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FAQ

Welcome to Dr LM Pretorius’ Frequently Asked Questions section. Click on one of the questions below to view the answer.

What is Orthodontics?

Orthodontics is one of many dental specialties.  The word “orthodontics” is derived from the Greek word orthos, meaning proper or straight and odons meaning teeth.  Orthodontics is specifically concerned with diagnosing and treating tooth misalignment and irregularity in the jaw area.

Orthodontic treatment involves the design and use of corrective appliances to bring the teeth and jaws into proper alignment.

To accomplish proper alignment, the orthodontist attaches braces to the patient’s teeth.  Braces consist of brackets and wires.  The wires apply light pressure to each tooth while the brackets are the handles that transmit the force to the tooth.  During the treatment, the orthodontist will periodically make adjustments to maintain the directional pressure required to continue the movement of the teeth.

Initially, orthodontic treatments were geared towards the treatment of teens and pre-teens, but these days around 30 percent of orthodontic patients are adults.

What is an Orthodontist?

An orthodontist is a specialist in the diagnosis, prevention and treatment of dental and facial irregularities.

In much the same way that doctors choose to specialize in areas such as radiology or neurology, dentists can also choose to specialize.

Orthodontists are fully qualified dentists who have completed a full-time four year post graduate program at a dental school, in order to learn the special skills required to manage tooth movement and guide facial development.

The American Association of Orthodontics (AAO) is the regulating body for this branch of dentistry.  Selecting an orthodontist who is a member of this organization adds the assurance that treatment is being administered by an individual with specialty education in oral biology and biomechanics.

What is a malocclusion and why should it be treated?

“Malocclusion’’ is a technical term for crooked, crowded or protruding teeth which do not fit together properly and literally means “bad bite”.  It is noted by the incorrect relationship between the upper arch (maxilla) and the lower arch (mandible), or a general misalignment of the teeth. Most malocclusions are inherited.  These include crowding of teeth, too much space between teeth, extra or missing teeth, cleft palate and a variety of irregularities of the jaws and face.  Some malocclusions are acquired.  They can be caused by thumb sucking, mouth breathing, prolonged pacifier use, poor oral hygiene, poor nutrition, tongue thrusting, dental disease, premature loss of primary or permanent teeth, accidents, injuries or some medical problems.

The following are three main classifications of malocclusion:

  • Class I: The occlusion is typical, but there are spacing or crowding problems with the other teeth.
  • Class II: The malocclusion is an overbite (the upper teeth are positioned further forward than the lower teeth). This can be caused by the protrusion of anterior teeth or the overlapping of the central teeth by the lateral teeth.
  • Class III: Prognathism (also known as “underbite”) is a malocclusion caused by the lower teeth being positioned further forward than the upper teeth. An under bite usually occurs when the jawbone is large or the maxillary bone is short.

The Before and After section might help you to identify your or your child’s specific orthodontic problem.

What does orthodontic treatment with Dr LM Pretorius offer you as a patient?

Orthodontic treatment will create self-confidence for anybody who was previously too self-conscious to smile or talk to people because they felt ashamed of their teeth.

Straighter teeth perform chewing, biting and speaking functions more effectively than crooked teeth.  In addition, research has found that a super smile is associated with superior intelligence and a higher income.   The correction of function can aid the prevention of many dental problems and helps to prevent discrimination because of facial appearance.

There are many advantages to well-aligned teeth, including easier cleaning, better oral hygiene, clearer speech, a more pleasant smile and a youthful appearance.

It is our practice’s passion to give you a super smile for others to admire.  Treatment with us will change your life.

It is the best investment you will ever give yourself or your child.

At what age should my child be checked by an orthodontist?

Early detection of problems is important to avoid complicated treatment later on.  Growth can also be utilized and manipulated in young patients.

Should severe skeletal malocclusions occur, orthodontic treatment must commence before puberty growth spurt, which is around the age of ten.  Surgical correction of the skeletal deviation can then be prevented in most cases.

Do I have to be referred by my dentist in order to get my consultation appointment with Orthodontist?

No, it is not essential to be referred by a dentist but many of our patients are indeed referred by their family dentist.  Many other patients take the initiative to schedule a complimentary examination themselves after familiarising themselves with our practise on our website.  It is however important to have a dentist who can look after your general dental health and who can advise you when you need to see a specialist.

How long will I be in braces?

The average case will take 18 to 24 months. Some cases can be completed in less than 18 months.  Our unique Dolphin Management system, as well as the self-ligating bracket system that we use, are designed to reduce the number of times you will need to be seen and the overall length of treatment.  Treatment time varies with the severity of the case, patient co-operation, growth and development.  Dr Pretorius will attempt to estimate treatment time at the initial appointment.

How often are appointments?

Our self-ligating bracket system, as well as our Dolphin Management system, are designed to keep appointments few in number and short in time.  The use of self-ligating braces in our practice, like the Damon® braces, reduces the amount of orthodontic visits.   After appliances have been placed in a person’s mouth, we routinely see the patient about every ten to twelve weeks.

