101 thoughts on “Answered Questions Page4

    1. Dear Brianna,

      If you’re talking about the elastic tie, on the bracket, that holds the wire in place, I don’t think there is a difference in using different colors. They all hold the wire the same. So silver elastic ties will not move your teeth faster than other colors.

      Thanks for the question.

  1. Hi Dr. Thompson,

    Is it ok to wear retainers after not wearing them for several years? I recently became concerned that there are minor gaps at the base of my teeth where they meet with the gum and was considering wearing my retainers again. The problem is that the last time I wore them was probably 3-4 years ago. I tried putting them back in my mouth, but some parts of the retainer don’t fit into the crevices of my teeth. I would say about 80- 90% of the retainers fit in my mouth, but I don’t want to risk that 10-20% damaging my teeth. Thanks for answering!

    1. Hello,

      Yes, you can start wearing your retainers again. You won’t damage your teeth. Depending on how old you were 3-4 years ago, you may have grown out of your retainers indicating that you may need new ones. Wear your retainers for a while and see if the teeth move back, they should. If you still aren’t satisfied or have concerns, see your orthodontist for a consultation.

      Thanks for the question.

  2. Dr.Thompson,

    I have been in the Nance appliance alone for 2 months now and although it has came with little pain to my mouth, I have noticed that my front top teeth have a feeling of tightness now and again. Is this normal? Should the nance arch cause any pain whatsoever to the teeth? Also, what is the usual time span for wearing a nance holding arch?

    I am having my two top bicuspids out and the full braces (top and bottom) by march 13th. I am 17 years old and have a crooked front incisor on the top due to moderate crowding. Also, will the brackets I receive with metal braces be as sharp as the ones used for the molar bands on the nance appliance? I have had minimal trouble with these. Also, I have noticed that I am getting moderate jaw aches every now and again and my right side clicks when I open it, is this also normal?

    Thank you for your help, I find your website very helpful. I hope to be able to ask you more questions in the foreseeable future.

    1. Dear Robert,

      Your orthodontist is setting up an anchor unit by connected your two 1st molars together. He/She doesn’t want them to move forward as he/she closes the space. A Nance appliance can be active but in your case, I don’t think so. You will wear the Nance arch until the orthodontist is done closing spaces. However, every orthodontist does treatment differently.

      Your brackets will be just as sharp as the ones on the molars. Use wax, the inside of your lips will get use to the braces in about two weeks.

      Your TMJ dysfunction “click” is probably due to you clenching or grinding your teeth. As your occlusion gets better, it should lessen but at times it will ache more because there will be interferences as the teeth move.

      Orthodontic treatment is a step by step procedure and it takes time. Talk to your orthodontist as you go through treatment and you will learn a lot.

      Thanks for the questions.

  3. Hello Dr Thompson,

    Well I went to 3 different orthodontist and they each had different views. First one said they aren’t that bad no extractions. Second one said just the 2 molars from the top only. The last one said 4 teeth extractions I stayed with him because we were recommend to him. I chickened out and said I wasn’t doing the extractions he was upset but continued…I am now worried because I feel he’s making them worse. What orthodontist was correct??
    Its so confusing

    1. Dear Adriana,

      Extractions are based on how much crowding exists. The question the orthodontist asks themselves during the examination is, “Can all the teeth be placed in a good position with the amount of jaw bone available?” If you have moderate to severe crowding, extractions are sometimes needed to align the teeth.

      If you have started treatment, go with what your orthodontist says needs to be done. If they say extractions, have extractions done. You won’t miss the teeth and your final occlusion will be stable. If your orthodontist forces the teeth into alignment and there is not enough jaw length, your teeth could move at a later date after you stop wearing retainers.

      Make sure you are dealing with an orthodontic specialist. In the United States, most orthodontic specialists are members of the American Association of Orthodontists. Talk with your orthodontist about the reason extractions are needed.

      Thanks for the question.

  4. Hi Dr!

    I have a crossbite and I really want to get it fixed. I’m 32 years old and I already went to see an orthodontist they took xrays a mold of my teeth etc. He said that because of a bridge I have on the top right side I cannot get regular braces and that I could only get invisalign. I really didnt like how he didn’t explain why right away and was just trying to convince me to get the invisalign. I did some research online and I saw more than one comment that said that invisalign may not correct a crossbite. I’m really confused and I do not want to keep wasting my time and money. I really need an honest opinion, I’m lost and dunno what to do or who to believe!! heeeeelppp!!!

    1. Dear Carina,

      I do not use invisalign for correction of a crossbite. Also, your bridge complicates the treatment plan and may have to be taken apart to perform the movements required for your treatment. Teeth that are bridged together are very difficult to move.

