of the longer tooth could be removed to make the incisal edges even.

      I’d get your retainers placed as quickly as possible so that no further movement will occur and then adjustments need to be made. I hope that helps.

  48. It has been a couple months since I have worn my retainer and the wire on the side that hooks around the first molar won’t go between the k9 and the molar. How can I get my teeth to separate a tiny bit so
    I can wedge the retainer in?
    Thanks a ton

    1. Hi Colin,

      Go back to wearing the retainer full time, 24/7. The retainer should move the teeth and it will fit better. If that doesn’t work, see your orthodontist. You may need a new retainer.

      Thanks for the question.

  49. What is the purpose of the impressions before getting braces? Is it so the ortho knows where to place the brackets? My ortho put my braces in without X-ray, imaging or impressions. Is this ok? Correct? Without impressions how did he know where to place the brackets?

    1. Dear Terrell,

      All orthodontic specialists take records, x-rays, models and photographs, to evaluate the patient and develop the best treatment plan for that patient. Based on the records, the orthodontist can decide how to move the teeth and what devices are needed.

      Records are also used to determine how the teeth are moving during treatment. They are a reference point in time to judge how treatment is progressing.

      I hope that helps.

      1. Thank you! It’s been 6 days since the orthodontist put my braces in and my mouth is extremely sore. I still cant bite down & when I try my teeth don’t align. After I inquired about the imaging they called me to get the imaging & X-ray. They also asked for a periodontal exam. Isn’t it too late for that? She should have gotten that before she put the braces on. Right?

        I really am not comfortable with the doctor! unfortunately I’ve already put down 50% but don’t feel confident she knows what she is doing. Is it possible to get a refund & find a more competent orthodontist?

        Thanks again.

        1. Orthodontic treatment is such a long period of time, losing confidence in your doctor is not good. You can always transfer to another orthodontist. Make sure that you are working with an orthodontic specialist. Members of the American Association of Orthodontists are orthodontic specialist who have 2 to 3 more years of advanced full time training after dental school. You can find AAO orthodontists by using their website locator http://www.mylifemysmile.org/

          As far as the refund, each office handles refunds differently. You basically pay for services rendered and the rest is refunded. An itemized statement can clear up details of what treatment has been rendered and that has been paid ahead. Later, a new fee and payment arrangements are made with the new orthodontist. The records would be transferred to the new orthodontist along with treatment notes. Most of the time, your braces can be used by the new orthodontist. I hope that helps.

  50. Doctor,

    I recently completed my orthodontic treatment. In the final detailing we used alastics to correct my bite in my premolars and molars. When the braces were removed my bite felt really good and even, I could feel the oclusal ridges as they should interact on my molars.

    2 days later I picked up my essix retainers, mostly for the upper, as I have a permanent retainer on the bottom.

    After about a week of wearing my upper retainer when I take it off to eat I no longer feel the same contact on my 7’s or 6’s. I notice there is a tiny bit of space about 1 mil between my 6’s now. My bite now feels more anterior than even. I may even be banging on my anteriors a bit. So I have 3 questions.

    First, did the Essix retainer intrude my 7’s causing that space on the 6’s to develop? How can this be corrected? Would that intrusion cause my anterior teeth to shift a bit and bang together? I am imaging a bit of IPR to correct the anterior teeth, will the Essix continue to intrude my 7’s as long as I continue to wear it?

    Thanks for the reply.

    1. Hi,

      A clear plastic retainer covering all the teeth will not intrude any teeth in my opinion. If the retainer does not cover the 2nd molars, then as the patient grows, the 2nd molars can extrude.

      I would say that you are experiencing normal tooth movement that occurs after braces are removed. The natural forces take over and can move the teeth even when retainers are being worn. The retention phase of treatment helps create a stable bite with the natural forces at work. When braces are removed, you are half way through treatment. I would continue to discuss with your orthodontist some of the movements you have observed. They can adjust your bite and retainers to improve your occlusion as it settles.

      I hope that helps.

  51. I’m 11 and I just visited my dentist and he said that in a couple months when my molars come in I might have to get braces . I have a huge over bite and I don’t have straight teeth .So does this happen to a lot of preteens and how long will it take for molars to come in ?

    1. Hi,

      A normal time to begin orthodontic treatment is age 11. This does vary from person to person because some patients receive their teeth early and some late. Most patients should have an orthodontic evaluation around 6 to 8 years old. And, it is not true that you have to wait for all your primary (baby) teeth to be lost before you begin treatment. Go ahead and get an appointment set up with an orthodontic specialist. They can tell your parents the best time to begin treatment.

  52. My daughter has a metal bar on the bottom and a metal bar going across the top palette. She just got her braces on and she is in so much pain. She can’t do anything. My questions are, what are the bars? Why does she need to have the bars and rubber bands? How do I make her feel a little bit better so she can enjoy what is left of her summer? Motrin isn’t helping:(

    1. Dear Holly,

      Right after a patient has braces placed, the teeth become very sore. You should go to a soft diet. The day after placing braces is the worst, then it gets better. It takes about 3 to 4 days for the soreness to go away. Besides eating soft foods, there is not much that can be done.

      As far as the metal bars, I’m not quite sure about the lower bar. However the upper metal bar may be a transpalatal bar. It is used to keep the molars from moving forward as space is closed.

      Rubber bands are used to move whole segments of teeth. We use elastics in a variety of ways to get to that proper occlusion.

      If your daughter, after a couple of days, is still having sore teeth and she can’t sleep, then call your orthodontist. They may lessen some of the forces.

  53. My son was told to wear his bionator 24-hours a day, 7 days a week for about 12 months. Is there anything wrong with taking it out for 6 hours of school 5 days a week even if it means he may have to wear it a total of, say, 18 months?

    1. Hello,

      A bionator will not work well wearing it part time. It has to be worn 24/7 to enhance the growth of the lower jaw (mandible). Intermittent forces will not cause bone growth that is required if worn part time. I understand your logic but it doesn’t work that way.

      Thanks for the question.

