Patient Info
Early Treatment
The American Association of Orthodontists recommends that a child receives his or her first orthodontic screening by age 7. By starting treatment early, we are able to recognize potential problems and correct them before they become more serious. This will save you and your child time and money by preventing future problems before they begin.
Early interceptive orthodontic treatment has proven to be beneficial for the overall desired result. Because a young child’s permanent teeth have not finished erupting, we are able to thoroughly evaluate and address any impending problems at the earliest stage.
During your child’s initial evaluation, we will first determine if there are any problems that need to be addressed, such as potential crowding, open bite, overbite or gummy smiles. The Phase I treatment plan can include preventive, interceptive or modifying treatment. Orthodontic appliances may be placed to prevent a problem from occurring, correct a current problem or help direct jawbone growth. Multiple problems with tooth alignment, gums, jaws and facial problems can be corrected with Phase I treatment.
To find out if your child is a candidate for early interceptive treatment, schedule a consultation.
Adolescent Treatment
Usually, it is normal orthodontic treatment which involves placing braces on the patient once his or her permanent teeth have erupted. The braces straighten the permanent teeth and finish correctly aligning the patient’s jaws. By age 12, most, if not all, permanent teeth have erupted and are in place, which is when crooked teeth, gaps and bad bites can easily be detected. These problems will hardly ever correct themselves, so this is when most parents decide to seek orthodontic treatment for their children.
For many teenagers, wearing braces is a part of life – an important part of life because a beautiful and healthy smile can boost one’s self-confidence.
Children at this age are growing rapidly, and we can usually take advantage of these growth spurts to help shape the bite and teeth correctly. Pre-teens and teenagers have high metabolisms, which can help shorten overall treatment time and reduce the discomfort of orthodontic treatment.
Adult Orthodontics
We’re seeing an increasing number of adults investing in orthodontic treatments.
More than 25 percent of patients considering Braces or Invisalign today are adults
There are a number of reasons why an adult might have crooked teeth or a bad bite and choose to have orthodontic treatment. Genetics is one of the main causes of common orthodontic problems such as underbites and overbites. Prolonged habits during childhood, such as biting your lips or sucking your thumb can cause the front teeth to become misaligned.
It’s also natural for our teeth to shift position as we age, when we lose or wear down our teeth, or if gum problems develop. Sometimes that means people who have had orthodontic treatment as a child and haven’t worn their retainers as instructed may require further orthodontic treatment as an adult.
Who is orthodontic treatment suitable for?
Orthodontic treatment is an option for most adults with crooked teeth or uneven bites, just as it is for children and teenagers. Call for a FREE consultation to find out
more!
Eating and cleaning with Braces
Cleaning your teeth and gums
The key to healthy teeth and gums is regular cleaning to remove plaque. Plaque is the white soft substance that collects on your teeth, gums, and braces. It is made up of millions of tiny bacteria that release acid and can damage your teeth and gums if left to build up.
Follow these simple instructions and you’ll be off to a great start:
- Brush your teeth, gums, and braces three times a day.
- Floss once a day.
- Use a fluoride toothpaste.
- Rinse with mouth wash at least once a day.
Brushing with braces:
First, remove any rubber bands or headgear. Using toothpaste on a soft brush, clean the outside surfaces of your teeth first, then the inside, then the biting surfaces. Use an up- and-down, side-to-side, and round-and-around motion with firm pressure. Clean both the teeth and the gums! When cleaning the gums, press the brush gently against the gum line at a 45-degree angle and massage the gums. This is very important as infected gums (gingivitis) can become swollen and red. Finish by cleaning around your braces. Take care not bend or break any of the brackets or wires. View brushing your braces with the toothbrush like a train travelling on train tracks, start from one end and finish at the other being sure not to ‘jump’ or miss areas!