      If your crossbite is an anterior crossbite, braces may be used to correct it. If it is a posterior crossbite, orthognathic surgery may be needed, in conjunction with a rapid palatal expander, to obtain the width for correction. After the width is obtain, braces are then used to obtain proper occlusion. I would get a second opinion.

      Thanks for the question.

  5. On which tooth are the silver bands put on because I have the separators in but the way my teeth is, is I have on wisdom tooth on the bottom and two on the top, but there were no seperaters put in between them and I want to know if there will be space so I don’t have to go through any more pain.

    1. Dear Catiana,

      Usually, bands are placed on the 1st molars. That is the 6th tooth counting from the front. Not all orthodontists place bands on the 1st molars. Some will bond brackets on the 1st molar.

      To avoid a lot of discomfort, some orthodontists will place bands on your molars on two separate appointments. If there is a space, a separator will not be needed. You should anticipate that your braces are gonna hurt.

      Thanks for the question.

  6. Hi i have had braces for about two years now getting ready to take them off soon. I have been wearing ruberbands and at my last app about a week ago they changed them again. Since they i have tried wearing them starting to put them on when i go to be and the next day i woke up my jaw so in a lot of pain. The rubberbands bearly let me open my mouth. so i took them off and my jaw would keep locking and is still really sore. It pops if i try to move it around. is that normal? I didnt know if maybe its something i have to deal with and get use to. it stays hurting even after i have tookin them off. Or maybe its pulling on my teeth too tight. I dont know if it something i should go in for or what will you please help. Thank you!

    1. Dear Lisa,

      I think your elastics are too tight. I’d advise that you call your orthodontist and tell them you are having TMJ symptoms of pain, popping and locking. They will advise you what to do.

      Thanks for the question.

  7. I am an adult who had braces when I was 26-28ish years of age. My bottom teeth are shifting now that I am in my 40’s. I pop my old retainer on to move them back but it is an ill fit (it does move them back). I would like to get a new reatiner that is more like the night guard material that I wear at night. I am not wanting a permanent wire attached because of flossing laziness (I know…) I am also not living near my old ortho. It is possible and reasonably priced to get a new retainer made? It’s just my front bottom teeth that I am interested in retaining. Thanks

    1. Hi Connie,

      Yes, you can get a new clear plastic “invisible” retainer. I’d advise that you wear your old retainer a lot right before you go into see the new orthodontist. That way, the teeth will be in good positions for the impression. Tell them over the phone that your old retainer needs to be replaced and you want to purchase a new one. What is the fee for obtaining a new retainer? You should find an orthodontist who will work with you.

      Thanks for the question.

  8. hi dr. thompson,
    i have had braces on for just over two years now. my teeth are in proper position, and so is my bite. my oral surgeon told me i have a canted jaw, and my orthodontist is using an intrusion wire to ‘correct’ it. can an intrusion wire really correct this ?

    1. Dear Alanah,

      There are some patients where one side of their face will grow longer than the other side causing an occlusal cant. The occlusal plane is slanted from one side to the other. In some patients, it is diagnosed as hemifacial microsomia.

      Usually, during treament the orthodontist can intrude one side and extrude the teeth on the other side, leveling out the occlusal plane. The jaw itself will still be asymmetrical. So, yes, we can correct occlusal cants with just the braces. This type of treatment does take a lot of time.

      If the occlusal cant is beyond standard orthodontic treatment, an oral surgeon could perform orthognathic surgery to correct the cant.

      Thanks for the question.

      1. my orthodontist said he is bringing up the right side to level it out. do you know how long this will take? and have you seen good results from this approach? and although i do have jaw asymmetry, my cant isn’t severe, just noticeable enough that i want it corrected

        1. Since your asymmetry isn’t severe, you should get a good result. I can’t estimate how long it will take.

  9. Hi, could you please explain to me the advantages and disadvantages of having a herbst appliance. My son is scheduled to get one soon but I am concerned because he is very active in sports and I have read that it is not a good idea because the herbst could break during contact sports and could cause injury to gums and teeth. Also, I am concerned about good cleaning with the herbst..it looks like there would be the possibility of lots of decay. Also, my son has a very sensitive mouth..when he initially got his braces on, he got a mouthful of canker sores..and everytime they have added any appliance, he gets cuts and sores in his mouth. I would prefer that he could use headgear instead of the herbst…what is your opinion concerning herbst and headgear? His orthodontist is insisting on the herbst.

    1. Hello,

      Both headgear and a herbst appliance modify growth of the jaws in different ways. A cervical pull headgear slows the growth of the upper jaw. A herbst appliance enchances the growth of the lower jaw. Looking at cephalometric measurements, your orthodontist has determined that the upper jaw is in proper position and the lower jaw needs help in its growth, therefore a herbst is indicated.