  54. Thanks for your timely response. I’m feeling badly for my boy right now. Does it get easier for him to wear? Easier to talk? He was back to school two days and then showed up the third day with this rather LARGE appliance in his mouth. I’m also concerned that it may cause him to recede into the background socially where he has always been so outgoing. Also, he has a new teacher. Will he be able to show his teacher how smart he is when he’s not answering questions or joining in discussions? These things concern me. Also, you say ‘bone growth that is REQUIRED’. I really hope that in my son’s case this bionator is necessary as a precursor to braces. Your response will be greatly appreciated.

    1. Dear Wellsy,

      As your son wears the bionator, it will get easier and he can learn to talk around it. If your son has a difficult time wearing the bionator, you can talk to your orthodontist about other appliances that enhance mandible growth like a jasper jumper, herbst appliance or a twin-block. The idea behind all these appliances is to make the mandible grow. Most of my patients that wear a bionator get use to it and do well. You need to tell the teacher that your son has a bionator and he can tell his school friends that it’s just a large retainer that he needs to wear. I hope that helps.

  55. my daugher just turned 8. She has drowding problem for both upper and lower teeth. We saw 2 orthodontics already, and both recommended a 2-phase treatment. One uses the term “spacer/retainer”, which I understand and can easily find information online to educate myself. The other doctor used the term, “Dtainer/Retainer” which I can’t find any info online for Dtainer (this is how the office spells it out too). Is it the same treatment as the spacer/retainer? What exactly is Dtainer/Retainer?

    Thank you,

    1. Dear Julia,

      I have never heard of a “Dtainer”. It must be a nickname that that orthodontist uses. You could ask more questions about what the appliance will do and what it looks like.

  56. I am 14 years old and I have one canine out of place on my left side on the too arch. When I smile, too much preassure is being applied to my lower teeth, mainly my bottom canine. It needs to be pushed back about 1-2 mm. It drives me crazy and it really bugs me. I asked my dentist about it and he said it’d move back on it’s own, but I really don’t think it will. Could I get a spring retainer or Inman alligner to fix this? I’ve heard it doesn’t work on canines and I’ve gears it does, so I’m not sure what to believe. Or will it move back in its own since I’m 14? I lost the the tooth last December and it’s still not in the right spot. Any feedback would be great!

    1. Hi,

      I doubt the cuspid (canine) tooth will erupt into place. They usually erupt at age 12 and you’ve had some time for it to do so. Since the cuspid erupts last, compared to other teeth, any crowding of the arch will leave it facial.

      What type of appliance that is needed is determined by a physical examination. To move the cuspid, the other teeth around the cuspid need to be moved so that space is created. Sometimes a spring retainer, clear plastic aligners or the Inman aligner will work. It just depends on how much crowding there is initially, as to what type of appliance is used. In most cases, braces are needed. Have a consultation with an orthodontic specialist to get the best information for correction.

      Thanks for the question.

  57. We went to the dentist to get the upper cuspids removed of my 8 yrs old daughter, because, they were very loose and about to fall. The dentist removed the lower cuspids too, where as they had proper roots around 2cm long and there was no sign of permanent Cuspids. He suggested that even if he removes the lower, it has no issues. My concern is that Is this normal to pull these lower Cuspids before time? Will there be permanent tooth coming up at their place at age of 9 or not?

    1. Hello,

      It is very rare for permanent cuspids to be congenitally missing. Therefore, the lower cuspids should have formed and are trying to erupt. It sounds like your daughter is receiving her permanent teeth early. Most of the time, patients cuspids try to erupt around the age of 11.

      One of the reasons I have lower primary cuspids removed early is to relieve severe crowding of the lower incisors. If your daughter’s lower incisors were crowded, removal of the lower primary cuspids would temporarily reduce the incisor crowding by aligning the incisors straighter from natural forces. The space created in the cuspid area will close slightly, crowding the permanent cuspid that has not erupted. Usually, the permanent cuspid will erupt and it may take awhile for it to do so.

      The second reason to remove a primary cuspid early is to help change the direction of the permanent cuspid eruption. Teeth will erupt through the path of least resistance. Since your daughter’s lower primary cuspid roots were long, the permanent cuspid may not be in the correct place to resorb the root of the primary cuspid. Removing the baby tooth can help with eruption. I hope that helps.

      Thanks for the question.

  58. Hello, I got my braces on a couple of months ago, nothing really went wrong except I broke one of the brackets, I went to my regular check up appointment and the man said that it was bad that I’d broken it and it was crucial to keep them on. So he put these weird white teeth like things beneath the brackets to stop me from breaking them, they almost felt like another tooth and I have broken one of them, what should I do? I find braces so awkward and when eating my mouth is so small I just don’t know where to eat encase of breaking them. I really want nice teeth but I find them irritating and annoying when trying to accomplice everyday tasks like brushing my teeth and eating. The wires stick out at the sides and dig into my gums, its painful but I don’t want to clip the ends of encase I break them or something, what should I do, also do you have any tips for making braces easier to handle!

    1. Hi Georgina,

      Sometimes breakage of the brackets is due to the type of malocclusion and not really anything that you have done. Patients with deep bites or buccal crossbites can easily knock the brackets off. Your orthodontist can replace the bracket with a band that is much more durable and won’t easily break.

      To make your experience with braces better, you have to tell your orthodontist the areas that are rubbing. They need to keep the wires short. You could use wax in the areas that are sore and use an electric toothbrush to help keep them clean.

      As your occlusion gets better, there will be less interferences with the brackets and wire. It just takes time and it will get better.

  59. I have enough space for the cuspid to go into it. That is NOT the issue at all. It’s really just getting it to go where needed. So you do not think it will go back on its own? Braces are Definately out of the question, because they are so expensive and it’s really just one tooth. Does an Inman aligner or spring retainer work on cuspids? If so, am I eligiable since I’m only 14? And do you really think its not going to move back by itself. Thank you so much for your time!

    1. Rebecca,

      If the cuspid has been in the mouth for a while and it is not in position, then it won’t. An Inman aligner or a spring retainer can be made to move the cuspid into place if it has enough room. Get a consultation soon with an orthodontist so that the space that is there will not close up and the cuspid can be moved.

  60. Hi, My 10 year old daughter is missing both her permanent upper cuspids is this unusual or problematic? The baby canines/cuspids are still present. What are your thoughts?

