FAQ – Fixed Standard Braces

The Midlands Orthodontic Specialists in Birmingham

Will my braces hurt?

No, having braces fitted shouldn’t hurt. We brush the surfaces of the teeth and stick the brackets onto them. The braces will, however, start to ache over the following 24 hours as the wires start to pull at the teeth. The aching tends to build a little over a few days and then settle down. The feel of the brace takes more time to get used to but most people are fine after a few weeks and become fully comfortable the feel of the braces in their mouth.

Can I choose colours?

Yes, just ask. The colour relates to the elastics that we use to tie the wire into the brace. The brace itself can be metal or ceramic, so silver or clear. You can still have coloured elastics whether you are having metal or ceramic braces.

What can I eat?

The two main factors with foods are what could break the brace and what could damage the teeth, but there are foods that can change the colour of the elastics as well. Hard foods can damage the brace because when clenching your teeth you can produce as much as 70kg of force (brushing your teeth will not break the brace but you might notice a breakage when brushing if not checking the brace after meals).

Foods which are hard, chewy, crunchy or crispy can create large forces as your teeth bite together and can break the brackets. Most foods can be cut up into small pieces and you can choose softer foods such as pasta, mash, soups and banana. Meats can be cut up into small pieces. Chocolate and toffee can be a particular problem because they will break the brace but can also cause holes to develop in the teeth.

Acids such as fruit juice and fizzy drinks can damage the teeth and leave marks on the teeth. Most wines are less acid but still should be considered with some caution. If you have a curry or anything with a lot of colour in it then the brace can go a little yellow in colour. We can always change the elastics for you but also some whitening mouth washes can help reduce the colour a little. Let us know if this becomes a problem and we can help you.

Will the braces affect my speech?

Most braces will not affect speech very much. A slight lisp can develop after having a fixed brace, this is not very noticeable but can be more so with lingual braces. With lingual braces speech settles down in most cases within three months of having the brace fitted. We use low profile braces to keep these issues to a minimum and there are other parts of the treatment that can be adapted to help. Removable braces have the greatest effect on speech but these are only used in very specific circumstances.

Will my braces be uncomfortable?

At first having something new in your mouth will feel strange but because everyone is different, everyone gets used to the feel of the braces in different ways. Some find the feel of the brace difficult for a few weeks but most people feel absolutely fine after three weeks. If there is anything sharp or difficult to cope with, we can provide wax which can be used to cover the sharp areas, or we could see you to cut wires shorter.

We can also change the shape of the brace in some circumstances, if there is a discomfort issue. Many people worry before the brace is fitted and it is most likely that any problems will appear in the first few weeks, but most people are quite happy once they have adapted to the feel of their new brace.

What do I do if there is a problem with my brace?

We do our utmost to fit your brace so that problems are not too much of an issue. We also provide you with wax to cover the braces with, if you find that it is catching anywhere. You can contact us by email at [email protected], or telephone us on 0121471 4004 to make an appointment to come and see us.

Are there any risks with having braces?

Fortunately most of the risk factors can be controlled or rectified before treatment starts but we can’t over-emphasise the importance of having a thorough assessment before starting treatment. Gum disease can easily be treated and if this is done, orthodontic treatment can be carried out safely.

Orthodontic treatment carried out without having gum disease controlled first will almost certainly lead to you losing one or more teeth or losing a lot of bone from around your teeth which could leave them loose. The same applies to untreated holes in the teeth or leaky fillings, which could develop further during treatment. Your dentist will find it more difficult to see holes that are present in your teeth once braces are fitted. These need to be diagnosed before treatment starts so that treatment is carried out before braces are placed.

Some people (about one in 10,000) are susceptible to root shortening and could lose teeth if starting treatment when the roots of the teeth are short, blunt or pipette shaped. The orthodontist can assess this and advise you accordingly. Diet can be a problem which can cause damage to the brace or to the teeth. Sugars can damage the teeth, as well as acids. Hard foods can damage the brace.

Will braces mark my teeth?