      The benefits of lower jaw growth obtained by using a herbst appliance can out weigh difficulties it could produce. Herbst appliances are made as smooth as possible to lessen irritation and some mouth guards can be modified to fit around the herbst. I’d discuss your concerns with your orthodontist and hopefully resolve any issues before treatment begins.

      Thanks for the questions.

  10. Hi, i have an overbite. I think i got it because i sucked my thumb until i was 6. Thus I’ve been having trouble speaking. Every time i speak, i have to repeat myself twice and it really makes me lose confidence. At school, i never talked because i couldn’t say anything without having to repeat myself. I didn’t have to repeat what i said all the time because sometimes they understood. When i had to do orals at schools, i would be so scared. I couldn’t communicate because of my speech problem. Thus, it has affected my health, studies and everything. I’m barely managing school. I can’t socialise because of this and i feel so annoyed. I got braces roughly 2 years ago in order to get my front teeth pushed back or something. I got like 6 months left at least until my braces go off. I’ve got some teeth extracted and i’ve been wearing those bands for 6 months. I was hoping that after the completion of my braces, i would be able to speak clear; if that is the case, then shouldn’t my speech impediment get better gradually? I feel that my problem hasn’t gone. i was expecting my speech to slowly get better. So i’m wondering whether once my braces are off, i’ll magically be able to speak clearly without having to repeat myself?

    This overbite speech problem has really destroyed my life, i’ve missed out on so many opportunities, my life would have been way better. I’m probably so unlucky. My parents took me to the orthodontist because of my upper jaw being in front of my lower jaw. They don’t really know that i have a speech problem. I haven’t been able to tell anyone about this because it’s so embarrassing telling others. I just want to know if i can speak clearly? Right now i’ve recorded myself speaking and heard them. I can sometimes know what i said but other times it feels like i’m mumbling. I talk slowly and try to emphasise the words. I just want a voice! I’ve googled to see whether braces cures my speech problem but there seems to be no answer. I wish i hadn’t sucked my thumb passed 3 years old. It has destroyed my life completely. I can never be my true self. School, Social life, everything is a mess for me. At school i just act differently. People take their voice for granted; if they were in my position, the most important thing for them is to be able to speak.

    1. Hi Max,

      Correcting your malocclusion will help in you being able to produce certain sounds, like “s”, “t” and “d”s. It will not help with repetitive speech problems. I’d advise that you seek consultation with a speech therapist for your other issues. I believe you need to continue taking steps to correct your speech problems after braces are removed because properly positioned teeth will only help your speech to a certain point.

      Thanks for the question.

  11. Hello,
    My fourteen year old daughter has had braces for nearly two weeks. She has broken all of the rules regarding food, and recently, after eating Skittles, has loosened many of her brackets. She absolutely hates braces and it is a struggle to get her to follow the rules. Is it worth it to make her have them? We have explored alternatives (invisalign), but she can’t get it, as she has a tooth in her gum that must be moved down. Is there any way this tooth can be removed to make invisalign possible? She has crowding and an overbite which braces are trying to fix.

    1. Dear Molly,

      If your daughter is having compliance issues with standard braces, she will not comply with wearing invisalign. When they start to hurt, she will take them out.

      The tooth that needs to come into the mouth is probably the cuspid and we keep cuspids. It sounds like your orthodontist has treatment planned the appropriate device, braces, to move her teeth.

      You and your orthodontist need to discuss with her the benefits of having straight teeth. Once she realizes that we are trying to do something good for her, she may understand and comply better. Some young teenagers don’t want braces and act up but eventually they grow out of their immaturity.

      In rare cases, the treatment is stopped, braces removed and resumed when the child is much older. Stopping treatment for your daughter is not wise because correcting an overbite is harder at later ages.

      I’d advise you to stay the course and she should calm down. Also, the brackets that are constantly broken can be replaced with bands, the older style, that do not break so easily.

      Thanks for the questions.

  12. hello , i Had a gap in to from of my teeth i wore braces for 17 months , just got them off 4-5 days ago and my retainer is hurting the right side and feels like its pushing i dont know what to do im scared my teeth will get messed up again what should i do

    1. Hi,

      Your retainer just needs adjusted. Continue to wear your retainer and call the orthodontist. Tell them your retainer is not fitting properly and it needs checked. They will adjust your retainer so that it fits properly.

      Thanks for the question.

        1. Some orthodontists charge a fee if you lose or break your retainer. They are fragile. If they are broken, try to wear them since your teeth try to move the most right after braces are removed. Get in to see your orthodontist asap.

  13. I have a baby “canine” tooth. I’m already 16 and it’s sort of embarrassing because it’s the only baby tooth I have. I have an appointment with an orthodontist on Tuesday. When I went to see the dentist they took an x-ray and said my adult tooth is off track and still in my gums just not visible when I smile of course. They said I’ll have the baby tooth extracted. However, will I need braces to allow that adult tooth to sit properly? And if so, will I only need my top arch braces?

