FAQs

FAQs

What is Orthodontics?

Orthodontics is a branch of dentistry that specialises in the diagnosis, prevention and treatment of problems related to the alignment of the teeth and jaws. Common problems encountered include crooked or crowded teeth, protruding or “bucky” teeth and incorrect jaw development. The technical term for these problems is malocclusion, which literally means bad bite. Orthodontic treatment involves the design and use of corrective appliances (such as braces, plates or aligners) to bring the teeth and jaws into proper alignment for functional and cosmetic benefit.

What’s the difference between a Dentist and an Orthodontist?

An orthodontist is a fully trained dentist who has completed a minimum of 2 years of work in general practice dentistry and then an additional 3 years of full time university based postgraduate training in the field of orthodontics.  Orthodontists hold a specialist registration with the Dental Board of Australia and as such do not perform general dental treatments such as fillings, extractions, crowns, veneers or tooth whitening. Most orthodontists in Australia are members of the Australian Society of Orthodontists and undergo regular peer assessment via the Australasian Orthodontic Board. Although some general dentists provide orthodontic treatments for their patients, they do not possess the same level of training and expertise in the field as a registered specialist orthodontist.

Why have orthodontic treatment?

Aside from the obvious improvements in smile aesthetics and self-esteem, orthodontic treatment can also lead to improvements in oral health and function. Orthodontic treatment will:

  • Create beautiful looking teeth and an attractive smile

  • Contribute greatly to facial aesthetics

  • Enhance your self confidence

  • Reduce the risk of tooth decay and gum disease by improving “cleanability”

  • Decrease the risk of irregular or excessive tooth wear

  • Help establish normal oral function related to chewing, breathing and speech

  • Decrease the risk of dental trauma (accidental chipped, broken or lost teeth)

  • Correct improper jaw relationships and reduce stress on the facial muscles and jaw joints

What’s the right age for orthodontic treatment?

The timing of orthodontic treatment is extremely important and greatly affects the final treatment result. Since no two patients are alike, there is no specific age that is best to begin treatment. The American Association of Orthodontists and Australian Society of Orthodontists recommend that children receive a specialist orthodontic examination by age 7-8 years if a parent or the family dentist identify a potential problem. Fortunately not all of the children examined at a young age actually require immediate or urgent treatment. For those that do, interceptive treatment early in their growth allows orthodontists to achieve results that may not be possible when the dentition and facial skeleton has fully developed. Early treatment can prevent more serious problems from developing and greatly simplify future care.

Typically, comprehensive treatment with braces is started after all the permanent teeth have erupted but in some cases there is an advantage to start just before the last baby teeth are lost. Therefore, from a biological (and social) perspective it is ideal for adolescents who present with most common orthodontic problems to undergo routine full braces treatment during the early high school years (age 12-15 years). Orthodontic treatment can be far more challenging and complex in older post-pubescent teens and adults however the basic biological process involved in moving teeth is the same at any age so it’s never too late.

Do I need a referral?

No, but it is strongly recommended that new patients see their general dentist for a routine dental health check and scale/clean before attending their initial orthodontic consultation appointment.

When can I start treatment?

At the initial consultation appointment preliminary recommendations will be given about the need for, and timing of orthodontic treatment. If it is determined that orthodontic treatment is necessary straight away, arrangements will be made for the assessment of pre-treatment diagnostic records so that an individualised treatment plan can be formulated. Patients/parents are then provided with a detailed treatment proposal and a final quotation on the cost of treatment. The process from initial consultation to final treatment planning normally takes about 2 weeks to complete. Upon acceptance of the final treatment proposal, patients can usually proceed directly into treatment if they wish. If extractions or any other general dental treatment is required, this will need to be arranged with a general dentist before the orthodontic appliances are fitted. A general dental check-up and scale and clean is also strongly advisable prior to the fitting of braces.

How long will treatment take?

Treatment times vary significantly depending on the severity of the initial problem, type of orthodontic appliances used, patient age and patient compliance. Routine comprehensive orthodontic treatment with braces typically lasts between 18 and 24 months. Multi-stage treatments or very complex treatments in adults and some teenagers may take in excess of 2 years to complete.

How often will I have appointments?

Appointments are scheduled according to each patient's needs. Most patients wearing braces or aligners will be seen every 6-8 weeks. If there are specific situations that require more frequent monitoring, we will schedule appointments accordingly.

How much does treatment cost?

Fees for comprehensive orthodontic treatment vary greatly depending on the nature and severity of the presenting problems, the age of the patient, the treatment method, the type of appliances used and the anticipated treatment duration. The total cost of treatment can vary between $900 and $9000 depending on the case. We can only provide an exact quotation once a thorough examination has been completed and all the relevant diagnostic information has been analysed.