Do braces hurt?

Because teeth are moving through the bone in the jaw, orthodontics can sometimes cause some discomfort.  Our well trained, very experienced staff will strive to make every appointment a relaxed experience.  The use of self-ligating braces in our practice, like the Damon® braces, reduces discomfort and pain and ensures increased comfort.  An information sheet is provided so if any discomfort is experienced, the patient will know what to do.  All patients are well informed through information sessions and the necessary instruction documents are provided.

Are there things I can’t eat?

Yes, once treatment begins, we will give complete instructions and provide a comprehensive list of foods to avoid.  Some of those foods include: ice, hard candy, raw vegetables and all sticky foods (i.e. caramel and toffee).  Some good foods can be cut up and chewed on the back teeth.  You can prevent most emergency appointments to repair broken or damaged braces by carefully following our care instructions.

A normal, healthy diet is still possible while in braces.  You can still eat many of your favourite foods, but there will be some foods that you will need to stay away from.  We provide each patient with a list of restricted foods.  This tells the patient which foods to stay away from and why.

Can I still play sport?

Yes. But we recommend a protective mouth guard for all sports.

Can I return to school the day I receive my braces?

Yes. There is no reason to miss school because of an orthodontic appointment.

How much does it cost?

Our goal is to give you a beautiful smile that will last a lifetime.  As soon as a treatment plan has been decided upon, a fee will be given.  Payment plans are available to make orthodontics affordable for almost everyone.  We are happy to co-operate with all medical aids, although we do not contact them directly.  Orthodontic treatment is not a cost, it’s a lifetime investment

Will I need to have teeth extracted for braces?

With traditional Edgewise braces, also called colour braces, a tooth or multiple teeth often need to be removed to create space.  Self-ligating brackets like Damon® braces that we use in our practice can be affixed without the removal of healthy teeth, because this system uses the body’s biological forces to create space naturally.

Are all types of braces the same and does the type of bracket influence the result of the orthodontic treatment? And which will be the best for me?

No all braces are not the same.  There are two main types of brace systems:

  • Traditional brace systems for instance the Butterfly System (also called colour braces)
  • Self-ligating brace systems, like the Damon System, Innovation C and Empower braces.

The type of bracket will influence the result of the orthodontic treatment.  The self-ligating system is an innovative way to straighten the teeth quickly and comfortably. With traditional braces, a tooth or multiple teeth often needs to be removed to create space.  Self-ligating braces can be affixed normally, without the removal of healthy teeth, because these systems use the body’s biological forces to create space naturally.

The best option is therefor the self-ligating system.

What makes Self-ligating braces like the Damon® System different?

What makes Self-ligating braces like the Damon® System different? The Damon® System differs from traditional braces systems in a number of important ways:

Self-ligating braces – Damon® braces are passive and completely tie-less.  The usual elastics and metals are replaced with unobtrusive sliders.  Not only does this mean that there is nothing for the orthodontist to “tighten”, it also means that there is less chafing on the lips and inner cheeks.

Shape-memory wires – Traditional braces require a heavy arch wire to link the brackets and assert pressure on the teeth.  The Damon® System replaces this with a hi-tech lightweight shape-memory wire.  In essence this wire is programmed to move the teeth quickly by working in conjunction with natural bodily forces.

Facial aesthetics – Damon® orthodontists use computers to project what the face might look like in 10,20 and even 30 years.  This is extremely useful when planning treatment, because changes to the teeth can affect the whole face.

Healthy teeth – Damon® brace brackets are much smaller than traditional brace brackets.  They are designed to reduce plaque build-up around the brackets and make home hygiene much easier.  Plaque built-up can quickly lead to decay- especially for those wearing braces, which makes easy cleaning even more critical.

Ceramic braces may lessen the visibility of braces; they blend in with the teeth for a more natural effect.  Invisible retainers can also be used in specific cases.

What problems can orthodontics treat?

Orthodontics can treat a wide range of dental problems and in most cases, completely re-align the teeth.  Orthodontists may work alone or in combination with a maxillofacial surgeon.

The typical irregularities requiring orthodontic treatment are as follows:

Crowding – A crowded mouth means there is insufficient space within the jaw for all of the teeth to fit naturally.  Crowding may lead to displaced, rotated or completely misaligned teeth.

Overbite – An overbite refers to the protrusion of the maxilla (upper jaw) relative to the mandible (lower jaw).  An overbite gives the smile a “toothy” appearance and the chin looks like it has receded.

Underbite – An underbite, also known as a negative underjet, refers to the protrusion of the mandible (lower jaw) in relation to the maxilla (upper jaw).  An underbite makes the chin look overly prominent.  Developmental delays and genetic factors generally cause underbites and overbites.

Can adults have braces?

Definitely!  People of all ages deserve a beautiful smile and we are proud to treat anyone interested in having a healthy bite and straight teeth.  The basic process involved in moving teeth is the same for adults as it is for children; therefor, orthodontic treatment can usually be successful at any age.