    1. Hi Melissa,

      It is rare for a maxillary permanent cuspid to be congenitally missing, let alone two. The treatment plan going forward would be determined by the type of malocclusion that she has and how the premolars erupt.

      You could try to keep the primary cuspids for as long as you can, but at some point in time, they will be lost. The enamel on the baby tooth cuspids is very thin and the tooth cannot withstand the forces being placed on it long term. Also, it is small compared to the permanent cuspid, so esthetics is an issue.

      I’d say that if there is no upper crowding, brace would be used to create space for false teeth (pontics) in the area of the cuspids. An implant or fixed bridges could be used to replace the congenitally missing teeth. At some point in time the primary cuspids would be extracted.

      The treatment plan has to be coordinated between the orthodontist and the family dentist. I hope that helps.

  61. Hello,
    I live in Europe and before getting braces, I needed to pull out one upper tooth. My orthodontist never told me about the possibility of shifted midline because of that. Now after 13 months she wants to take off my lower braces (teeth are straight) and leave the upper ones because of the gap that still isn’t closed. I am moving to USA in two weeks and I will have to continue the treatment here but to fix my shifted midline, do you think Dr. Thompson, I should keep the lower braces as well? How the shifted midline can be corrected? Thank you and have a nice day

    1. Hi Jani,

      Unilateral extraction can cause problems with a midline. I would keep the lower braces on. Elastics can be used from upper to lower to shift your midline. You may be able to get the midline back to the facial midline with elastic wear. If the lower braces are removed, it will be very difficult to shift the midline.

      In the USA, find an orthodontic specialist who is a member of the American Association of Orthodontists. AAO members are dentist with post-graduate dental school training of usually 3 extra years. I wish you well.

      Thanks for the question.

  62. My daughter has an impacted eye tooth and the ortho says it is ankylosed. My daughter has had an exposure and the ortho pulled on the tooth with no success. We then had the bracket removed from inside the gums and had an exposure done with a bracket on the outside of the gums. Again, no success. Her bite is now off and she has a cross bite. We have switched orthodontists and he says there is a new procedure called microfracture of the root. The root will be fractured, possibly causing nerve damage and may have to have a root canal. As parents, we have been trying to save the tooth at all cost. Do you think this is a good idea to try this procedure or have the tooth removed? If removed, she will have to wear a retainer with a prosthetic tooth for the next several years until she is fully grown. Then, she will have a post drilled in and can have a fake tooth. I would like to know your opinion. Thank you!

    1. Dear Krista,

      I have consulted with my colleagues in endodontics and we have never heard of a procedure called microfracture to dislodge an ankylosed tooth. It is our opinion that the ankylosed tooth be removed. Ankylosis can occur anywhere along the root of the tooth and cannot be identified by radiographs. Even luxation of the tooth will not remedy the ankylosis. I hope that helps.

  63. I got my braces off today and was fitted for one of the clear retainers. My orthodontist said to wear them every night, so I put the retainer on for the first time and the back left side isn’t really on all the way and I can’t get it on. What do I do? I don’t want to have to pay for another one if its not necessary.

    1. Dear Ryan,

      It sounds like there was distortion in the impression that was taken to make the clear plastic retainer. This results in distortion in the retainer and its usually in the posterior region. When this happens at my office, I remake the retainer. You may be able to use one you have until the new one is made if they adjust it. Call your orthodontist office and tell them you think it is distorted.

      Thanks for the question.

  64. I got my first brace yesterday and the there is a gap were I had a tooth pulled out. When I press down on the wire in the gap it will bend almost to the point were is comes out of the bracket is this normal on the first wire ?? Btw these are my two back brackets.

    1. Hi,

      It is normal for a wire that stretches across an extraction space to flex when eating or playing with it. What you don’t want is the wire to come out of the molar bracket. If that happens, you can try to place it back into the hole or call your orthodontist’s office for an appointment.

      In the very beginning of treatment, we use very small flexible wires to move and rotate teeth. These flexible wires can flex too much and become loose in an extraction space. I hope that helps.

  65. hi my glue has come off from one of my teeth which has slided down making it look like a very long tooth and was wondering if my orthodontist will put more glue on it . also will it move back to where it should be ?

    1. Hello,

      Orthodontic brackets are held on to the teeth with a special adhesive. If the glue breaks, you can get tooth movement that you don’t want. Your orthodontist will repair and place a new bracket on your tooth with the adhesive. Then they will move the tooth back into place.

  66. Dear Dr. Joseph,
    I’m wearing braces to close gaps in between my teeth(basically mid line diastemma) and i’d be going for post graduate studies in the UK. I just recently started using chains(barely a month).
    I’d like to find out the cost of continuing treatment. would it be cheaper or more expensive? If it would be more expensive would it make a difference if I buy my own dental supplies?
    Thank you.
    Lola

    1. Hi Lola,

      To find the cost of continuing treatment, you need to have a consultation with the new orthodontist. Every orthodontic office has different prices, so I can’t say how much it is going to cost and whether it will be more expensive. You do not need to buy your own dental supplies. The cost of orthodontic treatment is based on labor costs and length of time, not the materials that are used.

      Thanks for the questions.

  67. hi I have had my braces on for almost 5 months and have broke them many times. last time I went back they said that if I break them again they will come off. 6 weeks later a elastic ligature has came off. what shall I do :\

    1. Hi Lewis,

      I wouldn’t worry about an elastic ligature coming off. That is not a problem. It happens sometimes. They’ll put new ones on the next visit.

  68. Basically the wire at the end has come out of the slot and I don’t know what to do. Shall I go to the orthodontist as soon as possible or shall I wait for my next check up?

    1. Hello,

      This can happen when the wire is small and very flexible. If the wire is poking you, then call your orthodontist and ask if it is ok to cut the wire. You can also try to put the wire back into the slot or, if it’s not hurting, just leave it alone and wait for your next appointment for repair.

    1. Hi Rebecca,

      It depends on where the gap is located and if other teeth are erupting. Sometimes posterior teeth can close a gap but gaps in the anterior teeth usually don’t close.

