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122 thoughts on “Ask A Question

  1. Hello! So, I have an impacted canine and I plan to get exposure surgery and the braces to pull that tooth down. I haven’t been to the orthodontist recently to ask this question but I was wondering if I would have to wear a retainer after I get the braces off. Thanks 🙂

    1. Hi. Yes, you need to wear a retainer after your braces are removed. Right after your braces are removed, your teeth are slightly mobile and need to stabilize. The retainers help keep your teeth in their new positions.

      1. What if I never wore braces before my top teeth were always straight but not my bottom teeth. Would it be ok to get a retainer instead of braces to straighten my bottom row?

        1. Hi,
          A patient with just lower crowding may be able to use a retainer, Invisalign or braces to correct the lower teeth.

  2. Hi i would like to know what is TP Tubes? as that is what they are using for my braces thats being applied tomorrow but i cant find any answers of what they are or look like

    1. Hello. Every office uses abbreviations. “TP tubes” is not a common one that I know. The only thing that comes to my mind is TransPalatal bar tubes. This is a tube placed on the lingual side of a upper molar band for a removable transpalatal bar. A transpalatal bar is used to create an anchor unit with the posterior teeth. It’s then used to help retract upper anterior teeth. That’s my best guess.

  3. Hello,
    So I currently have ceramic braces on my top and bottom teeth. I have had them for a little over a year now for minor crowding and “overjet” or “flair” of my upper teeth as my orthodontist says. At the beginning of treatment she said possible extractions in the future but most likely not. A year later this morning at my tightening she takes an x-ray and say that I need extractions in order to pull the teeth back. I am extremely hesitant to extract and asked her if there is any other option and she said that they could file some enamel to make a little room but in order to get the teeth to be in it’s perfect position 4 extractions would be needed. My question is if it’s correct for her to be pushing the solution of doing extractions? 4 extractions for a bit of top teeth flair seems a bit extreme. I’m not going for absolutely perfect teeth. I am honestly satisfied with what they look like now but am intimidated by my ortho. If you are able to give me any input I would appreciate it!

    1. Hi. You need to ask your orthodontist to give you enough information to make an informed decision about your treatment. We call this informed consent. If your orthodontist thinks that four extractions is the best course of treatment, she should be able to tell you why to the extent that you can decide if it is best for you. If you are satisfied with the positions of your teeth now, and they will be stable, you could ask your orthodontist to finish treatment without the extractions. The person that is in charge of your treatment is you. You have the control over what treatment you consent to.

  4. Class I malocclusion with poor arch coordination. That’s what I found out at my consult the other day, I was told have braces for 18 to 22 months. Would I need an expander to help the arch issue or any other appliances? I didn’t get the full treatment details from the ortho but she said the braces and elastics for sure, but nothing about appliances or could that come after.

        1. I’m sorry, I miss read your question. If you have a posterior cross bite, an expander may be indicated. Most usually, the expander is done first and then the braces after that. I hope that helps.

  5. Ive had braces for almost two years now and I still have one baby tooth in the upper left back side of my mouth. Just in this mouth I’ve noticed that my tooth has started to wiggle and yesterday the back side of my tooth is out of my gums. I can feel that it’s about to come out and I want to pull it out but I have a bracket on that tooth and I’m not able to. What should I do? Very urgent I need a respond ASAP

    1. If the primary tooth comes completely loose from your gum tissue, you can call your orthodontist’s emergency number and see if they want to see you at the office. In some cases, your orthodontist may suggest that you clip the wire yourself to remove the baby tooth. Otherwise, if the tooth is not loose and it’s just mobile, call the office when they open for instructions.

  6. Hi,

    I’ve had braces for 18mths. My ortho thinks they are ready to come off. However, my lower 1st molars on both sides have been rotated out of alignement during my extraction space closing & got worse when I had class 2 elastics. My molars were straight before braces.

    My ortho tells me that there is nothing he can do to derotate them & that the cusps of my 1st molars lines up well with the 2nd molars. Can someone tell me if it’s true? The misalignment is obvious & I don’t want to finish like this.

    1. Hi. You could ask your family dentist their opinion about the molars. Or you could get a second opinion from another orthodontist in your area. I think if the molars rotated more when you wore elastics, one should be able to de-rotate them.

  7. Hello 🙂 I have had a permanent fixed retainer for some time now (in combination with my Hawley). I have found that the wire flexes slightly when pushed on, but seems securely bonded and properly secured. Is it normal for the wire to flex slightly when I push on it with my fingers? Or has it stretched or deformed? Is this to accomodate tooth movements when biting? I have had no movement from my teeth.

    1. Hi. Yes, it is normal for the wire to flex a little bit. As long as the wire is secure and your teeth have not moved, it’s doing good.

  8. Hi, it’s my second day with braces!the doctor put some white ceramic like things on two Of my bottom teeths!its very werid and when I can’t close my teeth when it hits my upper teeth it causes so much and it’s annoying in general I can’t stop feeling it with my tongue? I thought maybe its too high?or are these feelings normal

    1. Hi. The white ceramic things are called bite turbos. They are suppose to be in the way of your bite and to separate your teeth so that the lower teeth can move better. It takes a little time to get use to the bite turbos, also called bite ramps, and your experiences are normal.