Interdental brushes:
Interdental brushes are also known as ‘Christmas tree’ or ‘Bottle’ brushes and are designed to clean in between your braces. They remove plaque and food residue from between your brackets where your toothbrush may have missed. Hold the base and slide the brush behind the arch wire and in between your brackets. Rotate the brush for 5 seconds then move onto the next gap. Use your interdental brush every day. It is especially useful for removing any food between your braces.
Flossing with Braces
It is important to floss because it removes plaque from between your teeth. To floss with braces on, thread a piece of floss into the small gap between your teeth and archwire. This will result in the floss being in the perfect position to floss. Then simply floss (in an up and down motion) between the teeth as per normal. This technique will take some time and effort to master initially, but with practice it will become second nature! We also recommend floss threaders or Super Floss for cleaning the gums and in between the teeth. Thread the floss underneath the wire and between the teeth, and then gently clean the gum line.
Plaque disclosing tablets
Plaque disclosing tablets are pink tablets that when chewed stick to areas of the mouth that haven’t been cleaned. They highlight areas you’ve missed! Brush your teeth, chew a tablet and swirl it around your mouth, then rinse. The areas that are pink are where your brushing needs to improve. Use a disclosing tablet one week after your braces are fitted, then once a week for the next 3 weeks. After 4 weeks you should have identified any problem areas and mastered your brushing technique! (P.s. the new disclosing gels now leave a purple residue on your teeth to indicate areas of very old plaque that has been on for a long time -be sure to get to these areas!)
Orthodontic wax
When your braces are first fitted they may rub on your cheeks and lips. Overtime, your mouth will get used to this, just like your feet get used to new shoes! The gums and cheeks are quite hardy and will adapt quickly. However, to make it more comfortable initially, use orthodontic wax. Pinch off a small piece of wax and roll it into a ball. Dry the area with a tissue or cotton ball, as the wax will not stick if the area is moist. Press the wax over the irritating bracket or wire to provide immediate relief.
Electric toothbrushes
Electric toothbrushes can have very small heads and fine bristles which are ideal for cleaning around braces. A lot of them also have a timer to make sure you’ve brushed for the recommended 3-4 minutes. Kids love electric toothbrushes, so it may be a great way to make brushing fun and motivate them!
Eating with braces
Eating well and eating healthy is important. It will prevent damage to your braces, and ensure your teeth and gums stay healthy!
Hard foods such as lollies, popcorn, and nuts should be avoided as they can break the brackets and fracture the archwire. Gooey sugary foods such toffees, redskins, and caramels should also be avoided because they may stick to the braces and the sugar can get around and in behind the wire and cause cavities.
Fruit and vegetables such as apples, carrots, corn and celery can be eaten if they are cut into small pieces or grated.
Learn how to modify your foods, by boiling them to soften them, or by cutting them into smaller pieces. Suck, rather than bite into ice cubes/blocks.
Drinks
Drinks that are acidic and high in sugar can damage your teeth and lead to cavities and white spot lesions. If they are consumed frequently or sipped over extended periods of time, they can do serious damage.
It is recommended that you avoid soft drinks, juice, cordials, and sports drinks. Instead, drink lots of water and milk and chew SUGAR-FREE gum to increase your salvia flow which is your body’s natural defence against tooth decay.
Emergency Care
If you have an emergency, please call on (07) 49287700
- Food caught between the Braces
- Lost module or Coloured O ring
- Discomfort
- Ulcers
- Protruding Wires
- Snapping of Power chains
- Dislodged Bracket
- Broken Wire
- Lost or broken Plate/ Functional appliance/ Retainer
Orthodontic emergencies can occur frequently, and although they can be quite distressing for the patient, they are usually fairly simple to fix.
If you have an emergency call our clinic immediately and we will organize an appointment to fix it –please don’t rely on your upcoming visit to attend to an emergency. These ‘adjustment appointments’ are devoted solely to tightening you braces and a repair cannot be done at the same time. This is because repairs take time, special equipment, and extra staff that we need to prepare for -so please let us know in advance so we can organize a separate appointment :).