  69. Hi, I’ve had my braces since I was in 7th grade, now I am a senior. I was suppose to get them off in July but they made me wait again because I have a tiny bit of space in front of my top k9s and they have had me wearing rubber bands for the past month & it still has not completely closed and the space is rather small. I don’t know, why. It’s really frustrating because I wear them all the time, everyday like I’m suppose to and I have not seen not much of a change, the fact That i go next week to the orthodontics, to “get them off” is worrying me because I feel like they are gonna have me wait even longer and I am way to impatient. What should I do? A friend of mine told me they might not be closing because my wisdom teeth haven’t came in, can this be true?

    1. Hi Elyssa,

      All patients get excited when braces are almost ready to come off. Sometimes a gap is hard to close. The best thing for you to do is do what your orthodontist asks of you. Follow their instructions. Eventually, the gaps will be closed and your braces will be off. Wisdom teeth (3rd molars) will not have any effect with gaps around your cuspids (k9s) especially when braces are being used.

      Thanks for the question.

  70. Hello Dr. Thompson,

    I recently got my braces on about a month ago, although my upper teeth are straight. The only reason I got braces was because I have an impacted #11 tooth, I was referred to an oral surgeon to get a gold chain put on but I am worried it will not be successful since I am 20 years old. I’m paying out of my own pocket for everything so my question is, is it mandatory for me to get the surgery or can I just get a bridge put on? Also, what would you recommend is affordable? and successful?

    Oh and to add to my comment, I will have my braces on for 2 years so Im wondering, if I do the gold chain, will i have to wear my braces for over the 2 years?

    Thank you!

    1. Dear Emma,

      The best option is a natural tooth over any implant, bridge or false tooth. You will basically spend the same amount of money either way, however you will have problems with the bridge eventually and it will need replaced. Also, a bridge may not look as good as a natural tooth.

      All decisions are in your hands. It’s elective. Nothing is mandatory. I hope that helps.

  71. Hi! So I have recently come down with strep. I’m in antibiotics and am on my way to healing, however my mouth is very swollen still. Since I am no longer contagious, I plan on going back to school tomorrow, but my retainer doesn’t fit. It doesn’t fit over my swollen gums. And my retainer has my two fake teeth on it. Also, how long can I go safely without my retainer, if my mouth continues to swell, without my teeth moving? I need help! Thanks!

    1. Hi Kyla,

      You cannot go without wearing your retainer especially since you have missing teeth. If you don’t wear your retainer, the spaces will close up and any false teeth placed later will be too small and not look well. If you can’t get your retainer to seat, call your orthodontist for an appointment. If you can wear your retainer, it will be tight for a while until your teeth move back into position. Do not go any length of time without wearing your retainer.

  72. Hi Dr Thompson, I had my braces taken off today and had a permanent inside lower retainer wire put in and my lower mouth is still very swollen and still sore. How long will the swelling take to go down and how long will i be sore. I had the procedure done early this afternoon and i am having a hard time sleeping because of the pain from having the permanent inside retainer put in. What should i do thanks

    1. Hi,

      Most patients will have some gum swelling during treatment. Right after braces are removed, the gums start to return to normal size and it takes about a month for them to be back to normal. Flossing will help in reducing the swelling and massaging the gums with the bristles of your toothbrush also helps.

      As far as soreness, it will take about a day for the soreness to lessen. If you are still really sore after a day or so and it’s not getting any better, see your orthodontist. There may be something that needs adjusted.

  73. I have just taken out my braces, and I have to wait a month because my parents do not have the money to buy the retainers at the moment. Is there a big risk of my teeth shifting to its former position?

    1. Yes Stanley,

      Your teeth have a very high chance of moving quickly to their old position if you don’t have retainers. When I remove braces, my patients get their retainers either that day or the following day depending on what type of retainer they are going to wear.

      Retainers have to be worn immediately after braces are removed because your teeth will try to move the most right after they are removed. Please try to get your retainers as soon as possible.

  74. My son recently got his braces off and is wearing a standard retainer on top. Last night he informed me that the retainer seems to slip from the roof of his mouth when he runs and when he drinks something it “floats” in the roof of his mouth. Other than that it seems to fit fine. I even tugged on it myself to make sure it is snug enough and is. He is not due to go back to orthodontist for another 5 weeks. What do you think?

    Thanks,
    Debra

    1. Hi Debra,

      The upper retainer will get slightly loose after it is worn a little bit. That is normal. As long as the retainer does not fall down all the time, it will be ok. The retainer, at this point, is held more in place by the saliva that is between the palate and the plastic of the retainer, not the wires. I advise my patients not to wear their retainers during sport activities and while eating. I hope that helps.

  75. hi . my elastics have ran out on the 3rd september . my next appointment is on the 24th september . now its 14th september so im waiting for my appointment to get more elastics . will they move back 2 where they were before while i wait for my apointment ? & will my dentist shout at me for not coming in to get elastics because they ran out ?

    1. Hi Rhea,

      You can have a little relapse from not wearing your elastics. You could call the orthodontist’s office and have them send a pack through the mail or your parents or you could go by the office an just get a pack before your next appointment.

  76. Hi Dr. Thompson,

    I have some minor crowding & my top right incisor tooth has gone up a little. I was wondering, will braces be able to move a tooth down slightly.

    Thank You,
    Elizabeth

    1. Hi Elizabeth,

      With braces we can move the tooth in all three dimensions. There are certain positions that we place the teeth on an occlusal plane. Both your central incisors should be at one level and your lateral incisors are at the same level. Orthodontic treatment should align all your teeth into proper positions.

  77. I have a gap in between my teeth and like 2 more towards the end of my teeth and an overbite on my bottom front teeth, but what really bothers me is the gap in the front. So I was wondering if I could ask if I could get braces and if it will close the gap. Please help, this gap makes me feel ugly and hate myself so much, I just want it gone.

    1. Hi Mark,

      Orthodontists close spaces all the time with braces. We start with gaps in the front and move the front teeth together. We continue to slide the teeth along the wires moving the gap to the back of the mouth. Finally the gap disappears. Get an appointment with an orthodontic specialist. They can get you started in getting rid of the gaps.

