When Do I Get My Braces Off?

The absolute, single most most common question I get as an orthodontist is this:  “When do I get my braces off?” 
Although treatment is unique for every patient, there are some basic objectives and steps of orthodontic treatment that are similar for the majority of the patients I see in my office.  If you have braces now and want to know how you are progressing, please read on…
 

In my office there are three distinct phases of treatment through which every patient must pass. Although their order may be switched or there may be some overlap between them, the three steps of orthodontic include resolving the crowding/spacing, aligning the teeth, and correcting the bite.

In the first step, crowding is corrected by either expanding the arches or by removing teeth through extractions. Teeth cannot be aligned if there is simply not enough room for them. The decision to expand or extract is determined by a number of variables including the size of the teeth, the size of jaws, the amount of bone and gum tissue supporting the roots, and the profile and facial esthetics. The first step is to create room so that the teeth can be aligned. If a patient has extra space at the start of treatment, that space must be closed during this step.  If the teeth are crowded, then space must be created for them.

Once there is room, the second step is to align or straighten the teeth. Aligning the arches is accomplished using wires, elastic chains, springs, and other auxiliaries that rotate, tip, torque, tweak and tease the teeth into their desired positions. Another common step in the alignment process is “repositioning” individual brackets. Sometimes brackets cannot be put in the right place on the first day because of the bite, the alignment, or the shape of the teeth. After the teeth have been partially aligned however, the brackets can then be moved to better positions.

The third step of treatment is correcting the bite or making the upper teeth fit the lower ones. This must be accomplished in all three planes or dimensions of space, front to back (overbite or underbite), side to side (crossbites), as well as top to bottom (open bite or deep bite). Making the upper match the lower is accomplished with wires, rubber bands, springs, or in extreme cases surgery. When the bite is right, the backs of the top teeth rest lightly on the fronts of the bottom ones and the teeth should interdigitate nicely, such as how the teeth of a zipper fit together.

 

The “When do I get my braces off?” question usually arises during the third or “bite step” of treatment. By that time the crowded, crooked teeth are gone, the smile looks great, and the patient is generally happy with how things look. I have to admit that the first half of treatment exhibits more dramatic changes and is more exciting than the last half. But I must stress that it is during the final phase however where the overall bite is corrected so that the results will be healthy and stable.  I admit, this can be a hard sell to some people.  But rest assured that these small tweaks and adjustments are very important.  I am a big believer that the best long-term retainer is a good bite.

If you are wondering if you’re getting close to getting your braces off, compare what you see in your mouth with this quick checklist:

        1. Are the teeth straight?
        2. Are the spaces between the teeth closed completely?
        3. Do the upper front teeth overlap the lower front teeth appropriately (not too deep, but no visible   space between them)?
        4. Are the outer cusps of the upper teeth resting on the outside of the corresponding ones in the lower?
         5. Is the overbite or underbite corrected?

If it is obvious that your teeth are still crooked, have spaces between them, or you still have a deep bite or overbite, you probably still have some time remaining. If your treatment time is longer that was originally estimated, check out another article I wrote about that at http://wheelerortho.blogspot.com/ entitled Dr. Wheeler’s Formula for Successful Orthodontic Treatment.  If you have specific questions about your smile or your treatment, ask me to explain what objectives remain in your treatment.  Rest assured that your braces will come off when the best result is achieved and not before. 

--- Doc W

Content used with permission by Dr. Greg Jorgensen

http://www.gregjorgensen.com/blog