- Food caught between the Braces: This is not an emergency, but is just a little uncomfortable and embarrassing. Simply use a piece of floss, toothpick, or an interdental brush (Pikster™) to push the food out.
- Lost module or Coloured O ring: This is a fairly common problem. Remember that each of the 3 components of braces (brackets, wires, and modules) are important for them to work. Therefore, if a module has come off then your braces are not working on that tooth! The tooth may not move or it may become free to overcrowd. Therefore, if you notice a module off please call our office to be seen ASAP. To limit ‘module emergencies’, be sure not to pick at your braces, avoid anything sticky (that could pull o-rings off), and don’t eat sharp bits of food (that could split a module).
- Discomfort: After the braces go on it is quite common to experience a bit of discomfort for 1-2 days. This is best managed with over-the-counter pain killers for 48 hours. We recommend an alternating combination of Nurofen and Panadol taken every 4 hours. Consuming cold drinks also helps in reducing this discomfort as we use heat activated wires so a temperature drop can provide brief relief …aahh!. It is also quite normal to feel a bit of pressure after the braces are tightened at each appointment. This commonly happens when Dr. Sunita puts in a new wire (which is thicker and stiffer) or starts elastics (rubber bands). Again, to settle any discomfort, painkillers that night will help. Often, we find that our patients are fine the next day!
- Ulcers: Sometimes new braces may irritate the lips and cheeks. This commonly occurs around the canine brackets and molar tubes which have hooks added to them. Irritation can cause a tiny white ulcer to form. Rest assured that with time, your mouth will get used to the new braces and the ulcers will disappear. However, in the meantime, use orthodontic wax to cover the sharp area. Pinch off a small piece of wax and roll it into a ball the size of a pea. Dry the area and place the wax over the irritating region. This should do the trick until your mouth gets used to things!
- Protruding Wires: Occasionally the archwire may work itself around to protrude out of one side. This can dig into the cheek and cause discomfort when opening and closing. If possible, use tweezers to pull the archwire back around so that the ends are flush on both sides. In other cases, we may be closing spaces and as this happens the excess wire usually starts sticking out from the ends. In this case, the wire needs to be clipped. Call our practice and we can clip the wire anytime!
- Snapping of Power chains: If the power chain (elastic string) has snapped and a linkage is hence broken, please call our office to arrange an appointment to get it replaced. Broken power chain can cause uneven forces which can cause the teeth to move in wrong directions, so it’s important our dentist fixes it as soon as possible.
- Dislodged Bracket: Brackets are attached to the teeth using special glue. Occasionally they can be knocked off if the patient eats hard foods, gets struck in the mouth during sports, or clenches their teeth at night. Rest assured that this is quite a common occurrence and can be easily managed. If a bracket ‘pops off’ it is usually still attached to the wire and simply rotates on it. The worst that can happen is that it irritates the cheek or lips. It is best to place a ball of wax on the offending bracket and notify our clinic to organize the bracket to be re-bonded.
- Broken Wire: Sometimes with wear and tear, the archwire may snap. This is especially common when teeth have been removed prior to braces and there are long spans of unsupported wire. The continual flexing of the wire in this region can lead to it snapping. If this happens, please call out clinic as soon as possible to get it replaced.
- Lost or broken Plate/ Functional appliance/ Retainer: If a plate is broken, please call our office to arrange an appointment to have it repaired or replaced. We don’t like to charge any additional fees, but you will need to pay the laboratory fee for the cost of replacing the appliance. To avoid this happening again, please don’t keep orthodontic appliances in your pocket, but rather always in their proper case.
Our Fees
Free Initial Consultation
Your initial consultation is free. At this appointment our dentist will give you an idea of what is needed and an estimate of the cost of your treatment.
Records
Diagnosis and treatment planning is done by studying your models, photos and Radiographs (Lat Ceph and OPG). We will then give you a written fee quote for Braces (Metal, Ceramic or clear & Invisalign)
What does the fee for Braces include
Our quote is all-inclusive with no hidden extras: it covers your braces, all your orthodontic visits and retainers after treatment and retainer supervision and maintenance for up to 12 months!