The braces are extremely unlikely to mark your teeth but acids can easily cause white marks to appear. The main culprits are fizzy drinks and fruit juice. Look at the labels on food and any product with the suffix “ate” at the end is likely to be an acid, eg citrate is citric acid.

What causes braces to break?

Hard, crispy, crunchy or chewy foods tend to break the brace. Your jaws are designed to create very large forces to bite through foods and as they are compressed against the brace, this can lead to breakages. Cutting foods up, eating softer foods and checking your braces after every meal are the best ways of avoiding breakages. By checking the brace after meals you can learn what causes problems. If you happen to break the brace you can either avoid that particular food in future or work out a strategy to get around the problem. This is much better than just issuing a list of all the foods that people have broken their braces on.

Can I choose the colour of my brace?

Yes, ceramic braces are tooth coloured or see through, but metal braces are silver and as such can be more obvious. This is not always true though because we do lingual orthodontics where the braces are placed on the tongue side surface of the teeth and can be hidden completely. Whatever the type of brace you have, the elastics that are used can be provided in different colours. Some people go bright with strong colours, pink and baby blue are often used but also seasonal colours can also be used or even sports team colours. Just let us know what you would like.

Can I choose the colour of the wires in my brace?

It is possible to do this but most of the wires tend to break down in the mouth and cause other colour problems. There is no ideal coloured wire at the moment but most metal wires do not look obvious. If you are particularly keen on trying coloured wires out, just let us know.

How long will my treatment take?

Treatments can take anything from three months to three years and really the complexity of the treatment dictates the length of time with a brace on. Most treatments will take around six to 18 months but we can also tailor your treatment to a particular occasion. A wedding or other important event can be a reason to need treatment carried out to a specific deadline. We are very experienced in dealing with these types of deadlines and there are many choices that can be given. Just make sure that you let us know if you have a deadline and we will do our utmost to meet it.

Will I need to wear retainers?

Yes is the simple answer. Our teeth move throughout life and having braces does not make the teeth any different, so with straight teeth and a beautiful smile, you will want to maintain it. This is where retainers come in. There are many different types of retainers but we try and tailor the retention regime to your teeth, your mouth and the type of problem that you came to see us with.

What sort of retainers will I need?

We nearly always fit removable retainers at the end of treatment, but one time when we don’t is when there are still baby teeth to lose and a retainer would hinder the development of the teeth. Otherwise we always fit removable retainers at the end of treatment. There are occasions when the stability of treatment is such that a fixed retainer will be needed. These are not always possible to fit though, such as when the teeth are short in length or the bite is such that the retainer would be damaged or disturb the bite. If there is a problem with oral hygiene then it is not advisable to have a bonded retainer because it needs to be cleaned well, being stuck onto the tongue side of the teeth.

Will all of my dental care be given at the practice?

No, you must continue to have reviews with your own dentist during treatment because they will look after your general dental care. We are specialists in orthodontics and focus on being experts at that.

Will I need to keep seeing my own dentist?

Regular check-ups will be necessary with your own dentist so that they can spot if you need any treatment such as fillings or cleaning around your teeth.

Will my dentist be advised of what treatment is going on?

We normally write to your dentist when we are planning treatment and try to keep them informed of progress throughout. Please let us know if you are not happy for us to contact your dentist.

Will I need extractions?

We try to avoid extractions as much as possible but where it will give you a better orthodontic result we will suggest them. Extractions give us the space required to move your teeth and keep them within the bone. Sometimes we can create space in other ways but the success of any treatment is down to good detailed planning.

Will I need impressions taking?

At the moment you will need impressions taking when you have your brace removed but this could change in the future. Some braces also require impressions but we are phasing out many of the impressions that we do because we have invested in a scanner that gives us a three-dimensional image of your teeth on screen. This helps with the planning of your treatment and the storage of your records.

Why do I need photographs taking?