    1. Hi. For me I use bird beak pliers, three prong pliers and wire cutters most of the time for making and adjusting removable appliances. Some people like to use Jarabak, arch forming and optical pliers too, as well as arch forming pliers. It just depends on what pliers you like to use.

  9. hi, I lost my original retainer and it cost around $400 for a replacement from my orthodontist. I have found a website online that sells replacement retainers for less than half the cost. They send you the impression kit and then create your retainer. Is this a reliable option?


    1. Hello. The State Board of Dental Examiners are in charge of protecting the public for dental treatment in each respective state. They do this be requiring a license to practice dentistry in their state and they are issued to people who have met the educational requirements. When a dentist needs an appliance (ie medical device) made, a prescription is sent to the dental lab to make the device. The dental lab uses materials that are FDA approved for patient usage and the dentist provides the lab with the models they need for fabrication. So using a company that makes retainers over the internet, you are by-passing safeguards that protect you, the public. You don’t know what materials they are using and that company may be using grey market dental materials that come from overseas that are not regulated, just to save costs.

      Also, if there is distortion in your retainer, who is responsible in determining where the distortion occurred? Was it in the impression that you took or in their fabrication. Will you be responsible for the cost to take another impression? Finally, the fit of a retainer cannot be determined by the lay public. An ill fitted retainer can move teeth or damage your gum tissue. Your best option is to continue with your orthodontist and let them fit you with a new retainer. So, to answer your question, no, it is not a reliable option and I feel that the state boards will clamp down on companies that offer these services.

  10. How long do teeth need to stay in position before getting braces off? I’ve had braces for 4 years and the only thing wrong with them now is my first molars aren’t aligned, if I get them off early will those teeth disrupt the others or will my retainer keep my teeth in place. I need them off asap

    1. Hi, Your retainer will keep your teeth in good positions while the periodontal ligament goes back to it’s pre-braces width. Talk to your orthodontist about taking them off.

  11. Hello, I’m wearing my retainer everyday but my wisdom teeth are coming in. Two of them are basically fully grown in and straight and one of them is like 1/4th of the way in but its coming in crooked. I can’t get an appointment until in about a month and I am afraid that something will go wrong by then. I thought i had more time to get them removed since I’m only 17 but apparently not. The wisdom tooth that is growing in crooked is probably going to try to push on my other teeth since i don’t have enough room for it. I would ask my orthodontist but he moved away. Do you think wearing my hawley retainer will prevent my wisdom tooth from moving my other teeth?

    Also, another question, I stopped wearing my clear retainer about 6 months after treatment and only started to wear my wire one at night (which is what my orthodontist said to do), but i tried putting in my clear one again because I noticed a veryyy tiny, not very noticeable gap starting to come back between my front teeth. Like I can get a little bit of water out through it which i wasn’t able to do before so I started to worry it would grow but my clear retainer is really hard to put in and doesn’t fit very well. Do you think I should keep trying to wear it or just stick with my wire one at night?

    1. Hi, Until you can meet with your orthodntist, try to wear your clear retainers during the day and your hawley (wire) retainers at night time. That is probably what your orthodontist wanted you to do. Wearing your retainers will lessen the effects of the 3rd molars erupting.

  12. Hello Doctor, My just turned 5 year old has been diagnosed with a posterior crossbite. He has a high, narrow palate and low tongue position. One avenue of advice suggests use of myofunctional therapy, myobrace and possible Planas direct tracks (I have little hope of his compliance with the first two). Another avenue says he’s too young and just to wait. When should I act and what do you see as the most likely treatment trajectory? Many thanks.

    1. Hi. I would not start treatment until the 1st molars were completely erupted. At age 5, they are probably not in far enough. Once they are in, I would use a rapid palatal expander (RPE), attached to the 1st molars, to expand the palate and get rid of the posterior crossbite.

  13. I am gonna have my wisdom teeth removed on Tuesday and then about a week or 2 later i’m getting braces for both my top and bottom teeth. So, I’m wondering how long do you need the separators in your teeth and do you have it only until you get the surgery for the wisdom teeth or do you have it on when you have braces too, and since i have crooked teeth how long does it take normally to get it straightened out?

    1. Hi. Separators are used to create space between the teeth so that a band can be placed on the tooth. The separators are usually placed one week before the bands are seated. It takes about two years to correct a malocclusion.

  14. Hi, my orthodontist who did my top set of braces left out the 2 molars at the back of each side. I didn’t think this was a problem due to only my front teeth being out of place. However, when I got my bottom set done, the brackets were placed on by someone else who decided to fit the brackets on all the teeth including the ones the other orthodontist missed out. She was adamant I needed all brackets on. Recently, a bracket at the back of my mouth (bottom set) fell off and I went back to fix it. The first orthodontist who tightens my braces also, said it wasn’t “essential”. Again the bottom back teeth do not seem to be out of place but I wanted a second opinion. Should I tell him to place the bracket back on at my next appointment?