    1. Hello,

      Since upper cuspids come in so late, they can have a difficult time erupting if there is crowding. In other cases, the tooth buds are pointing in the wrong direction and they become impacted or ectopic. Without intervention, they would never erupt.

      Patients with an impacted cuspid usually have braces placed on the upper and lower teeth. It is determined by the panex whether there should be an attempt to go after the impacted cuspid. In some cases, if the cuspid is horizontal, extraction of the tooth is recommended. If we go after the tooth, a large space is created in the area of the impacted cuspid and the patient is referred to the oral surgeon.

      The oral surgeon will extract the primary cuspid and then uncover the crown of the permanent cuspid. The surgeon then places a bracket and chain on the crown and covers it back up. The gum tissue heals with the chain coming out of the gums.

      The orthodontist then applies pressure to the chain and protracts the cuspid into position. To get the cuspid to erupt, it could take over a year. Sometimes the cuspid becomes or is ankylosed and will not erupt. If this happens the cuspid is removed and a false tooth is needed in that area.

      Usually, the cuspid is brought into position and there are no complications. Impacted or ectopic cuspids happen often and is one of the harder orthodontic problems to correct.

      Thanks for the question.

  14. ok…. my orthodontist said to wear my rubber bands to move my teeth down. When i went in for my app they said that my teeth had moved down a lot but i needed to wear them at night only to move them down a little bit more but they scheduled my next app March 18 to see if they have moved and scheduled another app on April 29 to get them off…. what if my teeth havent moved down where they need to be on March 18 will they still take my braces off on April 29??

    1. Hi,

      Orthodontists make estimates of how far teeth will move but we don’t know how far they have moved until the examination at the following appointment. If they have not moved enough, your braces removal may be delayed. I know you’re anxious. Hang in there and wear the rubber bands as instructed. It sounds like it will happen soon.

      Thanks for the question.

  15. Hi, My 8 year old son is missing both the upper and lower left and right incisors. We are speaking to his ortho about options, we are self pay and dont see that changing anytime soon. One of the options was to move the upper teeth over to fill the gaps and eventually grind down the canines. I was a bit overwhelmed in the office and didnt think of all the questions until we left, so i want to know if this is possible with the lower jaw as well. I have put a call in to the office but havent gotten a response yet. We are trying to avoid implants if at all possible.

    1. Dear Cami,

      One viable option, when lateral incisors are congenitally missing, is to close the space with the cuspids and then reshape the cuspid into the shape of a lateral. This option may not be the most aesthetically pleasing treatment plan. The roots of the cuspids are very large compared to the lateral incisor root therefore you have root prominence in the wrong place. Also, it is hard to shape the crown down to the size of lateral. Cuspids are large teeth. Additionally, the 1st premolars have to have the lingual cusp partially removed to become a cuspid. Finally, if the child is going to grow a large sized jaw, there can be issues of spaces opening up after retention is stopped.

      The best answer is found by consulting with your orthodontist. They have all the information about tooth size, possible jaw growth of your son and the aesthetics. I usually treatment plan for spaces to be opened up for the lateral incisors. I believe it creates a fuller, broader smile, more lip support and wider anterior circumference. After braces are removed, the patient wears a retainer with false teeth until bridges or implants are placed.

      If you believe your son is going to be a large man when fully grown, I’d open up lateral spaces. I hope I’ve helped.

      Thanks for the question.

  16. Hello,
    I have braces and my doctor gave me elastic bands yesterday only.
    They are hurting me very much. Any suggestions to reduce the pain?

    1. Hi Aanavi,

      As you know, when you start rubber bands, your teeth can get very sore. As you wear them, it will lessen over time. Some of your pain could be from adjustments that your orthodontist made to the wire or if it is a new wire. Use over the counter pain meds and soft foods until your teeth aren’t so sore. Eventually you will get past the soreness by wearing the elastics consistently. Keep up the good work. Elastics are very important in creating a proper occlusion.

      Thanks for the question.

  17. Hi Doctor,

    I hope you’re doing fine. i like to ask do you know about teeth whitening as well? i got my braces removed and I am so excited to get my teeth bleached.

    I understand there are two ways, one is in the clinic and one is doing it at home with the tray dentist given. which one is the least sensitive?

    1. Hi Alan,

      The difference between the home treatment whitening kit or in the clinic treatment is the strength of the solutions. The solutions used in the office are very strong. You will get the results faster with the in clinic whitening but you have no control over the sensitivity. With the home treatment kit, you can go at the pace that keeps your teeth from being sensitive. You can skip a day or two if your teeth get really sensitive. It will take longer but you will get the same results. I hope that helps.

      Thanks for the question.

      1. Thanks for the reply Doctor.

        Well i plan to choose the clinic treatment. I understand is about 30-45 mins.