Before any treatment starts we will always take photographs because orthodontics can change your appearance. We need to be able to refer back to these images during the treatment and they help to demonstrate the changes that we have made. If you have any concerns then we will often refer to the photographs as a record of how things were before your treatment started. Photographs also help with planning your treatment. Sometimes photographs are used in lectures but we will always ask for your consent if using photographs for this purpose or for marketing purposes.

How often will I need to be seen for appointments?

We normally see people every few months, this gives time for the teeth to move but also for the teeth to recover from any movements made. We may see you more or less often at times to ensure that we do not slow your treatment down or keep you from your work.

How quickly can treatment start?

Some treatments can start very quickly. We need to examine your teeth and collect some records and this normally takes a few visits, to ensure that you can consent to a treatment that you understand and that suits you as an individual. We can often start treatment within a few weeks of the first visit. If you need extractions then it may take a little longer as your dentist would normally be the person to carry out this for you. If there is a laboratory procedure for us to organise for you such as construction of aligners or a lingual brace, it may take a little longer.

Does growth have any influence on my treatment?

We now understand that we are growing throughout life. Even in our 60s and onwards, the soft tissues on our faces is growing. So the answer to this has to be yes. Some treatments will work far better during active growth ie from the age of nine through to about 14 years of age, but whatever your age, we try to future proof treatments so that lip length, facial shape and convexity are also taken into account. This requires an understanding of facial changes not just during teenage years, but throughout life. Did you know that there are significant skeletal changes that happen from the age of 18 to 25 and the same level of change will happen to the bones of your face between the ages of 25 to 42?

Will I need any injections?

You will only need an injection if surgical procedures are required, such as removal of teeth, uncovering of teeth or placing microscrews into the jaws. The brace part of the treatment can be carried out without any injections.

Will I need to go to sleep (have a general anaesthetic) for any reason?

You will not need to go to sleep for any procedure other than difficult surgical procedures, and we would refer you to a local surgeon should this be necessary for any reason.

What if I am missing teeth?

If you are missing a tooth or teeth you may need to have treatment to either close the space up, or to localise the space so that some restorative work can be carried out to restore the missing teeth. These are usually bridges, a plate or implants. We would refer you to an expert in this field should it be necessary.

What if I have an important event coming up such as a wedding?

If you let us know we can delay treatment until after the event, or use lingual braces so that treatment is hidden. We could carry out a limited approach treatment and stop before the big day or remove the appliance for the day and place it back on again. The more notice we are given before the big event, the easier it is to be flexible on the options we can give you.

How long does it take to fit a brace?

A simple removable brace can take as little as 30 seconds to fit. Fixed braces of different kinds take between 10 minutes and 30 minutes. We aim to keep all of our procedures under 30 minutes as we know that longer than this is more difficult to tolerate for our patients.

How long does it take at each appointment?

Longer procedures where we might remove the brace or fit one may mean you will be in the practice for up to an hour. This is not an hour having treatment but everything combined. We will ensure that you have everything that you need throughout your appointment and are given all of the information that you require when having any new treatment carried out. Brace adjustments will usually take around 10 to 15 minutes.

What records do you need to take before I can have my brace fitted and why?

We normally take some photographs of your teeth and face so that we have a record of what you look like before treatment. As we are making changes to your teeth and sometimes your face, we need to be sure of what they were like before the treatment started. We use the images to plan treatment and to go back to if you have any concerns during treatment. We take an x-ray view of your teeth which shows the roots and structures around the teeth so that we can be as sure as possible that the roots will not be a problem for treatment, and that there is nothing hidden away that needs dealing with first such as holes in the teeth, or extra teeth. We need to know if the bone around your teeth will be healthy enough to sustain the treatment. If this is not checked out you could lose bone from around your teeth.

How long before I can have my brace fitted following my first appointment?

We will see you again to discuss treatment further, to collect final records and for you to consent to the treatment. We then make an appointment to fit the brace. This process can be as fast as two weeks.

How can I pay for my treatment?

Cheque, card or cash. We do not expect payment up front for treatment and can arrange a payment plan so that you are paying for your treatment as you go.