    1. Hi. Every orthodontist does treatment differently. Some get a hold of the 2nd molars, and some do not. In some cases the 2nd molars do not need to be moved and hence, don’t need brackets or bands. It’s a judgement call for each orthodontist. Sounds like they don’t need to be banded.

  15. i’m getting my braces off in 6 weeks, i have a midline shift that’s been corrected with elastics, however i notice when i don’t wear them all the time the lower midline shifts off centre. I am going to wear my elastics all the time so when i yet my braces off my midline is straight, my concern is when i get my braces off will my midline shift back to its original position because i won’t be wearing elastics anymore?

    1. Hi. Chances are when you get your braces off, your lower midline will shift a little but not back to it’s original position. This is called relapse and is hard to keep from occurring.

  16. I have braces for 4 days now and I have an transparent and sticky pellicle in my mouth that makes difficult for me to wash them properly because it’s hard to remove it due its texture. What is it and what can I use against it?

    1. Hi. The dental pellicle is a protein layer that forms on the surface of the enamel by selective binding of glycoproteins from saliva. It is always there and is briefly gone from the surface of the enamel after your teeth are cleaned. It will reform quickly and you really can’t see it. What you may be seeing in your mouth is a combination of plaque and saliva. The best way to remove this film is by using an electric toothbrush. Also, some patients have ropey thick saliva which adds to the formation of this film.

  17. Hi there,
    I went to the dentist recently and was told that I have a slight overbite which is why at 25, I still have mamelons.
    I am thinking of getting Invisalign which would correct this and was curious if the mamelons would slowly disappear once the Invisalign treatment was complete?

    1. Hello. After treatment, your anterior relationships should be better and the mamelons would start to wear down. This could take many years. It is very slow. You could also ask your orthodontist to remove the mamelons before you start orthodontic treatment. That way the incisors could be placed in their best positions during treatment.

  18. I’ve been wearing my elastics in a triangle on both side for the last 4 months and i’ve had no problems until recently. When i put the elastic on the left side it goes on normal and stays on. But when i do the same on the right side it goes on correctly but as soon as i close my mouth it snaps off. I was wondering is there a reason for this/should I just wear them in my left side?

    1. Hello. One of two things could be happening. If the elastics slides off the hook, then there is adhesive between the hook and the enamel that needs to be removed. If the elastic is breaking, there is a sharp edge of adhesive around the hook that needs to be smoothed out. Go see your orthodontist for a visit to have it repaired.

  19. My son, who recently turned 11 years old, had seen the same pediatric dentist since he was a toddler, and we think that he is great. Early on, he recognized that my son’s four lower primary molars were ankylosed. He has kept and eye on them, and at his last six-month appointment, which was in late October, he said that it was time to have them extracted by an oral surgeon due to the fact that his bite-wings showed signs of the permanent molars beginning to tip. He said that all four molars showed no signs of being even the tiniest bit loose, and when I asked if we could wait bit longer (I was thinking that we would cross this bridge at age 12.5), he said that he would not wait.

    Due to high demand for the oral surgeon and the holidays, we were not able to see him for a consultation until last week, which is three months after we got the referral from our dentist. In these three months, both of the first primary molars have become loose: one very wiggly and one with just a hint of play. The consultation with the oral surgeon went well, but he just goes by the diagnosis/order written by the dentist. So, for the purposes of the procedure he’ll just assume all four are ankylosed and surgically remove all four as the dentist requested.

    I put a call into our pediatric dentist to see if we should come back in for a reassessment and new x-rays before going through with the procedure with the oral surgeon. Like all surgeries, there are risks and costs involved that I would like to avoid unless it is absolutely necessary.

    The dentist said that the choice was ours. We can wait three months until our next scheduled cleaning to reassess the situation, or we can proceed with the extractions. When I asked about space maintainers if we decided to proceed, he said that they would not be needed, as he expected the adult teeth to come in quickly once the baby teeth were removed.

    So, here is the crux of my question. How much harm could be done by waiting three months? How much tipping can occur in three months time if the ankylosed teeth are left as-is?

    When I visually look at his teeth, the permanent molars are not obstructing the baby molars. In addition, I have to wonder if having the submerged baby molars serving as a place holder is better than nothing at all, as if we were to proceed with the extractions, space maintainers would not be part of the equation.

    Thanks for taking the time to read my questions! Your website is a great resource!

    1. Hello, Since the ankylosis was diagnosed at a young age on your son, the distortion of the growth of the mandible has been occurring over a long period of time. As the alveolar bone increases in height, the ankylosed teeth will stay in the same position inhibiting the growth of the bone. I say this without seeing a photograph of the teeth. Tipping of the molars are not the biggest issue. Some of the problems that can occur the ankylosed teeth are posterior open bites, ectopic eruption of the premolars and distorted growth of the mandible or maxilla. On the other hand, your pediatric dentist is concerned about this issue and wants the ankylosed teeth extracted so that natural eruption of permanent teeth will occur smoothly and these other problems are lessened or avoided. IMHO, waiting a little longer will probably not create any more of a problem that can’t be corrected with orthodontic treatment.

