By Stephen Yang, DMD, MS
Board Certified Orthodontist
In my office, patients usually come in already knowing a lot about braces and orthodontics. However, what they have heard from friends or read online is not always correct. Below, I will share some common myths that patients have about orthodontic braces.
1. Braces have to hurt or feel tight to work—No pain no gain right? Well, not exactly. In the old days, only stiff wires were available. When tied to the dental braces, these stiff wires exerted heavy forces leading to more pain and discomfort for the patient. Now, with new technologies and flexible wires, there is significantly less discomfort associated with tooth movement. These days, you can have straight teeth with minimal discomfort. However, there are always some patients that 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!”
2. The tighter the better—A common comment I get from patients is, “Make it tighter, doc. I want to get my braces off faster!” You may think that tighter adjustments and heavier forces will move your teeth faster. While a certain level of force is necessary to move teeth, a force level that is too high may start to damage the bone and surrounding tissues. Orthodontics is a delicate balance of forces. Too much force may cause some teeth to move the wrong way and increase overall time you need braces.
3. Wires need to be changed every visit—Super-elastic wires of the present day can be bent into all different shapes and still spring back into their nice U-shaped form. If you have crooked teeth, the super-elastic wire can be connected to your crooked teeth and prove a steady light force to straighten them without needing to change the wire very often. With the limited wires of the old orthodontia days, if a wire was used that put too much pressure on a tooth, the bracket would either pop off the tooth or the wire would be permanently deformed and not move your teeth at all! That is why in the old days, orthodontic patients got many wires with incrementally higher stiffness, and these wires were changed more frequently.
4. Only braces can straighten my teeth—Not necessarily. With new technology, it is now possible to have straight teeth without ever having to wear braces! Invisalign clear aligners are the most popular way to straighten teeth without braces. However, before you get too excited, know that Invisalign does have its limitations. For example, Invisalign may not be the best orthodontic option for fixing some bite problems or severely crooked teeth. The best way to see if Invisalign can straighten your teeth is to find an Invisalign orthodontist and schedule a consultation.
5. My spaces will start closing as soon as I get braces—Many people who get braces to close gaps between their teeth have the unrealistic expectation that the gaps will start closing as soon as they get braces. Often times, these patients are disappointed after a few months when their spaces have not closed (or have even gotten bigger. The issue with closing spaces is that is takes a controlled system of orthodontic braces and wires to close spaces. Often, the teeth need to be totally aligned before the spaces can begin to close. If spaces open up after getting braces, you may want to kindly ask your orthodontist about the new spaces, but rest assured that many patients get spaces early in braces which are closed later when the teeth are straighter.
6. Once I get my braces off, my teeth will stay straight forever—Getting your teeth straight and your bite right is just half the battle. Keeping your teeth straight after getting your braces off is the rest of the battle. Teeth are connected to the bone by elastic fibers. As the teeth are moved into their new straightened positions, some elastic fibers are stretched and others are compressed. After your braces are removed, these elastic fibers will tend to push and pull your teeth back towards their original position. That is why orthodontic retainers are required when braces are removed to keep your teeth straight.
7. My wisdom teeth are making my teeth crooked—You may think that wisdom teeth cause crowding. However, there is very little evidence to support the fact that wisdom teeth cause crowding. If this was true, then your teeth would never get crowded after your wisdom teeth were extracted. In fact, people who never developed wisdom teeth or who had their wisdom teeth removed may still see their teeth get crooked over time. Teeth just tend to drift forward over time regardless of whether or not you have wisdom teeth.
8. Any overbite is bad—If I had a dollar for every time a new patient complained of having an overbite, only to be told that their overbite is normal, if could probably have bought a car by now...ok, ok I'm exaggerating. The point is that many patients think that having a mild overbite is a bad thing and this is wrong. People with zero overbite (whose teeth bite together in the front) actually start wearing down their front teeth over time. So a small overbite actually protects the front teeth from wearing down. Of course, a large overbite can be problematic so a small overbite of only two to three millimeters is ideal.
9. The date that I am supposed to get my braces off is set in stone—When patients are told before treatment that they will be in dental braces for a certain number of years, it is very easy to focus on that date. Usually, an orthodontist can judge from his or her experience what the typical time frame is to finish treatment. However this depends on many factors. Some factors that would slow down treatment include: broken braces, not brushing well, not coming in for regular appointments, and having dense bone. If you want to get your braces off on time, make sure you co-operate by brushing and flossing well, wearing your elastics, and showing up for your regular appointments.
10. It is easy to transfer or switch orthodontists—Though it may just look like braces and wires to you, every orthodontist uses slightly different wires, brackets, and appliances. Sometimes, the wires that one orthodontist uses would not even fit in the braces that another orthodontist uses. Each orthodontist also has his or her own technique in treating each case. For example, in creating that beautiful smile, some orthodontists may focus on correcting a bite problem first while other orthodontists may focus on straightening the teeth first. Sorting out the finances is another difficult part of switching orthodontists because different offices structure their payment plans in different ways. If you switch orthodontists, you probably will end up paying more money than if you had just stayed with one orthodontist.