Do I have to pay up front?

You do not need to pay for treatment up front.

Will I need my teeth drilling to fit the brace?

No, we just need to polish the teeth and for some braces we will do a scale and polish to ensure that the brace can fit well.

Will the brace damage my teeth?

The brace will not damage the teeth but what you eat or drink during the treatment could. Fizzy drinks and fruit juice can cause white marks to appear on the teeth and too much sugar can lead to holes appearing in the teeth. Too much acid can also shorten the crowns of your teeth.

Does it hurt removing braces?

This is something which worries our patients. The feeling is more of pulling than anything else. Sometimes a bracket may be difficult to remove but we do not just keep pulling at it, as there are other ways to remove difficult brackets. In most cases the braces are removed in a few minutes without any real discomfort.

How are the braces removed?

Fixed braces are removed by jiggling the brackets at a weak point on the base so that the glue detaches. We then clean up the plastic which glued the brace on.

Will there be gaps between the teeth?

We aim to close all gaps if possible. If you have a gap between your teeth there are different ways of closing them. Some people have more tapered teeth than others with the widest section at the tip of the upper front teeth. When these teeth are crowded, aligning them can leave some triangular spaces between the teeth. There are techniques that we can use to close them and most can be reduced completely. Sometimes they have to be built up with a tooth coloured material but this not normally necessary.

What are black triangles?

Some people have more tapered teeth than others with the widest section at the tip of the upper front teeth. When these teeth are crowded, aligning them can leave some triangular spaces between the teeth. There are techniques that we can use to close them and most can be reduced completely. Sometimes they have to be built up with a tooth coloured material but this is not normally necessary.

Will people be able to see the brace?

Many people will not really notice your brace at all but some braces are more invisible than others. Metal braces work well but are more obvious. A slightly more subtle option is to have ceramic/clear brackets. White wires can be used but most of them chip and become unsightly. Aligners can be taken out but when in place, the plastic covers the surface of the teeth and so sometimes can be just about noticeable. The only truly invisible option is lingual braces, most of which are behind the teeth. For mechanical reasons we still place attachments on the outside of the teeth but these are normally tooth coloured.

When will I see any changes?

Normally after one or two months the changes are quite subtle but three to four months into treatment most people will notice major changes in the position of their teeth. When you come to see us we can show you photographs taken before the treatment started and you can compare using a mirror.

How long will I have to wait for my braces to be ready?

Normally it takes about two weeks for a normal fixed brace but some braces such as lingual braces can take about six weeks to get ready for you because they are custom made for your teeth.

How do I clean them?

It takes longer to clean around the braces and while using a normal tooth brush is fine, it is also useful to use interspace brushes such as Tepe brushes. We will give you a brush with a groove in it which helps to get around the brace. If you are using an electric brush it helps if you use one with an app eg Oral B 6000 professional. You can also use floss or superfloss but we will show how best to use this.

Can I play sports?

Of course, and this will help with a healthy lifestyle, just make sure that you keep hydrated because a dry mouth can lead to more problems with holes in teeth. When playing contact sports, wearing a mouth guard is essential. Elastics can be worn during sports but may need to be taken out if wearing a mouth guard.

Can I play musical instruments?

Musical instruments are a complex issue with braces and the level to which your play will be affected depends upon the type of contact that your mouth makes with the mouth piece. Reed instruments such as the clarinet will be affected less than in trumpet playing where the embouchure is more critical. Folding the lower lip over with the clarinet can be more uncomfortable with a lower fixed brace. The timing of grading or a major performance can also be considered when planning your treatment. We have tailored treatments for many instrument players in the past and this does need advice. Just let us know if you play an instrument and we will bear this in mind when planning your individual treatment. We can also tailor the appliance to your needs.

I have a metal allergy, will this be a problem?

Metal allergies are very common, the most common one being with nickel. The alloys that we use are bound together so the release of allergenic material in the mouth is not a high risk. The immune system in the mouth is very different to the outside skin surface. If needed we can change the materials that we use so that we can avoid a particular allergen. We are also happy to discuss or follow the advice of an allergy specialist if required. We can give them a sample of a material that we use for patch testing if requested.

