It’s important to discuss treatment options with your orthodontist.
Like stressful trips to the dentist, an appointment with an orthodontist can raise anxiety in many patients.
While dentists work on a wide range of oral health issues related to the teeth, the gums and the jaw, an orthodontist is a licensed dentist who is trained to diagnose, prevent and treat misaligned bite patterns and mal-positioned teeth and jaws.
Orthodontists are dental specialists who limit their practice to correcting bites and straightening teeth and jaws. Orthodontists work on an array of dental issues, including:
— Crooked teeth.
— Overcrowded teeth.
It’s important to get past any anxiety and ask your orthodontist for their opinion on what treatment, if any, you need, says Jeffrey Sulitzer, a dentist based in Nashville, Tennessee. He’s the chief clinical officer of SmileDirectClub, an oral care and telehealth company. He says SmileDirectClub is the creator of the first med tech platform for teeth straightening.
Here are nine questions you should ask your orthodontist:
1. How can I maintain my oral hygiene at home?
Whether starting or in the process of orthodontic treatments, it’s important to keep a high level of oral care, Sulitzer says. Although everyone should be brushing and flossing after every meal to prevent gum disease and its possible complications, it’s imperative for orthodontic patients to be doing so.
“Brushing and flossing after meals can prevent the buildup of plaque, cavities and food trapped between the teeth,” Sulitzer says. “For orthodontic patients, brushing and flossing after meals will help keep teeth healthy during the duration of treatment. With traditional braces, it’s critical that patients have impeccable home care because of the wires, bands and brackets that capture food easily. Aligners are more efficient and discreet and make it easier to perform oral care at home because they can be taken out before eating and drinking.”
“Finding an oral care routine that works for you and your unique schedule will allow you to get the most out of your treatment,” he says. “Chat with your orthodontist about ways you can stay on top of your oral care, like keeping a small travel kit with a toothbrush, toothpaste and floss in your bag or vehicle.” If you’re not already brushing after every meal, set timers to keep you on track.
2. What procedures does my insurance cover?
Ask your insurance company what procedures it covers, Sulitzer says. In many cases, patients using dental insurance for orthodontist visits find their dental plan doesn’t include orthodontia, and they wind up needing to add an additional policy to pay for orthodontic treatment or procedures — or pay for some procedures out of pocket.
If you have a flexible spending account or a health care spending account, you can use those funds for orthodontic procedures. “With this in mind, it’s best to check with your insurance company before beginning your orthodontic journey,” he says.
3. How do we make a plan that works for my smile goals?
Many people would like to keep an aspect of their current smile while undergoing treatment to improve their smile, Sulitzer says. “It’s important for patients to express these goals from the beginning of their orthodontic consultations and continue to address them throughout, so your orthodontist can make adjustments to your plan that suit your personal needs and goals,” Sulitzer says. “Be honest and up front about your goals.”
4. My dentist referred me, but do I really need braces?
There are many factors on whether a patient is a candidate for orthodontics, says Craig Feldman, director of orthodontics at the Smilist Dental practice in New York City. First, you’ll need X-rays, intraoral and facial photos and a scan or models of your teeth, which your orthodontist will evaluate, along with possibly a Cephalometric tracing of the jaws. “The orthodontist will look at the growth and development of the patient, along with the tooth development,” Feldman says.
The orthodontist will look for conditions that need to be treated, including:
— Anterior or posterior cross-bites.
— Large spacing.
— Deep bites causing bone loss or destruction in the upper arch.
— Impacted permanent teeth, which are not the third molars or wisdom teeth.
5. Are aligners an option, or do I need traditional braces?
Just about everyone knows someone who’s had traditional metal or ceramic braces, which are brackets attached to the tooth and connected by wires. They help teeth move over time so they are aligned correctly.
Aligners are an alternative to braces. Aligners are custom-made mouthpieces that fit over the teeth to achieve the same goal. Aligners are typically made of medical-grade plastic.
“Aligner therapy has improved dramatically in the past 20 years, to the point that most cases can be treated with aligners,” Feldman says, though more severe cases may still require traditional braces.
6. Will I need to wear a retainer following treatment?
Typically, yes. Whether you use traditional orthodontics or aligner therapy, the retention phase is as critical as the treatment phase, Feldman says. “Retention is necessary in order to maintain the correction which has been achieved,” he says. “Often, the retainers must be worn 24/7 for up to eight to 12 months, followed by the nightly wearing of the retainers in order to maintain proper stability in the movements of the teeth. If retainers are not worn, the patient can almost guarantee relapse to occur.”
Though similar to over-the-counter night guards to prevent teeth-grinding while you sleep, these retainers are customized to your specific mouth shape to keep teeth in place.
7. Do I need teeth extracted?
An orthodontist generally uses the lower arch, or the lower row of teeth, in determining if teeth need to be extracted, Feldman says. Excessive crowding and midline considerations are usually the determining factors on the need for tooth extraction.
“A patient’s bite can also dictate the need for extractions,” he says. “For example, if a patient has a very large overbite, often the two teeth behind the canines are extracted in order to retract the maxillary anterior teeth.”
Another common extraction, mainly in adults, is the removal of one lower incisor in order to resolve crowding in the lower arch. If the lower anterior teeth have become so crowded that there is insufficient space to move the teeth in a suitable position, often times orthodontists will remove one lower incisor rather than extracting multiple teeth in both arches.
8. Can teeth whitening be done at the same time as teeth straightening?
You may be considering teeth whitening if you’re looking to achieve a perfect smile, Sulitzer says. “While whitening is a safe and effective way to brighten teeth, your teeth may be more sensitive after straightening,” he says. “Therefore, it’s important to speak with a licensed dentist or orthodontist about your personal risk and the best timing for treatment.”
9. What sort of impact will teeth straightening have on my life?
While teeth straightening will result in your teeth changing physically, the benefits of orthodontic care oftentimes go beyond an improved smile.
“Teeth straightening has the potential to change people’s lives and make them feel better from the inside out,” Sulitzer says. “The confidence that can come from achieving your desired smile can open up doors in your personal and professional life, helping you put your best face forward no matter the situation.”
9 questions you should ask your orthodontist:
— How can I maintain my oral hygiene at home?
— What procedures does my insurance cover?
— How do we make a plan that works for my smile goals?
— My dentist referred me, but do I really need braces?
— Are aligners an option, or do I need traditional braces?
— Will I need to wear a retainer following treatment?
— Do I need teeth extracted?
— Can teeth whitening be done at the same time as teeth straightening?
— What sort of impact will teeth straightening have on my life?
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Update 03/17/22: The story was previously published at an earlier date and has been updated with new information.