During a conversation with an orthodontist earlier today, we were discussing some factors that might influence a new patient to pursue treatment. It was suggested that new patients like to consider three main things; length of treatment, visibility of the brace and cost. I added two more to the list, likelihood of extractions and perceived management of pain and this post explores these five factors in more detail.
Length of treatment – when a brace it first fitted, teeth appear to move fairly quickly as the arch wires begin to align and level the front teeth. This is one of the reasons why some of the short term orthodontic solutions are so popular, they achieve results fairly quickly by concentrating on some of the easier movements that produce a quick cosmetic solution and visibly straight teeth. Anyone who has undertaken a full course of treatment will realise that after the first few months, movement appears to slow down as the stronger arch wires get to work making some of the more difficult movements that can’t take place so quickly. These movements are often concerned with changing the bite or other more complex alignments leading to longer term stability so although it is true that conventional orthodontics can take a while, this is for a very good reason and one that you may only come to appreciate many years after completing treatment.
Visibility of the brace – Traditional stainless steel brackets are quite visible. Trust me, I had them for 33 months and you couldn’t really miss them but having said that, no one really took any interest in my treatment so it didn’t bother me at all. For many patients though, visibility is an issue and there are a number of options that are far less visible including ceramic brackets, lingual (behind the teeth) braces and clear aligners such as Invisalign. Although every brace is visible (or may cause you to lisp a bit), the majority are so discreet no one will really notice. What is interesting to observe though is that quite a few adults who elected to have less visible braces conceded during their treatment that given their time again, they would probably go with conventional brackets!
Cost – how do you put a cost on a great smile and long term oral health? Without other factors to judge the merits of various treatment options, what choice do adults have other than to compare the cost of different systems and practices? The cost of a course of treatment is made up of many factors including the complexity of your case, length of treatment, the type of brace chosen, practice overheads etc. No two practices are the same, but if you research the options, will find many offer similar solutions at a similar cost with the cost of a short term solutions offered by dentists often not much different from a full course of treatment delivered by a specialist orthodontist.
Extractions – There is only so much space that can be achieved with IPR and expanding arches and for a number of patients, the only way to achieve the result they and their orthodontist are looking for is for some teeth to be removed to make some room to better align those left. For many, this is quite a difficult decision to make based on nervousness about having the extractions and the discomfort afterwards and concerns about facial profile with fewer teeth supporting the cheeks and lips. For many adults, I’m sure this is something they need to give a great deal of thought to particularly if they have great oral health and have been looking after a full set of teeth for many years. Discussing options with your orthodontist and dentist will be the key to better understanding all the options you have as well as some of the limitations if you decide to pursue treatment without extracting teeth.
Management of pain – any orthodontic procedure will cause some discomfort but the level of pain associated with braces is fairly minimal after the first few days getting used to a new appliance. Yes, your tongue and cheeks will get sore rubbing on the brackets and arch wires will occasionally poke you and sometimes biting into food after an adjustment will be uncomfortable but quickly all this will disappear and you will be surprised how pain free modern orthodontic treatment is. I experienced no pain during my treatment and many of the other patients I spoke to found the same so don’t let this put you off starting!
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