  78. Hi Dr. Thompson,
    One last question, is Invisalign just as good as metal braces on moving a tooth slightly down or would the metal braces work better?

    Thank You.

  79. Hi, my 12 year old son has an overjet (6mm) and overbite. The orthodontist wants him to wear a bionator at night time only for 12 to 18 months and then braces at 14 with distal molar extractions. We went for a 2nd opinion and he advised against a bionator or any other functional appliance to bring jaw forward. He said it won’t work (due to the angle of his jaw) and will make his face grow longer (he already has a long thin face) He would extract 2 upper premolars now and then use braces. So now I am confused. Will the bionator do anything with night time use only, or will we be waisting our time, effort and money? Also is there any urgency at 12 years or can we take our time and get some more opinions? Thank you

    1. Hi Julie,

      There are a lot of factors involved in developing a treatment plan for a patient. Some of those factors are the patients jaw position, their age and potential future growth. We like to make changes while the child is growing to effect the positions of the jaws relative to one another, if there is a decrepancy.

      In my opinion, a bionator works well on younger patients when they wear it full time. Also, I believe, since your son is 12 y/o, that treatment should start very soon. I hope that helps.

  80. Hi,
    I visited the orthodontist recently for the first time and was told that I have an impacted canine. He referred me to an oral surgeon who informed me that I would need braces to make room for the tooth (which he was going to pull down with some chain). My teeth are perfectly straight and the tooth is not severely impacted. a. will invisalign work? b. roughly how long will treatment take?

    1. Hello Sarah,

      When a patient has an impacted cuspid, treatment is difficult. You will need braces, clear plastic aligners will not work. Braces are used to put pressure on the chain that pulls the cuspid into the mouth. The more horizontal your cuspid is positioned, the less likely it will be that it can be brought into proper position. It may take one year for the cuspid to erupt and two years to complete your treatment. After braces are removed, you’ll need retainers for an extended period of time.

  81. Hi
    I just got an Inman Aligner (woop!) and my dentist says that after I get it off after the full treatment, I’m supposed to wear a metal wire behind my teeth. Do I wear it forever? I’d REALLY like to have something at night instead and not have a wire behind my teeth. Are there other options or am I stuck with that? Thanks!

    1. Hi Kelly,

      Retention lasts for a period of time after active treatment to make sure the teeth do not move with natural forces being placed on them. Most patients begin treatment pre-teens and wear retainers until they stop growing. With adult patients, retention can be life time.

      There are a variety of appliances that can be used during retention. A fixed retainer, a Hawley retainer and a clear plastic retainer are the main choices. Discuss with your orthodontist what retainer options that are available. Your orthodontist may want to use a specific type due to certain factors involved in your occlusion and treatment.

  82. my elastkics ran out and i cant be bothered to get more elastics becuase my dentist is far . my appointment is in 6 days . when they give me more elastics will it take me time to get used to then until they are painless ?

    1. Hi Gayle,

      Your teeth will be sore again when you start elastic wear. Make sure you wear your elastics as instructed.

  83. I have had a fixed brace for six months on my lower teeth. Last week my orthodontist put my top braces on. And just one question: is it normal to fit a bracket that you do not intend to use untill later in the treatment? I ask because as soon a I got home one of my incisors had an empty bracket (no tie or arch wire) The archwire was running under the bracket. In some ways i feel the tie may have snapped as I felt my brace jump and the coil behinds ins it expand- but it is right at the front. I do not really want to go back to my orthodontist if it is not actually broke but was intentially left out. This is because her receptionist made a clerical error cancelling an appointment I asked her not to, then rescheduled it for another time that day reading the wrong time off the screen so I was an hour late. His meant I had to go back and have the top done the next week- to top it off the other side of the city and I am too young to drive. Really o not want to go a torpid week. To top this off I felt it before I left the practice but was so fed up after the person putting my brace on said “I should be counting my blessings” and was treating two patients simultaneously in the same room.

    One other short question: with exposure of canines and guided eruption how often does the surgical site get infected? I ask this as I am a GUCH/ ACH and my cardiologist is not the most supportive of any dental work that can cause an infection.

    Thanx

    1. Hi,

      I think you need your braces checked. Call and describe the situation. Also, your cardiologist should advise the orthodontist if and how you should be medicated for orthodontic visits. Some patients have to have antibiotic coverage for each appointment.

  84. Hi, I’m 14 and have a overbite/overjet its 10mm i think, but isnt very noticable when i have my mouth shut. My orthodontist recomended either braces worn with head gear for 2 years or jaw surgery, I’m not to keen on the jaw surgery but my parents want me to get the surgery. I just don’t think it is worth going through the pain and recovery of jaw surgery plus I will have to wait till I’m 16 to start anything :/. What would you recommend?

    1. Hi Chloe,

      Just based on your age, in my opinion, the surgical treatment plan would probably be the best. For me, headgear works better at a younger age.

  85. Hi Dr Joseph,

    I’ve recently been experiencing some problems with my teeth and jaw in general. Firstly, the top teeth protrude and push the top lip out, and are also a little crowded. I have been diagnosed with a slight overjet, But it’s not actually my teeth that bother me, it’s secondly, these jaw pains on the side of my cheeks, mostly the right, but the left side does pop every so often. I feel as if my jaw is too small and not developed enough as should be to accommodate my teeth but also my facial features. It feels too small in size and length, slightly. It also slants slightly left when I pull my top teeth in line with the bottom. My jaw is able to dislocate itself to open larger, which then triggers a popping issue.

    I visited the orthodontist two days ago and unfortunately she’s was rather quick talking and never let me get much of a word in… I’m wandering what advise you can give me on this.

    I don’t want just my teeth fixed, I want my entire jaw fixed. How would a 19 year old male go about achieving this?

    Thank you

    1. Dear Matt,

      It sounds like your case is complicated. You may have internal derangement of the temporomandibular joint and possible deficiencies/asymmetries of the jaws. I’d advise you seek consultation with an oral surgeon to evaluate your TMJs and jaw positions. You may need orthognathic surgery or TMJ surgery in combination with orthodontic treatment. Getting more professional opinions is needed.