        Does it lead too serious irritation during the process and also after back home?

        1. If any irritation, it would be after the procedure, not during. I think you will be fine. If your teeth are sensitive, you just have to change your eating habits for a day.

  18. I had my first consultation for braces about a week ago and the orthodontist said I will need two of my upper bicuspids removed for braces. After a little research, I have read that removal of bicuspids can cause unwanted facial shape changes. Is this true and how drastic can the changes be? Also, by removing the teeth and pulling the others into the gaps, would this give me a more narrow-looking smile?

    Much appreciated.

    1. Dear Stephen,

      We remove upper premolars (bicuspids) due to upper incisor protrusion or the maxilla grew too far anterior relative to the mandible (lower jaw). This is determined by clinical examination and cephalometric analysis. Any profile changes would be for the better and it only affects the upper lip slightly. So no major unwanted facial shape changes occur.

      The broadness of the smile is mainly due to the actual facial width of the jaws themselves and not whether teeth are removed. Often, when indicated, orthodontists routinely extract upper bicuspids to provide a stable occlusion and there are no drastic unwanted changes in aesthetics.

      Thanks for the questions.

  19. Dear Dr Thompson
    My orthodontist assigned me to wear four elastics for an overbite but idk if I am wearing them correctly. One pair is on my cuspids then goes down to my 2nd premolars on the bottom. Then the other two are from my top 1st premolars and goes down to my first molar on the bottom. Please help me. I get my braces off march 6th and if I wore them wrong I’ll have another 50 days!

    1. Dear Anthony,

      The way you are wearing your elastics appears correct to me. Continue to wear your rubber bands as instructed. It seems you are close to getting your braces removed. Keep up the good work.

      Thanks for the question.

  20. I’m all set for my first upper bicuspid removal tomorrow but I just realised I have no clue if they are removing my 1st or 2nd bicuspid. My nance holding arch makes me think it will be the one closest to my molars (I’m not sure if that’s 1st or 2nd). I’m just curious, is there any difference between which is extracted? I have a class II maloclusion, upper crowding where my left incisor has rotated slightly causing it to be crooked, slightly sticky-outy canines and a nance holding arch. Is there any way that you could predict which they will remove? I’m kind of excited to get started on getting straighter teeth!

    Many thanks.

    1. Dear Robert,

      Since your orthodontist is using a nance arch, she/he does not want the posterior teeth to move forward as the space is closed. Therefore, chances are, you will have your first premolars removed because that places the 2nd premolar a part of the anchor unit. A large majority of the time, 1st premolars are selected for removal over 2nd premolars for protrusion cases.

      Thanks for the question.

  21. Hi, My hook fell off the one where you put the elastic rubber bands on. And i was wondering if it would be okay if i dont wear it because i dont have a hook but i dont want to wait longer when my braces come off. And the office opens tomorrow so it should be okay untill monday right?

  22. My daughter has a palate expander in & we have been in a holding. pattern for 4 months . I became ill & have been out of work & am behind on my payments . What will happen now that my daughter hasn’t seen the orthodontist for a couple of months? She is complaining of pain. Should I have them remove the expander and just forget about braces until I go back to work or will we have to start from the beginning?

    1. Dear Elizabeth,

      Your daughter needs to be seen for a regular orthodontic visit. Talk to them about continuation of treatment and the circumstances. If treatment is stopped, the palatal expander will be removed. If the expander has been in for a while and the width has been achieved, there will be minimal loss of arch width when the expander is removed. So that part of treatment has been successful and you don’t have to start from the beginning. Treatment, with the braces, can begin at a later date.

      You and your orthodontist can work out what needs to be done. Do not stop communicating with the office. Continue regular appointments. They should work with you for the best of your daughter’s treatment.

      Thanks for the questions.

  23. Hi sir.

    I was just wondering if there is anyway to speed up the process of my braces. I’ve currently had them on since October but I only got them because it was my families last chance to make me do something before I was 18. (Long story) I don’t care much for braces and with no disrespect but dentistry and orthodontics in general. I’m trying my hardest to go to the dentist and take this seriously but again I don’t care. I just want the holes in my mouth where 3 and a half teeth user to be covered up then I want these horrid things off. But please there has to be a way to hurry this up I want them gone by July this year (which will mean 7months with them on). Now please don’t get me wrong my family isn’t paying for this treatment and I never would of gotten it but I was forced to. (I’m not going to go into it but its sorta free in a way). Long story short I want them gone. I’d pull em off with plyers myself to be honest with you.

    1. Dear Khiara,

      The biology of tooth movement has never changed, so you can’t make a tooth move any faster. It is a slow process. Light forces move the teeth better than heavy forces. Normal treatment time can be 18 to 24 months or longer. You need to talk with your orthodontist about expected treatment time so you can be mentally prepared. Remember, it is only an estimate.