  20. I’m afraid to get bottom braces because I have a gap in my bottom teeth from having one removerd (you can’t see it when I smile but I know it’s there). I want bottom braces but all my bottom teeth are in the right place and I don’t want them all to be moved around to fill the space because then they will look weird, is there anyway my orthodontist can do something to close the gap but not re arrange my neat teeth also my mother said I should get braces because what if my teeth gap themselves over the years because of the missing tooth gap? Could this happen because I had the tooth removed 1 year ago and all my teeth haven’t moved? Thank you

    1. Hi, When a tooth is extracted it is best to replace the space with a false tooth, an implant or a bridge. This keeps the other teeth from moving slightly into that space over time. You need to consult with your family dentist and if they think you need orthodontic treatment, they can refer you to the orthodontist. You may not need braces and the space may be handled by your family dentist.

  21. I’ve got braces and in a week I’m getting them taken off. I’ve noticed a slight gap between my two front teeth, only noticeable if you look close enough. I’m worried I’m going to have to wait longer or they’ll take them off and I’ll be left with a gap. Do you have any information on what will happen? Will the retainer I recieve afterwards close it?

    1. Hi. If the space is really, really small, a hawley retainer or an essix retainer can close the space. Before your braces are removed, discuss this small space with your orthodontist. They may want to close it before removing your braces.

  22. Hello,
    I have permanent metal retainers on my top and bottom teeth and it’s been just over 10 years since I got my braces off. I had the top retainer fixed about a month ago because a piece broke off of the cement, but since then my mouth hasn`t felt the same level of comfort it did before I needed it fixed. When I put my bite together I can feel my bottom teeth touch the top metal retainer, should it be doing that? I’m worried its going to wear my bottom teeth down over time.
    Thank you

    1. Hi. It’s ok to have the lower incisors hit the permanent upper fixed retainer. It will not wear down the lower enamel. You may want to have the upper fixed retainer removed and go to a removable retainer if you still feel uncomfortable.

  23. hello, i had braces years ago and slowly quit wearing retainers after about 7 years (stupid i know). Anyways i started wearing them again lately due to my teeth shifting some. They are really tight and somewhat painful at first. after a week wearing them i have one tooth that moves ever so lightly when i press on it. Is this normal? i don’t know if it matters but i am also pregnant.

    1. Hi, As you wear your retainer, if it is placing pressure on a tooth, the tooth will become mobile. After the tooth gets to the position the retainer is placing it, it should firm up. If it doesn’t firm up, go see your orthodontist. They may want to do interproximal reduction to eliminate some of the pressure that is trying to move the tooth.

    1. Hello,
      Enamel is made up of mainly a crystalline calcium phosphate. If a patient doesn’t brush away the plaque on a daily basis from around the brackets, the plaque will cause decalcification of the enamel. This usually occurs on the edge of the bracket and not underneath the bracket and looks like a white spot. Once the outside layer of weakened enamel brakes through to the decalcification, a cavity forms. This cavity will need to be restored by your family dentist or it will just get larger and larger.

  24. I have a permanent retainer on my bottom teeth that I’ve had for about 11 years. The wire was broken about 6 years ago and was glued back. Just today the same wire spot that was broken has come unglued and poking my mouth and tongue. I don’t live in the same town anymore as my orthodontist and was wondering what steps should I take. Would an orthodontist in my new town be apt to fix it or should I ask for it to be removed? Should I ask my dentist about removing it? I literally went to my dentist a couple days ago.

    1. Hi,
      You need to talk to a new local orthodontist to guide you in this matter. They may suggest to have it removed and have a removable retainer made.

  25. Hello doc, I know it’s 2019 and I’m getting my braces off in 2-3 months. I’ve had so many brackets and forays springs Brocken especially power chains during my treatment. My power chains keep ripping and detaching from my back bottom molars. And since I keep coming back to fix them I feel embarrassed and my school is being affected due to appt. My chains detached in my right back molar only not my left is it okay if my chain isn’t connected to one tooth. Will it cause a relapse?

    1. Hi,
      Broken brackets, wire and power chain can lengthen your treatment time and can allow relapse to occur. Call your orthodontist to see if it is critical to come back in to get the power chain repaired.

  26. I recently got new clear retainers from a new dental clinic because I misplaced my old hawley retainers. However I noticed that the new top retainer doesn’t cover the 2nd molars. I spoke to the dental clinic and I was told the reason the last molars were not included is because they are smaller and the retainer would not be able to clip on tight to the teeth. It would become floppy in the back. Also I was told that 2nd molars do not move or shift like other teeth. Is this true? If I wear this upper retainer, wouldn’t the uncovered teeth drift towards the opposing teeth which may cause a bite issue? I am 44 years old and had braces 27 years ago. Should I go back to the dental clinic and ask them to remake the upper retainer or there is no need for concern with the retainer not covering the 2nd molars? Thank-you in advance for your advice and reply.