The introduction of clear braces has allowed many more adults to seek treatment. Approximately 30% of our patients are adults.

Did you hear about Invisalign and need to know how that works?

Invisalign treatment is a series of clear covers which progressively align the teeth in treatment cases that only need minor alignment.  They are expensive at a cost of about R28 000 extra and generally are not as efficient as traditional braces.  They are fairly uncomfortable and limit the speech ability.  Their only appeal is that they can be removed, but this reason is why we do not recommend them.  Co-operation from the patient is essential as treatment can be prolonged and roots can be damaged due to forces out of the orthodontist’s control.  These cannot be used in cases where skeletal correction with growth modification or surgery is prescribed.

Do I need to keep up my regular 6 monthly visits with my dentist?

Orthodontics is a treatment area on another level of dentistry.  Orthodontists do not do fillings or any such restorations, therefor it is essential that you keep up your regular 6 monthly check-up appointments with your dentist.  It is of the utmost importance that you have your teeth cleaned by your dentist or oral hygienist at least every 6 months or at more regular intervals should you be advised to do so while you have braces.

Do orthodontists clean teeth?

Orhodontists work in close collaboration with dentists in their area and as their expertise fall in another category as those of the dentist, which include evaluation, treatment and prevention of oral and dental diseases, they prefer you to go to your dentist to have your teeth cleaned.

Do I have to floss and brush more than I used to?

Braces create a unique oral hygiene need because plaque and food might tend to get stuck more in areas that were previously easily accessible.  Patients should therefor try to brush their teeth after every meal and floss at least once a day. Keeping your teeth clean will help you prevent a wide range of dental diseases.  All patients will be provided with full instructions and illustrations for brushing and flossing.  For a full illustration please go visit our personal youtube video created for your convenience from our Dolphin Aquarium system.

Is orthodontic treatment possible when there are still baby teeth present?

In some cases early intervention is essential to utilise growth in order to prevent more serious orthodontic problems in the future and then baby teeth will still be present.   It is also advisable in cases where a space deficiency is detected at an early age, to intervene to create space for the permanent teeth developing.

Can orthodontic treatment be performed although I have some absent teeth and crowns?

Definitely!  The roots of the teeth move in the bone and therefor a crown or simple filling does not affect orthodontic treatment as these teeth move the same way as a tooth without any fillings.   It may in some cases where teeth are absent even be advisable to have orthodontic treatment in order to establish better functionality and aesthetics.   Implants however will not move in the bone as a normal rooted tooth would, and ideally should only be done after orthodontic treatment has been completed.  Should you however already have implants, we can still manipulate the surrounding teeth in order to correct any deviation that affects functionality or aesthetics.

Is jaw surgery always necessary?

No! A stable, aesthetically pleasing profile and occlusion can in some case only be achieved by jaw surgery if the discrepancy between the top and the bottom jaw is more than 5mm and cannot be corrected by orthodontics alone.  This will be decided by the orthodontist after all records have been evaluated and a personal treatment plan has been drafted for you.

Will surgery improve my looks?

In cases where the lower jaw is underdeveloped, you can experience the change for yourself by sliding your lower teeth forward until you bite edge to edge on your top teeth.  The change in your profile should give you an indication of the improvement that jaw surgery will have on your profile appearance.  Only in cases where the top or the bottom jaw is underdeveloped, will surgery be indicated.

Will smoking have an effect on recovery, should I need jaw or gum surgery?

As smoking is a contra-indication for infections, it is advisable that you should stop smoking for three months before and after surgery.

How does smoking effect orthodontic treatment?

As smoking promotes bone loss and gum disease and tend to constrict the little blood vessels in the bone, periodontal ligaments and gums, it is most likely to slow down your treatment and cause unnecessary infections.  Smoking also causes discolouration and staining on the teeth.  It also stains the elastics that we use in orthodontics.

Do I need to have my wisdom teeth removed before orthodontic treatment?

It is only in very rare cases that you find that there is enough space for wisdom teeth to develop and come out in normal positions in the mouth.  More often than not they cause all kinds of problems like headaches and gum infections because of their struggle to find space in the mouth.   It is common to find that because of the pressure they exert, that front teeth may tend to crowd, top and bottom.  They are normally fully developed and start to appear in the mouth at the age of 18.  It is advisable to have them removed at about 16 years of age before the roots are fully developed as removal later on can become complicated.  Wisdom teeth is one of the major factors influencing the stability of an orthodontic case as they create a negative force that can influence the long term results of your orthodontic treatment.

Can my dentist do orthodontics or should I choose an orthodontic specialist?

Because orthodontic treatment causes major changes to your facial structure and appearance it is advisable that you choose an orthodontic specialist with extensive and specialized training and experience to see to you orthodontic needs.

What causes orthodontic problems?

Most orthodontic problems are genetic, but other factors such as chronic sinus can also play a role. Genetic influences can result in crowding of the teeth, too much space with gaps in between the teeth, extra teeth or absent teeth. Abnormalities to the face, jaw or teeth are also a result of genetics.