      1. Hi Dr Joseph,

        Thank you for such a quick response! I failed too mention a few other things, such as speech problems, the mouth feeling heavy, undercut chin, full lips taking up a lot of facial room due to small jaw size, etc.

        I have a feeling this is all because of a childhood event, of taking a blow to the face. Twice.

        Anyhow, thanks for the advice, I’ll now do some searching about for an oral surgeon.

        Thanks for your time, it’s greatly appreciated!

        Matt.

  86. Hello, I am currently in my 13 month of treatment and I have noticed that ever since I’ve had to wear the rubber bands in a triangular shape my lower teeth in the back have turned in and look crooked. Especially the tooth with the anchor bracket and the next tooth in front of them. My bottom teeth also seem like they are laying inward now and my top teeth sit on the side of my bottom teeth and causing my bite to be off. It seem like my lower front teeth are even more overcrowded than when I began treatment. What could possibly be causing my teeth to move this way this far into treatment? Since my daughter has started wearing the triangular shape rubber bands her teeth with the anchor bracket have started to turn as well. Thank you.

    1. Hi,

      Every tooth in the mouth moves. For every force, an orthodontist creates an equal and opposite force is created. To keep adverse movements from occurring, we group teeth together to move one tooth.

      In your situation, it sounds like you need a heavier thicker rectangular wire to keep the molars from tipping towards the tongue as you use your elastics. Tell your orthodontist what you are observing and they should counteract the adverse movement.

  87. Hi, i have a essix retainer and i wanted to know it is durable? I sometime catch myself sleeping at night and grinding a little bit and waking up to stop myself. I’ve have done this severaly times. Do you think a the hawely retainers are more suited for me because i do want to constantly replace my retainers over and over again due to money issues.

    1. Hi,

      Yes, a hawley retainer is better for a person who grinds. Some of my patients will grind through a clear plastic retainer in a few months. I change them over to a hawley for just that reason.

  88. Hi,
    I have had braces about four years ago and i haven’t been wearing them since a month ago. It halfway fit and as I kept wearing them the retainer started to fit more and more. I have notice that my retainer isn’t all the way straight. Is there a way to fix that? I have also moved away from the place where my orthodontist did my treatment for braces. Will the orthodontist here help with my teeth and retainer? I am still wearing my retainer. I only have a retainer for my top teeth. My bottom teeth have shifted. So would there be a way my old orthodontist would still have my teeth model to make my bottom retainer or somehow send the orthodontist here the model or something so I can have access to bottom retainers that will shift my bottom teeth to being straight? Please help.

    If the teeth next to my buck teeth(front two teeth) on both sides are slightly inwards than my front teeth which are slightly outward and aligned with the rest of my teeth except the two that are inwards; Can orthodontist use composite filling to make those two teeth aligned with the front teeth?(also since my front teeth already are aligned with all the other teeth the two inwards teeth will be aligned with the rest of my teeth) Is this possible for them to do if I suggest this to my orthodontist? Help please.

    1. Dear Dhara,

      It is possible to continue to use your upper retainer to move your teeth back into position. Some of the factors that dictate success is the type of retainer you are using and how far the teeth have shifted. Your old models may not help with your lower teeth because the teeth may have shifted too far.

      As far as placing composites or bonding your teeth, most orthodontic specialists stay within their specialty and do not do composite restorations. You could talk to your family general dentist for possible bondings. The best option though, is to move the teeth into proper positions rather than bonding.

  89. Hi,

    My 15yo daughter is congenitally missing her adult #7 and has been in braces for two years to make room for a possible future implant. Her orthodontist is now fine tuning the space that the perio is looking for.

    My daughter’s midline (center of nose, top, and bottom teeth) lined up perfectly but the periodontist said the space was not enough Now the ortho is expanding the space and her upper midline veered left and is not inline with the bottom teeth. Will my daughter have to sacrifice her midline in order to make space for the future implant?

    Once the space is adequate the ortho wants to give her a flipper with a fake tooth and said that she can eat with it on. This doesn’t sound comfortable. She is 15yo and I know she doesn’t want to take it out to eat and have a hole in her mouth for all to see. Are there better alternatives, such as a bonded wire retainer with a fake tooth or a Maryland bridge?

    She lost that baby tooth at 13yo. At what age will she have to start worrying about a need for bone graft for the implant?

    Lastly, what do you think about removing the three corresponding teeth and just closing the spaces? If so, how long do you think it’ll take before there will be no gaps in front when she smiles? I know molars move slower but since nobody will see the gaps in the back that would not be a big concern.

    Sorry for so many questions. Thank you so much for reading!

    1. Hi Karen,

      1. To help prevent the midline shift, an anterior diagonal elastic and a Class II elastic can be used. Depending how much space is created will determine if the midline will be off or not.

      2. I’d go with the flipper. A acid etched bridge (Maryland bridge) would be ok to do but you are going to have an implant in that area long term. Your expense will be much less with a flipper.

      3. As soon as the baby tooth was lost, bone in that area started to disappear. The alveolar bone will remodel to a particular point and then stop. The need for a bone graft is determined by the periodontist or the oral surgeon at the time the implant is placed. I doubt that one will be needed.

      4. Removing three teeth and closing the space is not a viable treatment plan, in my opinion. The size of the maxilla and the beginning positions of the permanent teeth determine if space can be closed where a cuspid can be substituted for a lateral incisor. Due to the amount of bone circumference, and the loss of teeth, gaps would probably reopen during retention, assuming the space was completely closed. Finally, the occlusion would be compromised and not correct.

      I hope that helps.

      1. Thank you so much for your quick response!

        She probably will not be getting an implant until she is 21yo or older. The thinking was that perhaps a Maryland bridge (non removable, more aesthetic, more comfortable, easier to eat with) would be more convenient than a flipper (wearer dependent, uncomfortable, less aesthetic, food can get trapped) for the next six years.

        Taking out the expense factor, and given the pros and cons, do you think getting a Maryland bridge would be a good option to hold the space for a teenager until 21yo? I believe that a Maryland bridge needs minimum to no preparation on the adjoining teeth, so it should be “reversible” without harm to other teeth until implant.

        I just want to make this the easiest and least intrusive for her until implant. Are there other alternatives, perhaps a lingual retention bar with a fake tooth? I really appreciate your advice in this.