    1. Hi,
      It is best to have a clear retainer cover all or a portion of the last terminal molar. This will keep the molar from hyper eruption which can cause a problem with your occlusion. This happens mainly with growing patients and not so much in adults but I’d have it cover a part of the terminal tooth to be on the safe side.

  27. Hi,
    I was wondering if a wire that is loose on the bottom in the back could be left until next ortho appointment or will waiting effect treatment time? Is a loose back wire that important?

    1. Hi,
      It is possible that a loose wire allow movement of the posterior molar or cause hyper-eruption. I advised that you call your orthodontist and see if they want to see you before your regular appointment for a repair.

    1. Hi. That depends on how busy the orthodontist is and their operating procedures. I would say that most orthodontists like to look at their models when they develop their treatment plan, so a few days at a minimum.

  28. I started using a rubber band on only my left side, from the last bracket on the molar to my canine. Why did my ortho have me use them on just 1 side? Also, she told me that my teeth are going to begin to space out (my teeth were already together at the top) Why with the new arch wire and elastic are my teeth beginning to space?

    1. Hi. The reason your orthodontist wants elastics on one side only is because your lower jaw is growing asymmetrically and the elastic will make the left side grow more to even both sides up. Also, as you wear your elastics, if the front six teeth are not chained together with an elastic power chain, the elastic will move your teeth from the cuspid posterior causing a gap to show up between the cuspid and lateral incisor.

  29. I have gone to the orthodontist and they have said that the shape of my jaw is not right. They say this because when I bite, my middle teeth do not touch on either side. However, the teeth right at the back touch and the teeth right at the front also touch. However all the other teeth in the middle – most of the molar teeth and the canines – do not touch. Is this actually a problem? My orthodontist is trying to get me to have surgery at the moment. I do not have problem eating food as the teeth get close enough together for me to crush the food.
    Is this a problem for me?

    1. Hi Ali, It is hard for me to say, since I have limited information, whether this posterior open bite or adverse skeletal growth can be a long term problem. Since your orthodontist is suggesting orthognathic surgery, I’d suggest that your jaw growth is probably a problem that needs to be addressed. If you don’t understand the consequences of not going through treatment, talk to your orthodontist again and ask if they can explain why treatment is recommended and what could happen if you don’t go through with treatment.

  30. I recently decided to do Invisalign due to some slight crowding of bottom teeth. My dentist also recommended to fix my bite at the same time as my top teeth did not quite come over my bottom teeth. My top teeth were completely straight. During the treatment during aligner 6 or 7 of 11, I noticed that one of my front teeth was extruding a bit below the other one. I am now needing to do additional molds and get additional aligners to fix the vertical alignment of my front teeth. Can you remark on why the alignment did not go as expected?

    1. Hello. Active aligner treatment is different than using braces. With braces, each tooth is connected to the wire and adverse movements are limited. With aligners, teeth can shift vertically in undesirable movements. This happens when adjacent forces are placed on a tooth that extrudes or intrudes it. When treatment planning the movements from beginning to the end, the orthodontist cannot measure all these forces and unwanted movements can be built into the treatment plan and can occur. These adverse movements are usually countered by placing attachments on the teeth in places where we think we need more control over the tooth movement. These unwanted movements can happen frequently with the maxillary lateral incisors. You have to remember that with aligner therapy, it is an educated guess from the beginning point to where the teeth end up at the last aligner. This is why the orthodontist will do refinements as a patient goes through treatment to have new aligners made to get the result that they want at the end.

  31. Hello!

    I had braces for 3 years as a teen and only wore my retainers for two years after and due to my impacted wisdom teeth and that my teeth shifted alot. I’m 33 years old and my dentist is urging me to get ortho treatment due to severe crowding. Either invisalign or braces. I got a consultation for both and they both said my case is complicated because my lateral incisor tooth is an implant so they have to move the teeth around the implant. I still have a baby bicuspid tooth and the adult tooth is still up inside my gum. It never came out. The dentists say theres a chance that the baby tooth could come out during the treatment. I really don’t feel comfortable getting traditional braces again and really would prefer invisalign. The dentist said he would do invisalign but he can’t guarantee results. I’m feeling very unsure of what to do.

    1. Hi, Since you have an impacted tooth, you need to use braces so that your orthodontist can protract the tooth into position. That cannot be done with invisalign. A bracket and chain are placed on the impacted tooth and every month pressure is placed on the tooth to bring it into position.

  32. I have braces, and at my orthodontist appointment yesterday I asked if they could do anything for my tooth gap, as the power chain hadn’t done anything in the last 4 months. I didn’t have a gap, but after getting braces I slowly developed one. They said they could speed the process up by tying a small elastic string thing around my 2 front brackets. They tied it around the brackets and then put a power chain over it. Within 3 hours, my tooth gap was gone. My teeth normally don’t move that quickly, and there is a lot of pain. I’m worried that the band may move my front teeth inward. Should I be worried?