      Thanks for the question.

  24. Hi
    I got a fixed brace fitted a few weeks ago, and am still wearing Twin block removable braces to align my jaw. The twin blocks made a gap in my top front teeth and I need the braces to close the gap. Will I need retainers afterwards???


    Ps. I live in England…

    1. Hi Damon,

      After braces are removed, most patients wear retainers. In your case, your gap could open back if you don’t wear them.

      Thanks for the question.

        1. Yes. All my patients wear retainers after braces are removed. Retainers are easy to wear and have a big benefit.

  25. I got my molar build-ups removed after almost a year, but my orthodontist ground off parts of my molars themselves in the process, and the texture is weird. The teeth now have the same feeling as the cement did, and I’ve always hated that texture. Is there any way I can get those teeth to have the same smooth, glossy sort of feeling that my other teeth have? Maybe some kind of sealant?

    1. Hi Rose,

      Yes, your molar can be smoothed out. Talk with your family dentist. They will be able to give you the best advice on how to correct the roughness.

      Thanks for the question.

  26. My two front top teeth are starting to overlap. Is this normal, or is something going wrong? Also, my dog ran into my mouth and now one of my teeth are pushed back. Will my braces fix it or will i have to show my orthodontics to fix it?

    1. Dear Haley,

      I think your dog bent the wire. I’d advise that you see your orthodontist. They will either take out the wire and replace it or take the bend out of it.

      Thanks for the question.

  27. i have an inherited flaw. my dad and i both have jaws which favour the right… this flaw is not very evident but undermines my confidence.. it looks horrible in photos and i have a bad smile.. i also have class III malocculsion (is it because of my jaw???) and my teeth are also out of alignment… ( my central incisors do not come together properly and the lateral incisor of the bottom jaw comes with the central incisor of upper jaw… ) i sorta hear clicking or popping sounds and feel sort of uncomfortable.. i dont know if its just insecurity… i am 15 years old…i have migraines as well.. i dont know what to make out of all this, and wonder if i should go in for treatment? if so, what is the risk factor??? what will the treatment be like?

    1. Hello,

      Asymmetrical growth of the mandible can cause a Class III malocclusion. You need to have an examination and consultation with an orthodontic specialist. Sometimes, orthognathic surgery is needed to correct the malocclusion. If surgery is indicated, 3rd molars have to be removed 6 months prior to surgery. Braces are placed a year before surgery so there can be correction of malpositioned teeth. Surgery is performed with braces in place. After surgery, the patient continues with the braces for about a year for final adjustments. At best, treatment can be two years to three. Coordination is required between family dentist, orthodontist and oral surgeon for a good result. It is a major undertaking but worth it.

      On the other hand, you may not need surgery. A consultation will give you the information needed.

      Thanks for the question.

  28. My orthodontist told me that on my next visit i will get my final wires and get rubberbands, what does that mean?

    1. Dear Tabitha,

      Final wires, to me means, that they are the last wires that your orthodontist will use. We work from thin wires to thick wires over time. The last wires we use are thick so that the bracket will move the teeth where they should be. We place a lot of bends in the final wires. I think that is what your orthodontist meant. Rubber bands are used to move whole segments of teeth.

      Thanks for the questions.

    1. Dear Tae,

      After a patient stops their thumb or finger habit, I have them wear the thumb crib (guard) for three months. Usually after three months of not sucking their thumb or finger, their habit is broken.

      Thanks for the question.

  29. Hello,

    I recently got elastics in a sort of upside-down v shape. I’m a little upset because my front teeth look like they’re being pulled down, and my smile is much gummier than it used to be. I can’t talk to my orthodontist for a few days, but I don’t want my smile getting any worse, so do you think I could stop wearing the elastics until I’ve talked to him? Will my teeth move back if I do?

    Thank you,

    1. Ave,

      I don’t like suggesting changes to the instructions given to a patient by their orthodontist. If you stop wearing your elastics, you should see some relapse. Talk to your orthodontist soon to find out what he wants you to do.

      Thanks for the questions.

      1. Thank you for answering my questions, and I’m sorry for asking another one, but I was wondering if the vertical movement from the elastics could be reversed. So if the elastics really are moving my teeth in a negative way, would my orthodontist would be able to pull them up again?

        Thank you so much.

        1. In severe cases where the patient shows a lot of gum tissue when smiling, it is called vertical maxillary excess (VME). VME can be changed by temporary anchorage devices (TADs), high pull headgear or surgery.

          Explain to your orthodontist your concerns about how the aesthetics has changed since you started wearing elastics. To answer your question, I believe the movement can be reversed.

  30. Dear Dr. Thompson,

    First of all, thank you for your time in answering my question! I am getting my braces off tomorrow (YAY!). After I get my bottom braces off, next month, how soon after can I use whitening strips? I want to have nice, white teeth! Should I wait after getting my braces (both top and bottom) off? If so, why?

