WHICH TYPE OF BRACE IS BEST?
There is no ‘best’ brace as what is best for one person won’t necessarily be best for another. We are all different and so are our teeth. A good orthodontist will be able to run through all your options with you, explaining the advantages and disadvantages of each type of brace. Don’t set your heart on a particular type of brace until you’ve seen your orthodontist as it may not be suitable for you - but don’t worry there is a type of brace for every problem.

HOW LONG DOES ORTHODONTIC TREATMENT TAKE?
This depends on the type of problem you have. Very mild problems can sometimes be dealt with in as little as six months. More complex problems can take up to two years to achieve the best possible result. Don’t be too taken in by orthodontists or types of brace which claim to be able to move teeth quicker. This isn’t really the case as teeth move at a rate dictated by the physiology of the bone and should be moved gently to avoid pain and permanent damage to the teeth. If you want the best possible result you need to be patient -it will be worth it!

HOW MUCH DOES IT COST?
Prices for orthodontic treatment vary depending on the type of problem and the type of brace used. As a ballpark figure, treatment with fixed braces starts from £1500 for treatment of either upper or lower teeth, and from £3500 for upper and lower teeth using fixed braces. Treatment with Invisalign® starts from £3000 for very mild problems to £4500 for most cases.

The costs can usually be spread out over the course of the treatment after payment of an initial deposit.

Replacement of a removable retainer costs from £150.

A full consultation including a written report outlining the treatment options costs £150.

I’VE HEARD I HAVE TO WEAR A RETAINER FOREVER. IS THIS RIGHT?
If you want your teeth to stay in exactly the same position at the end of your orthodontic treatment you will have to wear a retainer. A retainer can either be a removable thin plastic ‘plate’ or gum shield; or can be a gold wire glued behind your teeth. Your orthodontist will be able to advise you which are the best options for you. Unfortunately there are lots of studies which show that teeth can move and drift into new positions throughout life - even if you haven’t had braces - and so wearing a retainer is really important. Lots of people forget this and end up with crooked teeth again - this is really disappointing for the patient, and the orthodontist!

HELP! I’VE LOST MY RETAINER, WHAT SHOULD I DO?
If you can go back to your original orthodontist that would be best as they will know which type of retainer you had before. If you have had your treatment carried out on the NHS and have been discharged you should see you own dentist as they will be able to advise you what to do or refer you back to the orthodontist. If you are no longer eligible for NHS treatment you might have to see an orthodontist privately to have a new retainer made. You can ask your dentist to refer you or you can refer yourself. If you would like me to see you to provide a new retainer privately please use the contact form.

MY BRACE HURTS, WHAT CAN I DO?
When your brace is first fitted and each time it is tightened your teeth will ache for two to three days. This is normal and means your teeth are moving as planned. For some people this is just a mild ache and for others the teeth are quite sore. If the teeth are sore you should avoid biting into hard and chewy foods; soft foods and liquids will be much more comfortable. Take regular mild analgesia - whatever you would normally take for a headache should be adequate. You could also consider taking analgesia about half an hour before your brace is tightened so that you don’t experience the discomfort while the brace is being tightened.

If you are wearing a fixed brace the attachments (we call them brackets) can make the inside of your lips and cheeks sore and cause ulcers. Usually this is only a problem at the beginning of treatment while the skin inside your mouth gets used to the braces but some people suffer from ulcers in their mouth periodically throughout the treatment. You will be given some packets of silicone wax when your brace is fitted and a small pea-sized portion of this can be rolled up and pressed over the bracket or wire which is digging in. This will ease the pressure on the mouth ulcer while it is healing up. Make sure you take the wax off when you brush your teeth and when you eat.

HOW DO I CLEAN MY TEETH WITH MY FIXED BRACES ON?
It is more difficult to clean your teeth with braces on but the better you look after your teeth, the better the results of your treatment will be. If teeth aren’t adequately cleaned the braces can leave permanent marks behind on the teeth, or even cause decay to form so that fillings are needed. Remember that plaque forms on teeth when you eat sugary food so if you can avoid sugary snacks between meals you will have less plaque to brush off your teeth and braces.