    1. To add to my previous question, I think I could cut the string if I needed to. I’ve been debating it for the last day, but I’m scared that cutting it may make my teeth move in a way they aren’t supposed to. And I know that pain after a tightening is normal, but it hurts quite a bit more than is usual for me. I have pain sensitive teeth, too, so it’s probably worse than for an average patient anyways.

      1. Hi. It sounds like they are using an elastic thread and a power chain. I’d leave both alone since it is working. If you see your teeth moving in an adverse way, call you orthodontist for an appointment.

  33. Hello. When i was 24 i wore braces for 3 years. I’m now 44 and noticed a space appeared between my top front teeth it seems within a few a days. I brush twice daily and floss a few times a day. Can you please let me know what might have caused that to happen.

    1. Hi. When a space opens up in the upper anterior teeth, it could be a couple of situations. A median palatal cyst can cause movement of the teeth. It can be seen on a radiograph, but it is rare. Another reason would be an extraction of a tooth, which the teeth slowly shift into that space. Finally, the most common reason for a space to show up many years later is that the patient exhibits bruxism. They move their teeth subconsciously front to back or side to side, creating tooth movement and causing the space. This usually occurs during sleep and is due to stress. If that is the case, a hawley retainer will stop the space opening up more and may reverse the slight anterior protrusion. Consult your orthodontist.

  34. I wore braces for 2 years ending 5 years ago. I have ALWAYS worn my retainer at night. I just had my wisdom teeth removed this is the 4th day since removal QUESTION when can I start wearing my retainer at night again? will I lose all the work that the braces did for me ?? It is very sore yet I have the kind of retainer that goes up over my gums alittle and it ended at my last Moller not the wisdom area…do I have anything to worry about not wearing it this 4 days to a week

    1. Hi. IMHO, as soon as you are able, you should start wearing your retainers. Call your orthodontist and ask them if it is ok to start wearing the retainers again. If any teeth have moved, the retainer will move the teeth back into proper position.

  35. I had braces for about 2 years. I got them off about 4 years ago and I had gotten a permanent retainer on my bottom, but not one on the top. I wore my retainer until I lost it about a year and a half ago and now my lateral incisor is moving back up, just like before my braces. It’s only the one on my left. I don’t know if I should get Invisalign, cause my teeth are straight but the one tooth bothers me. I also don’t know if I should just get my top teeth shaved down a tiny bit just so the bottom of my teeth with be even.

    1. Hi. Yes, you probably may need both, Invisalign treatment and the enameloplasty. I’d have the enameloplasty done first and then evaluate for Invisalign. Invisalign offers different treatment programs. You may be a candidate for Invisalign Lite or Express 10. Consult with your orthodontist.

  36. Hi I was wondering what would happen if I went to my orthodontist appointment and I haven’t been wearing my retainers. Will they shout at me and what will they do? Thankyou

    1. Hi, your orthodontist will not shout at you. They will evaluate your situation and make recommendations, like a different type of retainer or treatment. They will probably just see if you can start wearing your retainers full time again so your teeth will move back into good positions.

  37. After removing my braces.and I went 6days without wearing my retainer waiting for it from the lab . Now my teeth moved from it’s place, will my teeth go back to where they were? And how long it takes to get back to its perfect position?

    1. Hi. It shouldn’t take very long for your retainers to start feeling comfortable. When the retainers feel passive, your teeth have moved back.

  38. I got the elastic bands put on my braces and I was curious on how the elastics move the jaw so I was researching it. I came across multiple sites that say not to double up on the elastics as it can damage the teeth roots. The thing is, my orthodontist (she’s not technically a certified orthodontist she’s a general dentist doing orthodontic work) put overlapping double triangular elastics in so two of my teeth have double elastics. (my mouth isn’t even that misaligned, maybe about a millimeter off center) My mouth hurts really bad and I can’t even really open it. Is this normal? And will the teeth with the double bands be damaged?

    1. Hi. When wearing elastics, your mouth will get sore. That is normal. No root damage will occur from wearing double elastics.

  39. I’m having problems with one of my wisdom tooth I’m thinking of getting it removed, will this affect my braces? Will my teeth move back into the space?

    1. Hello. You can have your 3rd molars removed at any time. They may knock some of the braces loose during the procedure, but that’s about it. Once, the 3rd molars are removed, the second molars may slightly move into that space.

  40. I recently got power chains and 4 elastic bands on my braces, and because I have a very low pain tolerance, the combination of the both of them was enough to make me cry with pain and almost entirely unable to eat. I decided not to wear my bands for about 3 days, but will be wearing them full-time until my next ortho appointment in about a month. How much will this affect my treatment plan? Is there anything I can ask my orthodontist for at my next appointment to reduce the pain (besides ibuprofen or tylenol)?

    1. Hi. You not wearing your elastics for three days, will not slow down your orthodontic process. At you next tell your orthodontist about your low tolerance to pain. They may change their sequence of wire changes or use different wire materials, like nickel titanium, to keep the pressures down.