What is the difference between clear fixed braces (ceramic tooth coloured brackets) and metal braces?

We use a mono-crystaline material which is clear and, because it is see through, it takes on the colour of your own teeth. They are less obvious than metal braces.

Do the brackets stain?

The brackets tend not to stain but the elastics that hold the wire in could do. We can change these or use another type of elastic, or a metal tie if necessary. Drinking tea and coffee, smoking, red wine and Corsodyl mouth wash are common causes of staining in the mouth.

Can I have ceramic braces on my upper and lower teeth?

Sometimes you can but usually we do not put ceramic brackets on the lower teeth. The ceramic material is harder than enamel so it’s a little like putting 24 carat gold and nine carat gold next to each other, a ceramic brace on the lower teeth could damage the upper teeth by wearing them down or chipping them.

If I have ceramic braces will I get tooth coloured wires?

We have tried tooth coloured wires in the past and have found them to be inferior in quality compared to others. That is not to say that a good material may not come out in the future. We keep an eye on the market and will introduce tooth coloured wires when the technology has improved to the desired level. Many tooth coloured materials are coated in Teflon which tends to break off the surface of the underlying metal. Teflon is not a substance anyone should swallow.

Can I have colours?

Braces can be silver metal, ceramic (clear or tooth coloured) or gold but we can use coloured elastics and these can be in the colour of your favourite sports team or just a loud colour such as bright pink.

Apart from the colour, are there any other differences with tooth coloured braces?

Ceramic brackets look less obvious but are actually a little more bulky. They are harder than enamel so can damage the teeth if not used carefully. Ceramics, while hard, are more brittle and so can crack, a little like glass. This is only apparent when the brace is being removed.

How are the braces removed?

We use a special instrument to tweak the brackets off but sometimes just trim the brackets down and smooth them off.

Does it hurt removing braces?

This is something which worries orthodontic patients. The feeling is more of pulling than anything else. Sometimes a bracket may be difficult to remove but we do not just keep pulling at it, as there are other ways to remove difficult brackets. In most cases the braces are removed in a few minutes without any real discomfort.

Will the braces affect my speech?

Lingual braces have more of an effect on speech but in most cases it’s temporary and within three months very few people have an issue. People who talk as part of their profession are more likely to develop tactics to get around this problem.

Will it affect my jaw joints?

There is no evidence that orthodontic treatment will affect jaw joints but there are some parts of the treatment that can be adapted to help if necessary.

Will people be able to see the brace?

Many people will not really notice your brace at all but some braces are more invisible than others. Metal braces work well but are more obvious. A slightly more subtle option is to have ceramic/clear brackets. White wires can be used but most of them chip and become unsightly. Aligners can be taken out but when in place the plastic covers the surface of the teeth and so sometimes can be just about noticeable. The only truly invisible option is lingual braces, most of which are behind the teeth. For mechanical reasons we still place attachments on the outside of the teeth but these are normally tooth coloured.

When will I see any changes?

Normally after one or two months the changes are quite subtle but three to four months into treatment most people will notice major changes in the tooth position. When you come to see us we can show you photographs taken before the treatment started and you can compare using a mirror.

How long will I have to wait for my braces to be ready?

Normally it takes about two weeks for a normal fixed brace but some braces such as lingual braces can take about six weeks to get ready because they are custom made for your teeth.

How do I clean them?

It takes longer to clean around the braces and while using a normal tooth brush is adequate, it is also useful to use interspace brushes such as Tepe brushes. We will give you a brush with a groove in it which helps to get around the brace. If you are using an electric brush it helps if you use one with an app eg Oral B 6000 professional. You can use floss or superfloss too but we will show how best to use this.

What if they go a funny colour?

The elastics can sometimes go very bright after a curry. Just let us know and we will swap them for new elastics, or try another type of elastic.

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