    1. Dear Elysia,

      If you are using whitening strips for a short time, like a half hour, then you could start after your braces are removed. What you don’t want to do is not wear your retainers. Your teeth will try to move the most right after braces are removed so you need to wear them full time.

      Thanks for the question.

  31. Dear Dr. Thompson

    I have a tooth grown in the root of my mouth just behind my 2 front teeth. I want to have this removed but scared of what’s ahead. When I talk I feel my tongue touching the tooth which I have got used to since I was a kid.

    Would having this removed hurt or be painful?

    Thanks, Dean.

    1. Dear Dean,

      What you are describing is a mesiodens. A mesiodens is an extra tooth usually in the upper midline that can erupt around the central incisors. Since, yours has erupted, it should be easy to remove. This is done with local anesthetic and is considered a simple extraction. Talk with your family dentist about its removal.

      Thanks for the question.

      1. Thanks for the reply.

        How long would a tooth like this take to be removed? And also, under a local anesthetic would I feel much pain?

  32. I went to the dr about my braces I still have a little more space to close. I now have a power chain on my front teeth but no wire. Is it ok to have no wire for a week? I get them off in a week and just want to know it cool to have no wire!?

    1. Hi Colin,

      I some situations, I have used a power chain without a wire, mainly in the posterior region.

      Thanks for the question.

  33. Hello,

    My 13 month old has been sucking his thumb since he was about 4 months. Idk how to make him stop ive tried aloe Vera garlic and bitter nail polish and nothing. His doctor says its ok because he’s still little but I can see his upper front teeth moving in a V angle. Should I take him to a dentist already? Thank you!

    1. Hi,

      I’d try to get him to switch to a pacifier first. He’s too young, right now, to try to stop the thumb habit with a thumb crib. Go ahead and get a consult with an orthodontist or your family dentist. We do want to stop the thumb sucking as soon as possible. The earliest, I would try a thumb crib, is at age two.

      Thanks for the question.

  34. Hi, I was given twin blocks around 4-5 weeks ago and I have an appointment in a couple of days, and I have been barely wearing them. They are not uncomfortable or hurting in any way, they just annoy me deeply. I put them in for school at around 7:30am and wear them until around 12:00pm-ish, eat my lunch, and then I put them back in until around 4:00pm, and usually take them out when I get home. I often do not wear them at all on weekends. I think its because they are non-fixed braces so I know that I can take them out whenever I want to- apart from in class. Please, do you have any tips for me?

    PS. Also, the clear blocks are starting to get (I think its called calculus) on it, since I only have tomorrow to get rid of that, do you have any suggestions please?

    Thank you, Ellie.

    1. Hello,

      As with any removable appliance, compliance is an issue. I find that once a patient understands why they have to wear the appliance, the better they are at wearing them. In your case, your lower jaw needs to grow. A twin block appliance advances the lower jaw and makes it grow. The more that you wear it, the faster your jaw will grow and then you won’t have to wear it. You need to wear it the amount your orthodontist prescribed. If it is full time, then wear it full time. I see changes in growth after three months. Most of my patients will wear a growth enhancing appliance for a year.

      To prevent calculus from forming, scrub and rinse the saliva off every time you remove it, if you are going to go without it for a while. The calculus is dried saliva. Once calculus forms, you can only remove it by scraping it off.

      Thanks for the questions.

  35. Hi, I had braces around 2 or 3 years ago, and I was then given retainers to wear. Though I initially wore them regularly I haven’t worn them for a long time recently. Over the last few days in the morning when I wake up I have experienced my jaw sort of ‘locking’ where when I try to open it wide there is pain in my jaw and I am unable to open it very wide at all. After about 30 mins it ends up fixing back into place. Could this be to do with my retainer? If I wear my retainer again could this help the situation??

    Thank you so much!

    1. Hi,

      Locking of the menicus of the temporomandibular joint is usually due to the patient bruxism or clenching of the jaws while sleeping. This increasing muscle tension and dislocates the menicus forward out of position. That is why you hear a pop or a click when you open and close your mouth. Some patients will clench also during the day.

      During waking hours, there should be 1-2 mm of space between your upper and lower jaw at all times. The only time your teeth should come together is when you swallow. Even when you chew food your teeth do not come together. So, if you find that you are clenching during the day, don’t. Separate your teeth.

      If you think that you grind or clench at night, ask your family dentist or orthodontist to make you a maxillary hard acrylic splint. The splint is worn while sleeping. It opens the bite to relax the muscles and allows you to grind away on the plastic and not your teeth. The splint usually relaxes the muscles enough for the locking to stop, but not the clicking.

      Finally, massage the muscles around the joint. This may release muscle tension and help the joint. You can wear your retainer. It may help the TMJ symptoms.