  41. Hi I just recently had braces put on and bite plates on my bottom molar both side. But my top molar broke two weeks later. Can the bite plate make it break?

    1. Hi. Yes. If your bite plate is hitting your molar bracket hard everytime you close your mouth, it could knocked the bracket off.

  42. Hi. I am 35 and one of my front teeth is underlapping (right tooth underlaps the left one-slightly, like 20% maybe) is myobrace a good option? Btw, the rest of my teeth on both jaws are perfectly alighned

    1. Hi. Myobrace is like a toothpositioner. Myobrace works better in a growing child than in an adult aged patient. Since you are an adult, I would recommend active aligner treatment like Invisalign to move your teeth.

  43. Hi Joseph. I am using ceramic braces since last 4 months. due to my chewing habits, I loosened 5 brackets over the span of 2 months. My orthodontist removed these loosened brackets and the wire holding them saying that these won’t affect the treatment. These brackets which he removed were on my ride hand side on molars and premolars both up and down side. Will it affect my teeth alignment or is it a normal thing to do?

    1. Hi. Posterior teeth help move the anterior teeth. It is normal to place brackets or bands on posterior teeth. If bonded brackets are used on the molars and premolars, and they come off a lot, bands are then placed in those areas. Bands are harder to knock off and can take a lot of chewing forces before they come loose.

  44. My orthodontist used a clear cement adhesive with what I assume are metal brackets. My last visit, he forcefully tried to exchange the upper wire in which he popped the bracket off but did not replace it afterwards, I assume because I’m supposed to get them taken off within a month? A few days, maybe a week, after my appointment, I noticed there was an indent in my tooth that he broke the bracket off from. I’m now paranoid about it. Is it possible the cement pulled off a portion of tooth when he applied the force? And, although you cannot see the tooth yourself, is it a cavity even though I’m not feeling any pain or particular feelings from it?

    1. Hi. Our adhesive will not cause any damage to the enamel. The adhesive is made to create a mechanical bond with the enamel and not a chemical bond. It is made weak on purpose so it doesn’t effect the enamel. The indent in your tooth, may have been there from the very beginning when the tooth was formed and you just now noticed it. Another reason for an indentation in the enamel would be a cavity that formed right beside the adhesive while you had your braces and is now visible. Ask your orthodontist about the indentation to get a better idea why it is there and what needs to be done, if anything.

  45. Hello,
    I’m seeking advice on weather or not I should remove my permanent retainer on my bottom front row. I had braces when I was around 13 and am 28 now. The reason for my wanting to do this is due to an almost uncontrollable habbit of lip and cheek chewing/ biting that has caused my bottom row to shift/ angle to the left. This has caused a very uncomfortable bite (cross bite) My suspicion is that the bottom retainer is possibly magnifying the side effects of my habbit by pulling other teeth in that same direction that otherwise would have been uneffected.
    Also, would the permanent retainer lock this new position in place once my habbit is under control or act more like a spring and help pull them back in place?
    I should note that going to see an orthodontist or dentist is impossible for me in my current situation. I would be doing this myself. Any tips would be appreciated.

    Thanks hope to hear from you soon.

    1. Hi, I would suggest that you have the fixed retainer removed. It sounds like your teeth are shifting even with the fixed retainer in place. Do not remove it yourself. You will not be able to get the adhesive off of the lingual surfaces completely. You need to consult with an orthodontist for guidance and see if you need a removable retainer after the fixed retainer is removed.

  46. Hello Dr,
    So I currently have to get braces for a second time (The first I got them to straighten both rows of my teeth for about 1-2 years) because I have one tooth on my lower row that is smaller than the others. But then I thought, do I need to get braces to fix this? Because braces only shift my teeth and I don’t know if braces will lift this tooth up. Thank you.

    1. Hi. Braces can move teeth in all three dimensions including extrusion. The wire can be bent to lift the tooth. You may not need a second set of braces, Invisalign may be a treatment of choice. Talk about your options with your orthodontist.

  47. Hello, my son has had two consults with different orthodontists and both have different approaches to treatment and I’m unsure what’s the best option. He was a thumb sucker for many years, and has a fairly significant overbite and crooked teeth. The first doctor said it could be fixed with braces and elastics, the second said only an herbst appliance could help his overbite. Is there that much difference in the end result with the herbst? Thanks in advance for any advice!

    1. Hi. A thumb sucking habit has the follow effects on the upper and lower jaws and teeth. The upper jaw is narrow and the upper teeth are protruding. The lower jaw sets back and the lower incisor are tipped lingual. The very first thing that needs to be accomplished, is that the thumb habit is stopped. Once the habit is broken, natural forces will come into play and the upper incisors may retract a little and the lower jaw may come forward a little. Based on clinical observations of the facial profile, location of the jaws relative to one another, severity of the malocclusion and the age of your child, a treatment plan can be developed. If the lower jaw is highly retrusive, a growth enhancing device, like a herbst, a bionator or Forces appliances, can be used to enhance mandibular growth before braces. If the malocclusion is not severe, braces and elastics may be all that is needed. Every orthodontist will suggest tools that work well for them to get the results they are working towards.