Does private health insurance cover orthodontic treatment?

Yes, but your insurance rebate entitlement and the associated “gap” you are required to pay varies greatly depending on your insurer, the level of your cover and the number of years you have held the insurance.  Some private health insurance funds may rebate up to 75% of the total cost of treatment if you have top level ancillary/extras coverage and have held the cover for many years. The most basic health insurance policies do not usually cover orthodontics. It is strongly recommended that individuals check their rebate entitlements BEFORE commencing treatment.

What is a “preferred” or “participating” provider?

A “preferred” provider is a dentist or dental specialist who has signed a commercial contract with a health insurance company in an attempt to increase patient numbers at their practice. Preferred or participating provider schemes require the dental provider to bill patients according to a predetermined, inflexible and cheaper fee schedule that is largely determined by the health insurance company, not the actual provider of the service. Many dentists have contracted themselves to these schemes with numerous different health insurance companies in an attempt to increase their busyness, but that decision often results in over-servicing, rorting, cost-cutting ploys and clinical shortcuts. This is a recipe for reduced quality of care. This practice is committed to providing only the highest possible standards of care for all our patients.  We believe in quality, individualised treatment over production-line style, high patient turnover orthodontics. Therefore, like most specialist orthodontic practices in WA, we have chosen not to enter into direct contractual arrangements with any third party health insurers.

Are radiographs (X-rays) necessary and are they safe?

Yes and yes.

In fact, dentofacial radiographs are so important to successful orthodontic diagnosis and treatment planning that treatment cannot be safely initiated without them.

The two radiographs obtained for all new patients are the panoramic view (OPG) and Lateral Cephalogram. The OPG provides information about the presence and position of unerupted teeth, the health of the supporting bone around the teeth, jaw joints (TMJ's) sinuses, and the  jaw bones (maxilla and mandible). The Lateral Cephalogram is a profile x-ray of the facial skeleton and soft tissues and is used to assess the relation of the teeth in the jaws, the relation of the jaws to the skull and the relationship of the soft tissues and airways to the teeth and jaws. In children, growth predictions can be made and we can also determine the changes that have occured with treatment.

The implementation and use of x-ray equipment is strictly monitored by state authorities. This means that our x-ray machine, the room which it is housed in and the staff who are allowed to operate the machine have all received official accreditation and undergo regular compliance testing. We have the latest digital OPG and Lateral Cephalogram machine available which ensures absolute minimal radiation exposure whilst still delivering excellent quality radiographs. As the images are digital, they can be viewed on any computer on our network and transferred rapidly to other dentists and specialists whenever this is needed or requested.

Orthodontic or dental radiographs account for a only very small percent of radiation that you will encounter every year. X-rays are naturally occurring and the body is exposed to radiation from natural sources such as the sun all the time. The average person in Australia receives an effective dose of background radiation approximating 2000 μSv* (micro-Sievert). The effective radiation dose from an OPG or Lateral Cephalogram taken on a modern machine is between 3 and 7 μSv. This equates to an equivalent normal background radiation dose of 1/2 - 1 day. The effective radiation exposure you would receive on a return flight from Sydney to Los Angeles is approximately 160 μSv*, or 25-50 times what you would receive having an orthodontic radiograph taken. These numbers provide compelling evidence of the safety of dental radiography.

* Source: Australian Nuclear Science and Technology Organisation

Will I need to have teeth extracted?

We believe in a non-extraction treatment philosophy whenever possible. With this goal in mind, we stress the importance of early screenings and interceptive treatment for young children whenever it is indicated. Even with early treatment, sometimes removing permanent teeth is required to achieve the best orthodontic result - especially if there is severe dental crowding and protruding teeth to begin with. Recent research suggests that about 25% of patients will need teeth removed as part of their overall orthodontic treatment program.

Do I have to wear metal braces?

No. We offer the latest innovative and cosmetic options in orthodontic treatment, particularly for our adult patients. These include tooth-coloured ceramic braces and Invisalign tooth aligners. Colourful elastics used in conjunction with metal braces make braces fun for most of our younger patients.

What are separators?

Separators (or “spacers”) are tiny rubber rings that are placed between the back molar teeth for a few days prior to the fitting of some orthodontic appliances. The separators push the teeth apart slightly, thereby creating a small space between them. This is required for the easy and comfortable fitting of orthodontics bands around the teeth at a subsequent appointment. Many patients describe separators as like having a piece of food stuck between your teeth.

Do braces hurt?