You need to brush your teeth well at least twice a day with fluoride toothpaste while you are wearing braces. You will need to buy a small headed toothbrush and some small interdental or interspace brushes to clean in between the teeth and behind the wires. There are some good clips on YouTube which demonstrate how to use these. My favourite is the one by Elmsleigh House which I think you will find useful.

Using a fluoride (alcohol-free) mouthwash once a day and rinsing with it for 3 minutes also helps to keep your teeth healthy. It is best to do this at a different time to tooth brushing as you will get extra benefit from the fluoride.

Adults undergoing orthodontic treatment should continue to see the hygienist regularly if they usually do this.

ARE THERE CERTAIN FOODS AND DRINKS I SHOULD AVOID DURING TREATMENT WITH FIXED BRACES?
The attachments (brackets) are quite firmly attached to your teeth but it is still possible for them to become detached if you bite down accidentally on something too hard so I would advise you to avoid biting into apples, raw carrots, corn-on-the-cob and such like using your front teeth. Try to cut food up into smaller pieces so that you aren’t putting too much force on the brackets when you bite and chew.

Sticky foods, such as toffees, chewing gum and chewy sweets can get stuck on the brackets and wires and pull them off so they are banned completely!

You should avoid sugary foods and drinks between meals and avoid fizzy drinks altogether as they are acidic and will dissolve the outer surface of your teeth - even diet fizzy drinks are acidic. Sports drinks are also acidic and should be avoided - especially when you are dehydrated after sport as there is less saliva in your mouth to counteract the effects of the acid. It is much better for your teeth to rehydrate with water!

If you have ceramic (clear) brackets on your teeth it is advisable to avoid coffee, red wine, curries and tomato based sauces as these can discolour the see-through elastics holding the wire in place, and eventually will discolour the actual brackets as well. The same is true for cigarette smoking so remember this when you are choosing the type of brace best for you.

ARE THERE CERTAIN FOODS AND DRINKS I SHOULD AVOID DURING TREATMENT WITH ALIGNER BRACES, SUCH AS Invisalign®?
Your aligners should be removed from your mouth for all eating and drinking, except for still water. Don’t forget to replace them again straightway after eating/drinking to ensure you wear your aligners for at least 22 hours per day.

I’M DUE TO HAVE MY BRACES FITTED SOON, WHAT SHOULD I EXPECT?
If you are having fixed braces the attachments (brackets) are ‘glued’ to your teeth using special tooth glue. The teeth need to be clean and dry for this to work so you may have some cotton wool rolls and/or plastic lip and cheek retractors put in your mouth to keep everything nice and dry. The glue itself can be a bit unpleasant tasting. The brackets are pressed onto each tooth individually and then set in position using a special light. Once each bracket is in the correct position a thin wire will be inserted and held in place using a tiny elastic band - these can be coloured or see-through and will be changed each time the brace is tightened. It is not painful but about 30-60 minutes after the brace has been fitted you might find the teeth ache. It is probably best to take some mild analgesics (whatever you would normally take for a headache) and plan a softish meal on the first night. You won’t need time off work or school but it is probably best not to plan any meals out for the first few days.

I’M DUE TO HAVE MY BRACES REMOVED SOON, WHAT SHOULD I EXPECT?
Congratulations! You must be very excited. Fixed braces are removed using a special plier that places a gentle force on each tooth individually to remove each bracket. You may hear a little ‘click’ as the glue comes away from the teeth. It is mildly uncomfortable but not painful. Once all the brackets and wires have been removed, your teeth will still feel a bit rough as there is usually a bit of glue left behind. This is gently removed from the teeth until they feel smooth. Your orthodontist will give your teeth a good clean so that they look and feel lovely and smooth. You will probably have moulds of your teeth taken too so that your retainers can be made. Your retainers will usually be fitted in the first few days after your brace has been removed to make sure your teeth don’t move at all. Your orthodontist will advise you how many hours a day you need to wear your retainers but they usually only need to be worn at night.


Pre-treatment with fixed braces                                      Post-treatment with fixed braces


Pre-treatment with fixed braces                                      Post-treatment with fixed braces


Pre-treatment with fixed braces                                      Post-treatment with fixed braces




































GDC 64981    BDS MSc MOrth FDSRCS (Orth) (Eng)
© Jo Clark 2015