Methods of payment
For your convenience, we accept bank transfers, direct debit, cash, EFTPOS, Visa, MasterCard and cheque. We also have HICAPS facilities to process health fund rebates instantly in the clinic.
Payment plans
We understand that payment plans are important. Therefore, we offer tailored payment plans for all our patients so you can comfortably spread out your treatment fee over the duration treatment.
After an initial deposit is paid, the remaining balance is fixed up in regular instalments over the next 18-30 months, depending upon the case. This usually equates to $60 a week or $250 a month.
Health Funds
Private health funds can cover a portion of the fee. The rebate usually depends on your level of cover and the health fund you’re with. As all health funds are different, we recommend checking with your health fund prior to beginning treatment.
Health funds pay in different ways. For this reason we offer our patients different payment options including:
1) an upfront payment;
2) thirds;
3) and a payment plan -which is the most popular choice. We are happy to help and accommodate you wherever we can!
Retainers
At the end of your orthodontic treatment, when the braces are removed, your teeth have a natural tendency to crowd again. This is a normal part of ageing, and things may start shifting back to their original positions or even new positions. Therefore, it is very important you wear your retainers after orthodontic treatment to keep your smile beautiful! Our Dentist would advise you the suitable retainers in your case and also give you all the options available with their pros and cons.
Retainers are devices which hold your teeth in their corrected positions. There are generally two types of retainers: removable and bonded.
Removable retainers:
Hawley Retainer
This is an acrylic plate with three wire segments. It is firm, steady and good for maintaining any expansion of the jaw that was done with a rapid maxillary expander (RME).
Begg Retainer
This is also an acrylic plate but with one wire segment that wraps around all the teeth. It allows good ‘settling’ or meshing of the teeth into the bite after the braces are removed. You can take it in and out and choose different colours!
Truform
This is a clear upper retainer that is almost invisible. Truform retainers are comfortable and aesthetic. It is important they are removed using TWO fingers, one on either side to ‘flick’ it down. If pulled out from just one side they are prone to cracking in the center! Cleaning is very important. We recommend gentle brushing of the retainer using liquid soap and water. Avoid toothpaste as it can cause the retainer to go cloudy. If it starts to stain we recommend soaking it in a solution of part vinegar and part water to dissolve any tartar build-up.
Like shoes, Truform retainers wear out after time, so you may need to get them replaced every few years.
Bonded retainers:
Hygienic retainer
This is a looped metal bar bonded behind the front teeth. It is made with loops incorporated so to allow patients to floss easily. Hygienic retainers hold all the teeth.
Straight retainer
This is a straight metal bar bonded behind the front teeth and attached only to the canines. It is sturdy and reliable The advantage of a straight retainer is that if one lump of glue comes off, the entire retainer will become loose, alerting the patient know that they need to see the dentist as soon as possible to get it fixed!
We recommend wearing your retainers full-time (that is, 24 hours a day and only taking them out to eat, drink, brush your teeth and play sports/swimming) for the first 6 months. Thereafter, night time only wear is suffice.
For the first few years after your braces come off it is important to wear your retainers every night. After that, the teeth are generally stable and wearing your retainers a couple of times a week or once a week is enough. However, there is no stage when you no longer have to wear retainers. Retainers are a lifetime commitment if you want your teeth to stay straight!
It is important to clean your retainers regularly. The best time to do it is when you take them out to brush your teeth. There are commercial cleaners available, but toothpaste and a soft-brush will do the job in most cases.
Like shoes, Truform retainers wear out after time, so you may need to get them replaced every few years. Bonded retainers, on the other hand, last a lot longer so long as glue is added to the back every time it wears off.
Risks of treatment
All forms of medical and dental treatment, including orthodontics, have risks involved. Fortunately, in orthodontics, complications are rare, and when they do occur, they are usually minor in consequence.