Having braces put on is a relatively easy and painless procedure. No needles or "drilling" are involved in the fitting of braces, as they are simply glued to the teeth. The majority of patients will experience slight pressure or discomfort for about two or three days after their braces and archwires are first fitted and then again for a day or two after each adjustment. In years gone by, only stiff orthodontic wires were available so there was much more discomfort when moving teeth with braces. Now, with new bracket designs and super-flexible wires, there is significantly less discomfort. In fact, some patients complain about not having any pain because they think that without pain, their teeth are not moving. Remember, "It does not have to hurt to work!"

Even though braces only protrude out about 2-3 millimetres from your teeth, it may take your lips, cheeks and tongue a few days to a few weeks to become accustomed to rubbing against the braces. Any small ulcers that develop usually resolve with a few weeks.

What are retainers?

At the completion of the active part of orthodontic treatment, the appliances are removed and retaining appliances (retainers) are fitted to hold the teeth steady in their new position while the surrounding bone and gums adjust around them. These appliances may be plastic removable plates or fixed wires fitted behind the teeth.

For more information on retainers go HERE.

Are there certain foods I cannot eat with braces on?

Yes. Once treatment begins, we will give detailed wear and care instructions and provide a comprehensive list of foods to avoid. These foods include chewing gum and sticky lollies. You can usually avoid broken or damaged braces and extra emergency appointments by carefully following the simple dietary instructions provided to you.

Can braces damage the teeth?

No. Bad tooth brushing and poor oral hygiene can lead to damage of the tooth surface around the braces but the braces themselves do not harm the teeth.

Can I play sport and can I wear a mouthguard with braces?

Yes and yes. There are no restrictions on sporting activities whilst undergoing orthodontic treatment although full contact boxing and martial arts are probably best avoided. Sporting mouthguards are strongly recommended whilst wearing braces for obvious reasons. Custom-fitted dentist made mouthguards are of little use during active orthodontic treatment as they cannot adapt to changes in the position of the teeth and will be poorly fitting after just a few weeks. We recommend remouldable braces specific mouthguards that are available online or at sports stores.

www.signature-mouthguards.com

www.rebelsport.com.au

Can I get treatment for just on my top or bottom teeth?

Yes, but it is usually not recommended. Whilst we are primarily concerned with straightening teeth for cosmetic purposes and addressing our patient’s main concerns, we also need to make sure that the final bite relationship (occlusion) is comfortable and the teeth are stable at the end of treatment. Generally if only one arch is treated, the biting relationship between top and bottom teeth cannot be controlled properly and the therefore final bite will be quite uneven and maybe even worse than it was before treatment. Over time, an unbalanced bite can lead to orthodontic relapse, uneven wear of the teeth, damage to the gums and jaw joint pain/dysfunction. Therefore, with many orthodontic problems, correcting just top or bottom teeth alone would not be recommended and would only be offered as a compromise option with the inherent risks accepted by the patient before commencing.

Do I need my wisdom teeth removed after orthodontic treatment?

Sometimes. There is limited compelling evidence to suggest that routinely extracting wisdom teeth will prevent the front teeth from moving over time and therefore the third molars are no longer removed as a matter of routine. However,  in many cases there are tangible benefits in extracting them soon after treatment has finished. For example - if a wisdom tooth has very limited space and cannot fully erupt, a local gum problem will usually develop over time. Episodes of acute gum infection can become very regular and chronic abscesses can form. Damage to the adjacent teeth is also possible. In these cases, the wisdom teeth should be removed. With the aid of a jaw radiograph (X-ray) taken near the completion of orthodontic treatment, we can advise on the status of third molars and potential future problems. In older patients, sometimes it is necessary to remove the wisdom teeth before treatment commences.

Sometimes. There is limited compelling evidence to suggest that routinely extracting wisdom teeth will prevent the front teeth from moving over time and therefore the third molars are no longer removed as a matter of routine. However,  in many cases there are tangible benefits in extracting them soon after treatment has finished. For example - if a wisdom tooth has very limited space and cannot fully erupt, a local gum problem will usually develop over time. Episodes of acute gum infection can become very regular and chronic abscesses can form. Damage to the adjacent teeth is also possible. In these cases, the wisdom teeth should be removed. With the aid of a jaw radiograph (X-ray) taken near the completion of orthodontic treatment, we can advise on the status of third molars and potential future problems. In older patients, sometimes it is necessary to remove the wisdom teeth before treatment commences.

Do I still need to see a dentist during orthodontic treatment?

Yes. It is very important that orthodontic patients continue regular 6-monthly checks and cleans with their general dentist to ensure oral health is maintained. Orthodontic treatment may need to be put on hold or stopped altogether if there is a significant deterioration in oral health during the active treatment period.