  48. Hi, I am interested in becoming an Orthodontist. I was assigned a class project that requires me to ask an Orthodontist questions about their career. If you could answer these for me it would be greatly appreciated!

    1.) How is Math used in your career field?

    2.) What is the average annual salary?

    3.) What college courses did you have to take for your career?

    Thanks again!

    1. Hi Gabbi,
      Dentistry is a very nice career to consider. Keep pushing towards the goal of becoming a dentist. Once you have graduated dental school, you can then set your sites on becoming an orthodontist. Read my small article on “How to Become An Orthodontist”.

      Here are your answers to your questions:

      1. Math is used in a lot of areas in orthodontics. For example, we use fractions with elastics and measurements particularly in arch width assessment and cephalometric analysis. We use math all the time.
      2. An orthodontist’s income can vary a lot for many different reasons. Mainly, it is a six figure income. I don’t know what the average is.
      3. After high school graduation, you need to be enrolled in the College of Science and your major should be in Biology or Chemistry.

  49. Hello, I have just had a tooth extracted and a small fragment of the tooth snapped off and remains. I have an appointment to fix braces in 3 weeks is this fragment likely to be a problem/will I still be able to get the braces? Thanks very much

    1. Hi, A small primary root tip should be no problem. The root tip should work it’s way out of your gum tissue if it is small. Tell your orthodontist that the root tip was left. They should be able to place your braces.

  50. After several years of consistent wear, my son’s retainers broke. Is information kept on file to make new retainers from the original mold? Can a new set be made from the wires alone? How many years after braces are removed are retainers needed?

    1. Hello. Your orthodontist may store bonds off models or a computer scan of your son’s mouth. If your son is still growing (<25 years old), he would benefit from wearing retainers. Retainers cannot be made from the wires alone. If retainers are indicated, I'd suggest making new retainers from a new mold.

  51. Hello,
    I am 15 years old and have been through 2 sets of braces. I wore my retainers (mostly) everyday and every night. All of my 12 year old molars weren’t in all the way when I had my retainers. I recently got my wisdom teeth taken out, but some of my teeth already shifted. My overbite has come back, but not near as bad. I have an appointment scheduled to get my bottom 12 year old molars removed May 20th. Due to the shifting of the teeth, would I need braces again?

    1. HI. It is difficult for me to recommend whether you need treatment again based on limited information. Some patients have a higher rate of relapse even if the 3rd molars are removed. If you fall into this category and you have treatment with braces again, you may have to wear retainers for the rest of your life to keep them straight.

  52. Hello
    My name is Bailey and I am a current student at Youngstown State University. In my writing class, I am putting together a research paper on different types of orthodontic wires used in the industry. Part of the research requirement is to get a primary source of information regarding the topic I have chosen. If you have the time and are willing, I would really appreciate it if you could answer a few questions.
    **The assignment requires that I document the name of the person that provided me with the information gathered. If you do not wish for your name to be documented or to answer the questions at all, kindly disregard this email.**

    What type of wire do/did you use most often in patients (specifically stainless steel, nickel-titanium, etc.)?

    When treating patients, what qualities do you consider when choosing a wire for the period it will be used?

    Are there any types of wires that you have noticed usually cause pain/discomfort in patients?

    Thank you so much for your time!

    1. Hi. I use stainless steel and Nickel Titanium wires. I use Ni-Ti wires in the beginning of treatment to level, align and rotate teeth. They are a very gentle wires that places small forces and that keeps discomfort to a minimum. I use five different sizes of Ni-Ti wires. You cannot permanently deform a Ni-Ti wire. They have a preformed arch form and place continuous force on the teeth until they reach their given arch form. Therefore, they are working all the time.

      At the latter part of treatment I change to stainless wires so I can refine the occlusion by placing bends in the wires. I sometimes use four different sizes of stainless steel wires. They only move teeth for about two weeks. As far as wire selection, I evaluate bracket slot positions and tooth positions to determine what type and size of wires to use.

  53. I am undergoing mse and the expansion is over, the appliance is still in place and will stay put for another year. Can I undergo DJS in this timeframe?

  54. I have braces and my orthodontist keeps telling me to wear a left brand to fix my underbite, but it makes my midline worse, so I’m supposed to wear a band for the midline too, but then it makes my underbite worse, it’s like they are counteracting each other.

    1. Hello,

      If you have an underbite on the left hand side, you probably have a mandible that is growing asymmetrical, too much on the left side. When the lower left side grows too far forward, the lower midline is usually to the left of the upper midline. Sometimes this can be corrected with rubber band wear. The normal placement of elastics would be left side rubber band from the lower cuspid to the upper molar. this elastic tries to correct the underbite. Then the other elastic is usually worn from lower right cuspid to upper left cuspid. This elastic is used to help with the midlines. You need to wear your elastics as your orthodontist has directed you to. At your next appointment, talk with your orthodontist about how your elastics should be worn.

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