FAQ for Schools

Orthodontic treatment is treatment to correct irregularities of the teeth or developing jaws and to improve the function and appearance of the mouth and face.

About one third of all children have a demonstrable need of orthodontic treatment and a further third are borderline cases. The causes of these widespread dental anomalies are still somewhat unclear and controversial.

Orthodontic treatment is carried out with braces of various types. Widespread correction of the teeth to modern standards requires braces fixed to the teeth - "train tracks", usually in the early teens. Some simple movements of the teeth can be carried out with removable appliances, which should be worn full time. Although they cover the palate, interference with speech after the first day or two is uncommon and may be a sign of intermittent wear. Treatment to correct the growth of the jaws is often started earlier and is carried out using more complicated removable appliances ("functional appliances") which engage with both upper and lower teeth.

At the outset, several appointments may be required to assess the problem, take impressions, arrange for any extractions and fit the appliances. Subsequently the patient may need to be seen as often as every 4-8 weeks to assess progress and to have adjustments carried out.

The great majority of orthodontic patients are in full time education and it is just not possible to schedule all their appointments outside school hours. If there is a real problem for a particular subject it may be possible to vary the timing and day of the appointments.

When an appliance is first fitted it is unfamiliar and the pressure on the teeth can cause some discomfort or pain for the first few days; this can normally be expected to wear off quite rapidly. Simple pain killers such as paracetamol or ibuprofen are helpful. In case there is irritation to the lips and cheeks the orthodontist will usually have provided soft wax to place over the brace in the offending spot to help relieve problems until they settle.

Active treatment typically lasts between 18 and 24 months. Some simple treatment may take a lot less than this but long treatments are often associated with repeated missed appointments, or repeated breakages of the brace. When the brace has been removed, retainers are then fitted to hold the position of the teeth while they settle.

If the appliance breaks the patient should contact the orthodontic practice as soon as possible to arrange an appointment. Patients are given instructions on care of the appliance and what to do if the appliance is broken.

There is more risk of cutting the inside of the mouth during contact sports with an orthodontic appliance in place. It is recommended that removable appliances are removed for contact sports, and that mouthguards should be worn over fixed appliances.

Orthodontic appliances can certainly affect the playing of wind instruments. If the appliance is removable, its removal during playing may be advisable and the absence of the appliance for the limited periods in question will not normally have any adverse effect on treatment. Fixed appliances can cause some initial difficulty during playing especially for brass players; however, with persistence, most players find they can overcome any problems successfully. If necessary the orthodontist can provide soft wax or a guard to place over the appliance to help with the problem,

Some teenagers can feel self-conscious about wearing an appliance at least in the early stages. It is helpful if teachers can be discreetly supportive particularly if the child becomes shy or withdrawn. Any teasing or bullying on the part of other pupils obviously needs to be dealt with appropriately.