Nevertheless, you should be aware of the potential risks of treatment and limitations when making the decision to undergo an orthodontic procedure.
Tooth decay
If the teeth are not cleaned properly during orthodontic treatment, cavities can form. Braces themselves do not cause cavities, but rather it is the poor brushing around them that does. Therefore, it is imperative that extra care be taken with your oral hygiene, by brushing and flossing regularly and seeing the dentist for check-ups.
White spot lesions
White spot lesions are white marks on the teeth. Excessive sugar and soft drink intake along with poor brushing can lead to white marks on the teeth when the braces come off. This can be quite unsightly, so it is important to brush well and eat healthy to prevent this from occurring.
Relapse
After treatment your teeth have a tendency to start crowding again. This is a natural process that occurs in everyone, regardless of whether or not they’ve had braces. To prevent this, long-term faithful wear of retainers is required.
Gum disease
If the mouth is not kept clean by regular brushing and flossing, plaque and bacteria can build-up which can lead to gum (periodontal) disease.
Root shortening
In some patients, the length of the tooth roots may become shortened during orthodontic treatment. Certain patients are prone to this occurring whereas others are not, with susceptibility being difficult to predict. Root shortening is usually minor and rarely has significant consequences, but in severe cases it can threaten the longevity of the teeth.
Jaw joints
Occasionally patients undergoing orthodontic treatment may suffer from jaw joint pain or temporomandibular disorders (TMD). These problems are unrelated to orthodontic treatment and are usually a coincidence as they tend to appear during our teenage and young adult years –a time when we usually get braces.
Tooth vitality
Sometimes a tooth may have a delicate nerve because it has been traumatised previously or has a deep filling. Orthodontic tooth movement in some cases can aggravate this condition and in rare instances lead to a loss of vitality and discolouration of the tooth, requiring root canal treatment and other dental treatment to restore the colour.
Allergy
Very infrequently an allergic response may develop to orthodontic materials in the form of ulcers in the mouth. If this happens we have alternative treatment options, like ceramic braces or Invisalign®.
Atypical growth
If the jaw doesn’t grow normally it may be difficult to achieve the desired result. Insufficient growth can limit the effectiveness of some of the orthodontic appliances whereas too much growth may change the bite significantly.
Discomfort
The gums, cheeks and lips may be scratched or irritated by newly placed appliances or by poking wires. However, braces are like new shoes –requiring a period of settling in, and after a while the mouth usually gets used to them.
General health
Certain medical conditions can affect tooth movement so it is important to inform us of any medical problems that you have and any medications that you are taking.
Wisdom Teeth
Wisdom teeth are also known as third molars or 8s. They first start to appear on a dental x-ray at about 5-7 years of age, with calcification beginning around 12 years of age. Wisdom teeth erupt usually between 17-25 years of age. Most people have four wisdom teeth, two in the upper jaw and two in the lower jaw. Others may not develop their wisdom teeth at all and can be missing one or more of them.
It was once thought that pressure from erupting wisdom teeth was the main cause of crowding of the lower front teeth. However, studies now show that wisdom teeth play may play some role in this process.
Crowding of the lower front teeth is due to a number of factors, with wisdom teeth being just one of them. Therefore, the routine removal of wisdom teeth simply to prevent crowding is not recommended.
Instead, the removal of wisdom teeth should be based on whether they are likely to cause you other problems.
General rules for the management of wisdom teeth:
If a wisdom tooth fully erupts into a good position and can be kept clean, then it should be retained.
If a wisdom tooth does not erupt, it may be left where it is, under the bone.
If a wisdom tooth partly erupts because of a lack of space, it should be monitored closely.
If a wisdom tooth is decayed or has repeated gum infections around it, then is should be removed.
If a wisdom tooth grows horizontally, it may damage the adjacent teeth so removal is wise.
If it looks like there’s no room for the wisdom tooth, removal may prevent future impaction.
