For the blog this month, Id like to tackle the most prevalent question we get as orthodontists. It doesnt matter whether the patient is a child, teenager, or adult. At some point, I can always expect this question.

When are my braces coming off?

Now, although this seems like a straightforward question with an equally straightforward answer, it is not. It may appear that creating a beautiful smile is as simple as placing some braces, bending some wires, and waiting. Nothing could be farther from the truth. As orthodontists, we undergo many years of specialized training in order to help us diagnose, treatment plan, and correct the malocclusions our patients present to us. Through this training, and the experience we gain over years of treating orthodontic cases, we are able to develop personalized treatment plans that will produce optimal results in the shortest reasonable amount of time.

Most cases are completed in 18-24 months, some longer and some shorter in duration. At our initial visit and consultation, we give you our best estimate of the time required for your treatment. Let me repeat, this is just an estimate. Estimates of treatment time are based upon our evaluation of the complexity of your orthodontic problem, and the expected response of the teeth to typical orthodontic forces. However, every patients biology is different, and factors such as the density of the bone surrounding the teeth and the inflammatory response responsible for tooth movement can drastically affect treatment times. These differences can cause teeth to move more slowly, cannot be known of ahead of time, and are unfortunately out of our control. In a perfect world, every case we started would finish within our estimated time, but sometimes teeth take a little extra time moving.

The most frequent culprit for elongated treatment time, however, is poor patient compliance. You can really help shorten the amount of time you spend in braces if you do your part at home. As I tell most of my patients in consult, this means keeping them clean, keeping them on, wearing your elastics, and making scheduled appointments.

First and foremost, is excellent oral hygiene. Keeping your teeth and gums clean while in treatment will result in a better environment for your teeth to move (when bleeding gums and inflammation are present teeth actually do not move as well).Additionally, poor oral hygiene can result in tooth decay, which may require braces to be removed for restorative dental procedures and elongated treatment times. We always stress the importance of brushing and flossing to all our patients, both in and out of braces.

Keeping your braces on is usually as simple as following the eating list we provide on the day you get your braces on. Sticky/chewy and hard/crunchy foods are out. Dont bite into raw fruits and veggies. Cut them up and chew with your back teeth instead. Keep your bite sizes small, because even a huge bite of bread can bend a wire out of place. Basically, if you question if something may break a brace, dont eat it. Also, try to stay away from chewing on pens, pencils, ice, your nails, etc. The braces only work when they are on your teeth, and that means following the rules.

Most patients have some elastic (rubber band) wear at some point during their treatment. Just like the braces, elastics only work when they are on. To make matters worse, the muscles of the jaw move things backwards when you arent wearing your rubber bands. I like to use the analogy of running a race. If you wear your rubber bands, its like running straight through to the finish. Not wearing you rubber bands is like running three steps forward, and then two back. Youll finish the race, but it is going to take a much longer time. Remember, we are trying to train the jaw muscles and teeth to move into a new position, which is no easy feat.

Lastly, make sure you make your regularly scheduled appointments. In our office, that usually means once a month. Each visit allows us to adjust your braces or aligners, and to make sure things are progressing smoothly. Missing monthly visits can seriously delay the end of your treatment. Additionally, try to make it to your appointment on time. This will ensure we have all the time necessary to complete our planned procedures for that appointment, and will streamline the process.

As long as you do your part, we here at L&M will try to finish things as expediently as possible. If you feel like youve been in treatment for a long time, remember, the Star Smile we finish with will be yours for the rest of your life. Good things never come easily, but are always worth the wait!