Frequently asked questions
In this tab you will find answers to frequently asked questions by patients which I come across during consultation appointments.
- When to report for the first orthodontic appointment with the child?
It depends on several factors. First of all, if something worries you about the appearance of your child's teeth or jaw bones, it is always worth checking it out during a medical consultation, even to dispel fears regardless of the patient's age. The second factor is the child's psycho-emotional state. A patient who is afraid, refuses to open their mouth or sit on a dental chair cannot be examined or treated. Prior psychological preparation for the appointment is on the parents' side. Having many years of experience working with children, I am in many cases able to help in changing the attitude towards orthodontic treatment and contact with a doctor, but unfortunately not in all cases. In my practice, I recommend the first "serious" control after the first phase of tooth replacement (the presence of all permanent upper and lower incisors and the first permanent molars), i.e. at the age of about 8-8.5 years. This is the time when the ratio between the size of the permanent teeth and the size of the bones can be observed (possible lack of space) and it is also the optimal age for possible start with removable braces. Over the next two years, there is no replacement of more teeth and the jaw bones grow. Removable appliances are generally speaking to control the growth of jaw bones and a child at this age is more willing to cooperate during treatment and aware of its importance (motivation). Of course, every patient is different and you should not pressurize too hard because with a negative attitude of a young patient we will not be able to achieve regular wearing of the braces for a long time. All removable appliances have the common disadvantage of requiring patient cooperation.
- Do you remove milk teeth and when to do it?
The general rule is to interfere as little as possible with the natural tooth exchange process. The presence of milk teeth and their roots stimulates the growth of jaw bones. Premature loss of milk teeth will therefore cause bone deficit and less space for permanent teeth, as well as a greater orthodontic problem in the future. In addition, the residual roots of primary teeth form a specific path inside the bone for the direction of eruption of permanent teeth, so their absence may cause irregularities in the area of eruption of their permanent successors. However, there is a situation when you need to help nature and remove a "milk" tooth. This happens when the milk tooth has not yet fallen out and its permanent successor begins to erupt in its vicinity. Then the decision should be quick because leaving it for a long time will affect the wrong place of eruption of the permanent tooth. And finally, I would like to dispel one myth. We never remove a milk tooth to make "more space" for an adjacent permanent tooth. This will only reduce the size of the jaw bones in the future.
- How long is the removable brace worn and until when?
Fixed appliances are mainly used to control bone growth, so they will have the greatest efficiency during the period of greatest bone growth, i.e. between 8 and 12 years of age. Considering the low effectiveness of treatment (compared to fixed appliances) resulting from the fact that they are not worn around the clock, a relatively long time is needed to achieve the desired effects. Therefore, it is best to start treatment with them at the age of 8-9. For the above reasons, it is pointless to start treatment with removable braces after 11 years of age, and it is certainly not guaranteed that you will achieve your goals. The operation of removable braces ends with a decrease in the growth rate associated with the growth spurt (puberty), i.e. around 12 years of age.
- From what age can treatment with fixed braces be started?
In my treatment procedure I pay attention to three necessary factors. The first is willingness and strong motivation on the part of the patient. Secondly, the presence of all permanent teeth and, thirdly, the patient after the growth peak during the growth spurt (puberty). There may be exceptions to the second and third conditions. These are individual cases when younger patients use partial fixed braces (for example D-Gainer). Due to the different pace of development, girls start their treatment at around 12 years of age, and boys at 13 years old.
- Up to what age can orthodontic treatment be applied?
The reconstruction of our bones (also jaws) lasts a lifetime. Given that during orthodontic treatment we use the natural ability of jaws to remodel, this process can be started at any age. Of course, the different age-related remodelling rates and its effect on treatment time and bone stabilization after treatment should be considered. Very often at a later age orthodontic treatment is used to treat disorders of the temporomandibular joints and as a preparation for prosthetic treatment.
- Are there any contraindications to orthodontic treatment?
Of course, as with any type of treatment, there are also absolute and relative contraindications. The first group includes the patient's lack of willingness and cooperation. In addition, they include poor oral hygiene, active periodontal disease, oral cancer and some systemic diseases. Relative contraindications include, for example, smoking (it disturbs fibre remodelling and produces negative pressure in the mouth, which may prevent you from achieving your goals or a stable treatment effect), as well as taking certain medications. For these reasons, it is important to inform your doctor during the consultation about existing systemic diseases and permanent medications.
- What things should parents pay attention to in terms of the proper development of the masticatory system in their children?
Many factors affect the proper development of the body. Diet and type of food, adequate rest and sleep, daily physical activity. There are now more and more publications on healthy lifestyles, and there is no need to duplicate this. However, I would like to draw attention to the so-called parafunctions. There are incorrect activities or habits that, if not corrected, can lead to the development of malocclusion. So it is prevention of disorders, which is currently considered the best form of treatment. Parafunctions are associated with the way of breathing, swallowing, chewing, speech and unnecessary habits. During sleep and in a relaxed state of the body, breathing should be through the nose (with the mouth closed).