        1. The reason I like the flipper is that it doesn’t connect two teeth together and keep them from moving naturally during her growth. If she grows in height quickly the bridge will not move like the rest of her teeth. It could result in a difference in height from the bridge to adjacent teeth not connected to the bridge. A flipper allows for tooth movement as the patient continues to grow. Dentists like to do more permanent restorations after patient growth for esthetic purposes. I am more concerned about tooth movement during growth while in retention. I still think the flipper is the best option if she may still have a lot of potential growth.

  90. The orthodontist is going to take off my daughter’s brace next week, but her two molars aren’t lined up edge to edge with other teeth yet. It’s slanted. When I asked the orthodontist about this, he said it’s not need to line up as long as her bite is fit, grooves/cusps to fit the bite.

    It’s really bothering me b/c it doesn’t look straight to me. Is it supposed to be like this to fit the bite? Can’t it also be straight and lined up with the grooves?

    1. Hi,

      2nd molars are not a large concern if they occlude properly. Due to non-extraction treatment, timing of eruption, amount of alveolar bone and age of the patient, 2nd molars can be slanted. Some orthodontists do not place brackets on the 2nd molars because it is not needed, they have not erupted or they can cause more harm by moving them than good.

      If there is room and all 2nd molars have erupted, brackets can be placed on them and aligned. If it is going to be some time before they are fully erupted, a small compliment of braces can be placed on posterior teeth to align the 2nd molars.

      Most of the time, 2nd molars erupt into proper position without aligning them with braces.

      I hope that helps.

  91. My permanent retainer fell out I have had it for over 15 years. My appointment with my dentist is not until the end of this month. What can I do until then as far as the feeling of glue on my teeth? I do not think I am going to have it put back in .

    1. Hi Suzie,

      It’s amazing how long a fixed retainer can stay in place. There is not much that you can do about the glue until your next appointment. Your dentist will use a high speed handpiece and a round bur to remove it.

  92. I just got my braces 2 days ago. They hurt like crazy and I can’t eat anything but applesauce. Touching my teeth on each other or anything else makes my entire mouth ache. On top of that one of my wires just made a gigantic sore on the inside of my mouth. The problem is I don’t like wearing wax on my braces. What can I do to make my teeth less sensitive and what can I do to prevent more sores?

    1. Hi Kate,

      The first week with newly applied braces is a hard week. It will get better. Everyday your teeth will be less sore. Eating soft foods helps. Use your wax in areas that are rubbing. For the sore that the wire is creating, call your orthodontist about cutting the wire to eliminate the problem. There is not much else that you can do. As time goes on, it will get better.

  93. Hi

    My bracket has totally fell out of mouth last week when I got it done and my spacer (band) on the bottom it is moving up and down. I’m wondering what should I do ?

    1. Hello,

      Call your orthodontist office and explain what has happened. If none of your wires are poking you, they may wait to fix everything at your next appointment. Your band will need to be recemented and the bracket replaced. Make sure that you do not chew on hard foods. Chewing on hard foods knocks brackets off and makes bands loose. Remember, breaking your braces can lead to longer treatment times.

  94. Hi. Been wearing braces for 2 months now and i’m 23.
    I’ve lost my two first molars in my lower teeth and one first molar in my upper teeth.
    My ortho suggested to put bridges to close the space but i don’t want that to happen.
    Cause i wanted my second molars to replace my first molars.
    IS THAT POSSIBLE? Btw, my 4 wisdom teeth haven’t grown yet.

    1. Hi,

      Probably not a good treatment plan. It depends on when the teeth were lost, how much bone has been lost in the extraction sites and how large your jaws are. If you try to close space and the jaw circumference is large, then spaces will not close or open back up after retention. Your orthodontist has evaluated the variables of your mouth and has determined that protracting 2nd molars into 1st molar lower space is not advisable. Plus, it would increase your overbite. The space closure has to be even. You’d have to have two upper molars extracted as well. I hope that helps.

      1. so if my ortho extract my other 1st molar on upper teeth……that would be even? i really dont like putting bridges on and i know it will cost a lot.
        what should i do…..and i wanna know if wearing braces will change a face shape? thank you so much for a quick reply 🙂

        1. I’d say a bridge or implants would be your best option as your orthodontist has indicated. Right after braces are removed, you will be wearing a retainer to hold the molar spaces. So, you don’t have to have an implant or bridges placed immediately.

          In the adult, braces would only change the lips slightly in some cases where the teeth were protruding at the beginning of treatment. So, to answer your question, your face shape will remain the same.

  95. hi, I’m 21 and i had braces for 14 months. I removed my braces last week. My arch was too narrow(V-shaped) and problem was crowding. I haven’t had my teeth extracted, my orthodontist planned a treatment where she would move my teeth with braces so my arch would appear in Ushape and crowding would reduce. After the treatment my front teeth now look better aligned, crowding has been significantly reduced but my front 4 teeth have move forward, they are not totally vertical but slanted slightly and coordination with my lips seems to be disturbed. My front teeth now touches the inner walls of my lips and premolars on back seems to have moved outward and are slightly slanted as well.I have permanent retainers on both the upper and lower teeth but the wire of retainer don’t extend till the premolars only upto the canines. So I want to ask you how stable are my teeth going to be, with no retainer will my premolars move back to there original position and disturb my bite and what if retainers come out and I don’t wear it again?

    1. Hi Raj,

      If your orthodontist wanted to remove teeth to reduce the crowding, that indicates to me that the jaw size was too small to accommodate all your teeth. Since extractions were not performed, there may be instability in the bite and you may experience tooth movement. You should be having follow up appointments with your orthodontist during the retention phase.

      In a growing child, an orthodontist can create jaw bone space easier than in the adult. Adults that have orthodontic treatment have a higher chance of relapse during retention and some adults have to wear retainers for long times to create a stable occlusion.

    1. Patients have sore teeth for about 3 to 4 days after braces are placed. It’s difficult to chew on regular food. During this time, patients eat soft foods.