When the decision is made to remove wisdom teeth, it is best done when you are young. In young patients, the roots are often not fully formed and the bone is softer, making removal easier and less traumatic. If wisdom teeth are left in place until the patient is older, then removal may be more difficult as the roots may become hooked and the bone is generally denser.
Wisdom teeth may be removed under local anaesthetic (the needle) in the dentist’s chair, under intravenous sedation in the dentist’s chair, or under general anaesthetic in the hospital.
Our dentist will advise for an OPG x-ray to check your wisdom teeth and provide advice on what to do.
Your Appointments
Initial Consultation
Your first appointment will be an initial consultation. This is free. It is basically a chat between you and our friendly dentist.
Tell us what you want improved with your smile! Our dentist will then have a look at your teeth and bite and provide an opinion as to your suitability and need for treatment. We will present you with all the treatment options so you can choose the right plan for yourself! Ask us any questions you might have and then when you’re ready, we’ll then book you in for your next appointment -congratulations!
Some patients have a thorough knowledge of braces beforehand, they can choose to have the records (diagnostics) done on the same day as initial consultation if time permits.
Records
At this appointment we will gather all the information needed to formulate your treatment plan. We will take photos, moulds (dental impressions -don’t worry, we have excellent staff who specialize in this and will put you at complete ease during the 30 second impression process!), and send you off for x-rays.
Our 2-dimensional x-rays (OPG and Lateral Cephalogram) are taken at CQMI, Rockhampton Diagnostic Imaging. All 2 D x-rays are bulk billed with Dr. Sunita’s referral and we will electronically access them once completed for your convenience. The entire records appointment usually takes 20-30 minutes.
Case Presentation
After Dr. Sunita has studied your records carefully and formulated a plan (there is an immense amount of planning involved in orthodontics, and Dr. Sunita usually spends about an hour for each of her patients devising the different options and treatment plans), she will sit down with you and discuss your treatment options. Your photos, moulds, and x-rays will be presented on a computer screen so you understand exactly what’s going on in your mouth.
We will list all the problems and then reveal the plan to address these issues and get you a perfect smile! Please feel free to ask any questions as this appointment as it’s all about you! We will explain your braces options (metal braces, clear braces, Invisalign), the estimated treatment time, and costs.
Band up
If you’re ready, the braces will then go on! This is usually a 1.15hr appointment. There are no needles, and no drills! Lay back and Dr. Sunita will simply stick the braces on one-by-one using bracket placement pliers and glue. After all the braces are attached, we will then thread the wire through them and place coloured (or clear!) modules over them. The most important part of the procedure is the ‘band up talk’ at the end. Here, one of our friendly assistants will take you through brushing, eating, how to handle emergencies with your braces, managing discomfort after the appointment, and what the components of the braces are. We will also emphasize the importance of regular 6-month check-ups to keep your teeth clean and healthy during treatment!
Adjustment
Adjustment appointments are usually booked every 5-6 weeks. At these visits we will tighten your braces and replace your modules –so be ready to choose your colours! Sometimes the intervals between adjustment visits vary from 4 to 10 weeks depending on the stage of treatment you are at. New wires are usually placed at adjustment visits -and progressing up wires is a good sign your treatment is going well! Don’t worry about discomfort at these visits -as Dr. Sunita says: “Getting braces on the first time is like new shoes, and adjustment visits thereafter are like tightening your laces!”.
Debond
Once we’ve achieved that beautiful smile, you’re ready to have your braces off! At this appointment we simply click the brackets off one by one, and polish the glue off your teeth. Photos and moulds are then taken to record the beautiful result. During this appointment we will also glue in a custom made retainers behind your front teeth to prevent the tendency to relapse.
Retention Visits
We like to keep seeing our patients! So please return for your regular retainer maintenance visits so we can keep an eye on things post-braces. These is usually scheduled 6 weeks after your braces are removed, 6 months later, and 12 months after. After 12 months you graduate from the clinic and are free to enjoy your new smile! For more information on retainers please visit our retainers page.