Advice of patient
Orthodontics and gnathic orthopaedics is an autonomous stomatological discipline concerned with teeth displacement, dental archs and jaw abnormalities. The orthodontic therapy is aimed at regular dental archs, which helps patient to get rid of both functional and aesthetic complaints, or prepare the teeth for prosthetic, periodontic or even surgical treatment.
Determining a therapeutic plan
Before the treatment itself begins, determining the right therapeutic plan is necessary. Primary examination, filing the documentation, X-ray picture taking, dental impression and taking photos as parts of documentation are inseparable steps of the treatment. Therapeutic plan becomes binging after your approval, however, in the course of the treatment the plan is rather difficult to change. On the other hand, due to individual specifics, treatment sometimes gets complicated and circumstances change and in these cases the therapeutic plan has to be changed as well. Rely on your dentist that all changes will result into the best treatment possible. Besides the dentist, professionally trained orthodontic nurses perform at the time of regular fixed appliance checkups under her supervision and in accordance with her instructions.
Active orthodontic treatment
Removable and fixed appliances are used when orthodontic treatment is provided. Removable appliance can be removed by patient himself/herself and it serves for slight defects treatment or pre-treatment in the case of difficult abnormalities before fixed appliance is placed, previously in oneīs childhood. Removable appliance is also used after fixed appliance treatment to stabilize and keep the results.
Fixed appliances are nowadays the most frequent treatment practice. It is represented by brackets and rings stuck down the teeth during the treatment. Progressively, enclosed wires form ideal arch and, with them, we move the teeth into the right place. Long-term all-day acting is the right way to reach very good and permanent results even when defects are extensive. According to the severenity of the defect, the approximate treatment range from 1.5 to 3 years.
This technique was developed in the USA and Scandinavia more then fifty years ago and there has been a lot of experience with it. We are able to offer you the treatment of the same quality level as in these countries. It is important for you to know that the fixed appliance is the only apparatus that can ensure the teeth moving through light, straightly directed and continuously acted forces. Some patients from some reasons donīt want to have the fixed appliance placed and in such cases no treatment is often better than the risk of unfinished defect treatment complications.
The patientīs cooperation
Fixed appliance doesnīt mean any handicap, the opposite is true it is in among teenagers and it is a sign of good care of yourself or your children. But perfect patientīs cooperation is a must. Regular monthly checkups are once a month approximately in the case of fixed appliance, after 2 or 3 months when removable appliance is concerned. When you donīt comply with checkups, the treatment is prolonged or some harmful effects can occur. If you canīt come to regular checkup, please, make your appointment over the telephone again. We try our best for you not to wait so long and to reduce the time of the treatment as much as possible.
Thatīs why we ask you for consideration to us and other patients too. In extreme situations we are forced to claim financial compensation for unauthorized checkups. When using removable appliance you are expected to follow the doctorīs advice on screw activating and keeping the appliance carrying schedule. The cooperation is essential, otherwise no progress in treatment is made and all efforts as well as finances are useless. We would like to treat only the patients really interested in their treatment and willing to cooperate. In some patientsīcases we use some additional appliances together with the fixed appliance.They are mainly external traction and elastic traction of various types. Nurses will inform you on using them and provide you with some practice.
Perfect oral hygiene is an exceptionally important requirement of successful treatment. Teeth with fixed appliance need to be cleaned after each meal for at least 3 minutes. It is important for patient to get used to carrying toothbrush with him/her to school, checkups and every place where eating is expected. Inadequate hygiene can result into the development of stains from the reason of enamel decalcity. Oral hygiene insufficiency is the most common reason for removing the fixed appliance, as we canīt allow the teeth devastation. When fixed appliance is inserting, everybody is instructed in details how to take care of it, including appropriate cleaning and recommendation of suitable tools. Some eating habits changes are unavoidable. You can feel some pain in a few first days, so we can recommend you to eat previously soft or liquid food, e.g. yoghurt. After this period everything can be eaten, except for extremely hard food like toast, nuts, raw carrot, kohlrabi etc. This food can be cut into small pieces. But toffee sweets or Turkish delight have to be eliminated completely. Biting pencils is also harmful. When gum is sugar free, its careful chewing is possible.
If bracket looses, making an appointment is needed. It is important for you to realize that we are specialists in our field and so regular checkups at your dentist are necessary. We often cooperate with other dental specializations as implantation, prosthetic or stomatology.
The partial cost of the treatment is carried by health insurance company, which means that your health insurance companies will cover the cost of labour but not the cost of material. As nowadays almost no materials are made in the Czech Republic, they are of foreign origin whose quality is first-class and at the same time for reasonable prices. The approximate price of fixed appliance is about 12,000 -15,000 CZK and it depends on the amount and type of the material used. The cost can be paid in instalments. Your health insurance company will provide you with further information.
Retention or stabilization phase of the treatment is no less important stage aimed at stabilization of fixed appliance treatment results. Sometimes this fact is underestimated by patients and that can lead to recurrence of the previous state. To prevent such a situation we use retention removable appliance that has to be used according to the doctorīs advice. Retainer, a thin wire put on anterior hindside, ensures 100% stabilization. If it looses, the soonest coming to the orthodontist is unavoidable. From the early middle age some teeth movement can occur as a result of ageing. And this is the reason why fixed appliances are used by many adult patients. After orthodontic treatment of young patients both dental archs are regular and fit one another. But this state is not guaranteed for all life and some patients can be treated repeatedly.
Orthodontic treatment difficulties and complications
At the beginning you may feel some pressure or even have a toothache after the fixed appliance is inserted. These difficulties are very individual, mostly starting a day after inserting but they donīt last more than a week. In extreme cases painkillers are recommended. Difficulties of this kind can occur after each checkup but they tend to be slighter and they last for shorter time. Sometimes erosion and decubitus appear and in such a case use protective wax or see the doctor. Few patients suffer from root absorption, that is tooth root shortening, and this process may accelerate in the course of treatment. But changes are so slight that they mean no threat for teeth functions and durability.
In exceptional cases some unexpected complications delay the therapeutic plan that canīt be kept (unusual patientīs tissue reaction or his/her growth). But the most frequent barrier of successful treatment is poor oral hygiene, as mentioned above, which can result into the teeth stains, cavities, gingivitis etc and there is a possibility of prematurely finished treatment. And the patient himself/herself bears the responsibility for such a state.
I was obliged to inform you about all important aspects and possible difficulties of orthodontic treatment. But donīt worry, please, I believe our cooperation is going to be very good and our efforts supported by your diligence and patience will lead to good results and you will get healthy teeth and a beautiful smile as a reward.
Looking forward to seeing you.
MUDr. Eva rámková