      Thanks for the question.

  36. I recently read your article on chewing gum with braces, but I have been doing that forever! What should I do besides stop chewing gum?

    1. Hello,

      Chewing gum is not good long term for braces or your temporomandibular joint. You can overwork your TMJ just like any joint. My advice is to stop chewing gum. If you can’t stop cold turkey, then wean yourself off. Start each week with only chewing “x” number of hours or so many sticks per day. However you do it, stop chewing. Your orthodontic treatment will go smoother and you will get a better result.

      Thanks for the question.

  37. Only 4 of my front teeth are an underbite but there is no space between them and my bottom teeth so do I have to have surgery for that? And if I don’t how much would the braces without surgery cost?

    1. Hello,

      The majority of the time, an underbite is corrected without surgery using braces and rubber bands. Orthognathic surgery is indicated if the upper and lower jaws are way off from each other. The cost of braces varies from orthodontist to orthodontist and there is not a set nationwide fee. You need to have a consultation for definite answers.

      Thank you for your questions.

  38. Hello,
    I’ve seen some frustration lately and cannot get an answer. Maybe you can help. As I try to get my teenage daughter in for a consultation on braces, I am learning that orthodontists can have several offices. In the dental office I frequent, the orthodontist is only there three times a month and travels between his offices all over. This may be great for him, but is terrible for his patients as we cannot see him for months as he is booked up fast, but also, in the event of an emergency, he is unavailable. After telling them that the Dr.’s schedule has lost them a family of patients, I called around and get the same story from several other offices. Some had employed several orthodontists so there would be more Drs available, but there was even complication there. “This Dr. only works every other Tuesday, and this one works every Wed. We want you to see this Dr., but you can’t since you can only come Thursdays.”
    My question is why is this the norm? Why will they not tell me why? Why do orthodontists not have an office they work in daily like most other doctors??
    Thank you!

    1. Hi,

      You ask a very good question. This answer has multiple facets. First, I personally have never had a multiple location practice so I have a certain point of view. I own one office location and work there four days a week. Having multiple offices to me just increases the overhead and is not as profitable as having one location. For proper, attentive service, I believe patients will travel to my one office location.

      On the other hand, orthodontists know that having multiple locations increases their chances of obtaining a patient because parents and patients would want to go to an office that is close, even though the office is open for just a few days. This is seen in larger cities where there is a lot of competition. Multiple offices are also possible because orthodontists can see a large volume of patients in one day.

      Some orthodontists will rent out office space from a family dentist in rural areas to provide a service in that area. The orthodontist has low overhead costs because the office was built by the family dentist, the equipment is already there and maintained by them. The family dentist usually uses their office only four days a week and makes money from renting one or two days to the orthodontist.

      So there are, in my humble opinion, multiple reasons why some orthodontists have multiple office locations. I do not believe that nationwide it is the norm for multiple locations, but I have not done the research. You should be able to find an orthodontist that you can work with to provide treatment for your daughter. Ask the person over the phone about office hours and if there are multiple doctors working in the office and how patient continuity of care is handled. Make sure you work with an orthodontist who is a member of the American Association of Orthodontists. I hope I have helped.

      Thanks for the questions.

    1. Hi Nicole,

      When my patients wear a headgear, they usually wear it for one year. If you are really good and wear it well, your orthodontist may stop it sooner. Ask your orthodontist about how long they think you need to wear your headgear.

      Thanks for the question.

  39. Dear Dr.Thompson,

    I just got my new retainer in yesterday, my front tooth is causing me much pain if I barely touch it. I tried to eat food once, and will not dare to do it again. what should I do?


    1. Hi,

      Change to soft foods while this is worked out. Your orthodontist may be trying to move your tooth with the retainer. If that is the case, just wait it out and the soreness will lessen. If your orthodontist is not trying to move that front tooth, then the retainer may be too tight. Call your orthodontist and ask them if you need to be seen for an adjustment.

      Thanks for the question.

  40. Hi, I am 34 and am missing all 4 1st yr molars. I have had a nance arch for 5 days and was wondering if it is absolutely necessary, because it is causing a bruised pain to my tongue. I can barely swallow because of the pain when my tongue presses against it. I called my Ortho and was told i’ll get used to it. I want it removed so badly. Please give advice.

    1. Dear Gina,

      A nance arch should not bother your tongue. It may take some time to get used to it, about a week, but you shouldn’t have a lot of pain when swallowing. The nance arch has a piece of plastic against the palate that may be rough. That can be fixed by removing the nance and polishing it. Or the nance arch possibly needs remade. At any rate, after a week your tongue should be getting better. Continue to talk to your orthodontist until the issue is resolved. Your orthodontist needs the nance for a reason so try to keep it in.

      Thanks for the question.

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