The success or otherwise of orthodontic treatment depends to a large extent on treatment plan. One of the most significant aspects of treatment plan is the extraction of permanent teeth to solve crowding problems. This could have severe implications for the effectiveness of orthodontic treatment as unnecessary removal of healthy permanent teeth to make room for the alignment of other teeth can result in prolonged treatment, jaw joint dysfunction problems and unsatisfactory aesthetic profile. Remember, teeth do not grow back! Extraction of healthy permanent teeth to correct crowding should be the last resort. In our practice, a large majority of the cases can be treated without extraction.
The length of active orthodontic treatment with braces can be as short as a few months to as long as three years, depending on the length of time between each adjustment, individual cases and co-operation of patients. In many cases, the willingness of patients to follow instructions such as wearing of elastics, keeping the teeth/appliances clean and avoidance of hard and sticky food, will avoid prolonged treatment. In our practice, we strive to achieve optimum results by utilizing the light wire technique and mini-braces. To this end, 90% of our cases are completed within 18 months.
The main reason many people are seeking orthodontic treatment is for appearance. Crooked teeth can affect a person's confidence in their everyday speech. In this new age of aesthetics, a set of white and straight teeth can certainly enhance the image and self esteem of a person. More importantly, well aligned teeth are easier to keep clean, lessen the incidence of decay and gum disease. In addition, correction of bad bites can prevent jaw joint problems and abnormal wear of teeth.
Some of the physical signs of orthodontic problems are:
At the first consultation, a preliminary examination of the teeth and their supporting tissues are carried out, followed by evaluation of the bite and jaw joint function. Patients are asked about their main concern regarding their teeth and various types of treatments are discussed. If patients are ready for treatment, impressions of the teeth will be taken and patient sent to have jaw X-rays taken by the radiologist (these X-rays are fully claimable from Medicare). Most patients will be given a second appointment to analyse the plaster casts of their teeth and the jaw profile X-ray.
At the second visit, results of the jaw X-ray will be discussed. They will be advised of detailed treatment plan, estimated treatment time and fees. If patients need dental attention such as restorations, scale/clean or extractions, they will be referred back to their dentists.
Six or seven is a good age for your child's first orthodontic examination. At this early age, abnormal jaw growth, lack of spaces for proper eruption of permanent teeth and dental interferences can be managed with removable plates, thus lessening the need for more severe measures at an older age. Early intervention of habits such as finger/lip/thumb sucking, chronic mouth breathing and tongue thrusting can also reduce the need for prolonged treatment or surgery in future.
Baby teeth play a very important role in the formative stages of the jaw. The first permanent teeth usually begin to erupt around the ages six to eight year. Around this time, the jaw begins to grow and spaces appear between the front baby teeth to prepare for the larger permanent teeth to appear. During this stage, permanent teeth might not erupt in the right positions, prompting the simple perception that adjacent baby teeth be removed to make room. This action must be taken with extreme caution as early extraction of baby teeth can affect jaw bone growth and causes more complicated crowding problems.
Braces or brackets connected by an archwire are the most common appliances used by orthodontist to straighten teeth. Periodic adjustment of these archwires puts pressure on the teeth to ensure proper positioning. At different stages of treatment, the patients may wear a headgear, elastics, a positioner or retainer.
As orthodontic treatments usually last around eighteen months to two years, some patients are concerned with showing braces on their teeth, either for work related reasons or otherwise. With the advent of dental technology, their concern can be addressed by having transparent or tooth-coloured braces and wires. More recently, there has been a trend towards dressing braces with colour rings. While there is no functional difference, braces with colour rings that can be changed every visit tend to attract young people who wish to be in tune with fashion or use different colours to make a statement about themselves.
Moving teeth initially will result in discomfort, depending on the pain threshold of patients. This usually lasts about 48 to 72 hours when the teeth become comfortable with the new positions. Each succeeding adjustment could also result in small discomfort although it tends to lessen as treatment progresses.
For full treatment cases with braces, appointments will be made after initial consultation for records taking(diagnostics casts and photographs). A one hour appointment for placement of brackets and wires will then be made. Once the braces are in place, visits are usually scheduled at four to six weekly intervals for adjustment of wires.
For removable plates/retainers, visits are usually scheduled at eight to twelve weekly intervals.
Treatment fees for Dr. Lee's patients vary according to the complexity of the dental problem, the type of appliances to be used, the estimated total treatment time and the duration and nature of the retention period. As a general guideline, fees for active removable appliance treatment varies between $1,000 to $1,400. Single arch treatment varies between $4,000 to $4,500 and 2-arch treatment between $6,500 to $7,000. This fee includes the provision of a set of retainers at the end of treatment. In addition, patients might need to set aside other dental expenses such as extractions, jaw surgeries, gum correction etc.
Patients can claim rebate from their private health fund under Extra Cover for full treatment with braces over two to three years. Most health fund require a twelve month membership qualifying period. Enquiries should be directed to the individual health fund regarding the amount of rebate applicable. An option is to pay for the treatment within the same financial year to maximise tax rebate for medical/dental expenses.
The combined experience of orthodontists across the country points to a 95% permanent improvement rate. While jaw relationships affecting facial contours can be expected to remain for life, teeth are constantly changing and adapting to usage. However, proper after care by patients would minimize irregular movements and chances of relapse.
Appointment for consultation with Dr. Lee can be made without needing a referral from dentist. However, it is preferable for patients to have their own dentists to look after general well-being of their teeth.