  96. i just got my braces off yesterday and on the vacuum covered retainer it doesn’t cover only one of my back molars is it a problem or should i redo the retainer at a a doctor

    1. Hi,

      Most clear plastic retainers cover a portion of the 2nd molars. Some are made short if the 2nd molar needs to erupt more. Ask your orthodontist about the length of your retainer at your next appointment.

  97. So I’ve had my braces on for almost more than a year. And I’ve had the power chain on several times but my two top front teeth still have a little gap. It bothers me becuz I feel they are not doing there job right. Is there any way I can explain to them or some other method more powerful than the power chain to close my remaining gaps. ???
    Also I haven’t gotten my wire changed it’s been the same once since I first got them. (I have standard not Damon braces) thanx

    1. Hi,

      Sometimes the teeth are shaped or angled in such a way that a small gap will not close. The wire will need a bend or the teeth need to be reshaped to lessen or eliminate the space. At your next appointment, ask the orthodontist about the space you see and ask them how and when it can be closed. Sometimes orthodontists concentrate on bigger issues and fix smaller issues in the latter part of treatment.

  98. Hi!

    Love your site and would be interested in buying your book when its done.

    Question: I have braces but my upper-left canine (tooth #2.3) is a slight mesial rotation towards the palate. I have been trying to tell my ortho the problem but he doesn’t seem to understand what i mean entirely. He’s tried to do a detail bend to correct it but i feel after 3 attempts the bend is not working and my canine is still incorrectly positioned. So i would like to better describe the problem to him. So to be clear:

    My tooth #2.3 is mesially rotated towards my palate. Which means that its distal surface is a tad rotated facially (labially). So my thinking is it needs a 1st-order rotation bend? Is that the correct terminology for it? I say this because 1st order bends are all about step-ins and step-outs and so i am looking to step-out the mesial surface, but at the same time step-in its distal surface. By doing so at the same time would result in a rotation around its long axis. The bend i am thinking would look like this:

    Is that correct? If you can give me the problem wording i would say to my ortho that would be great. Thanks very much!

    1. Hi Kimberly,

      You are correct in the type of bend needed. If your orthodontist has placed that type of bend and it has not worked, there could be a couple of reasons why it’s not.

      1. Adhesive may have connected the cuspid to the adjacent tooth. I know this is not probable but possible and needs ruled out. Floss the area, just to make sure they are not connected.

      2. The wire may be too large. A large wire sometimes will not rotate the tooth because it is hitting up against the wings of the bracket. A smaller wire like .016″ stainless steel or nickel titanium may rotate the tooth.

      3. More room is needed. A compressed open coil spring can be placed between the teeth on the wire to rotate the cuspid.

      4. Finally, you may be dealing with an ankylosed tooth. In that case, the tooth will not rotate and stay in the same position. This can be ruled out by a percussion test and observation.

      #2 & #3 usually solves the problem when I have a tooth that is difficult to rotate. I don’t know how you can bring this up to your orthodontist. It seems you have done your research well. Just keep asking questions.

  99. Hi
    So I’ve had my braces off for about 3 years now and I would wear my retainer off again on again between months. Now I’ve gone almost a year without using my retainer and started to use it again, but I noticed that the part that is suppose to be under the roof of my mouth is now resting on my teeth letting me know that my over bite is back. Should I continue to use my retainer in hopes of my retainer fixing my over bite or is it too late? And when I started using my retainer again, it was really tight, but now it not so noticeable. Does that mean the retainer is working, or did my teeth just out stretch the retainer?

    1. Hello,
      When you start to wear your retainer, it will start to move the teeth back to where they were when the retainer was made. You will have to continue to wear the retainer to keep them in a good position. To create a stable occlusion that does not move back and forth, you will need an orthodontist to adjust your teeth and retainer to eliminate the pressures that are moving your teeth out of position..

    1. Hello,
      Yes, a tooth can be moved down. An orthodontist can move a tooth in all three dimensions with braces. The most difficult movements are root torque and intrusion. Moving a tooth down is extrusion and it is the easiest movement to make.

  100. Ok. Great news. Thank you so much Dr. Thompson. I was wondering, which type of braces would work best to move a tooth down?

    1. Christina, there are different types of braces, edgewise, self-ligating, Begg, etc. They all move teeth the same. If someone is saying their brackets are better and faster. It is not true. The rate of tooth movement is the same no matter what system is being used.

  101. I had braces for about 2 years, and got them off in 2011, and havent worn my retainers in over a year (They broke and we could not afford to repair them) and now my front two bottom teeth have moved and one other tooth up top.

    will I need braces again? or could an orthodntist just make a new retainer that would gradually move my teeth?

    thanks,

    Ryan

    1. Hi Ryan,

      Chances are your orthodontist can make an active removable appliance that will move the teeth back into good positions. You could use a spring retainer, a Hawley retainer with fingersprings or a clear plastic aligner. These can be used up to a point. If there is a lot of relapse, then sometimes retreating with braces is the best choice.

  102. Hi Dr. Thompson,
    It’s been 5 years since I last had braces & I noticed by teeth have shifted some & I wear my retainers religiously every night. I recently got my wisdom teeth removed & am wondering was it the wisdom teeth that pushed my teeth out of alignment? Also, my Orthodontist is giving me a clear plastic retainer now. Will this be able to position my teeth back the way they were before or will I need braces again?

    Thanks,
    Denise

    1. Hi Denise,
      3rd molars can cause some crowding when they try to erupt however the majority of crowding is due to the circumference of the jaw is not being long enough to accommodate the width of your teeth. To eliminate the pressure and the crowding, a little bit of enamel needs to be removed on the sides of the teeth. This is called interproximal enamel reduction. Orthodontists use this technique to create a non-crowded stable occlusion. Your clear plastic retainer can be adjusted or made to push the teeth if needed. Braces should not be needed.

  103. Ok. Thank you Dr. Thompson. I also have 2 teeth that need to be moved down by looking at the plastic retainer. Will the clear retainer be able to do this? Also, in order to fix the crowding, could I still get braces instead of removing the enamel on the sides of the teeth?

    Denise

    1. Clear plastic aligners are not good for extrusion types of movements. You may need to use braces again with interproximal reduction as well. If you don’t have some enamel removed, you may have relapse during the retention phase again.

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