The most frequent question I receive in our
office is, “When will I get my braces off?” In second place and right behind is, “Dr. Kelley, is there
any way to speed up the process?”.
My professional goal for every patient is to
create an esthetically pleasing smile with the teeth fitting properly together.
Unfortunately, there is no substitute for time to allow both of these things to
happen simultaneously. This goal is most often accomplished with traditional or
lingual braces in combination with rubber bands. The braces are utilized to place the teeth in the proper
alignment. Rubber bands are
responsible for fitting the teeth together in the correct position.
Predicting the finish of orthodontic treatment
is dependent on the cooperation we have with each one of our patients. Patients who finish treatment early or
at the beginning of the estimated treatment time have one main characteristic
in common. They are MOTIVATED.
Patients who are motivated to get their braces off will come to their
appointments on time, maintain excellent oral hygiene, and comply with our
instructions for rubber bands.
Finishing time for braces is dependent on how well we partner as a
team. I love, like really love,
taking braces off earlier than expected when patients have trusted us and
worked hard to achieve their goal.
The second question, “Is there anyway to speed
up the process?” has two answers with a lengthy explanation. From an anatomy/physiology standpoint, orthodontists
are currently unable to significantly speed up the process of moving teeth. The bone and gum tissue of the mouth
can remodel only so fast.
From a treatment viewpoint, the orthodontic
process can be sped up ONLY by performing
less treatment. That’s right, less treatment. Less treatment means straightening
fewer teeth while often neglecting the most important part of orthodontics, the
fit of the teeth. Research and
experience show the long term health and stability of a patient’s mouth is
greatly affected by how the teeth fit together.
Here lies every American orthodontist’s modern
day dilemma. We live in an
immediate gratification world. We wait for little. There are companies that
will market to this way of thinking. There are several “short-term orthodontic”
companies that offer general dentists (not orthodontic specialists) weekend long
courses in straightening teeth. I am asked about these products and their
results regularly. They entice a large potential patient-base by promising
shorter treatment time for less money.
There is nothing special or magical about the products used in short-term orthodontics. Dentists
practicing this faster orthodontic plan use exactly the same brackets and wires as those used by orthodontists. BUT the
biological rules of the mouth don't change. *The rate at which
teeth move is limited by natural processes in the bone and ligaments around the
teeth, and in the end, all doctors play by these same rules. So if the rate of
tooth movement doesn’t change, how can they get the same orthodontic result in significantly
less time?
The bottom line is, they CAN’T. The end result is different. As a board
certified orthodontic specialist, *I am trained not only to align the front
teeth known as the “social six", but also to correct crowding, protrusion, open
bites, deep bites, cross bites, over bites, under bites, impacted teeth, extra
teeth, missing teeth, etc. Straightening the six front teeth is generally
achievable in the first six months of treatment no matter who provides the
braces. It is the attention given to the previously listed bite issues that requires
the extra time. The braces are on the teeth a shorter time with short-term
orthodontics because the provider merely aligns the front teeth and then takes
the braces off without addressing the positioning of the bite. In other words,
the process isn’t faster. It is just shorter because it is intentionally
terminated before thorough treatment is complete.
I always tell my patients that every smile and
orthodontic case is different. There are some patients that can be treated in
six months or less and the results are just fine. However, if you have any of
the previously mentioned bite issues, simply aligning the front teeth in six
months may leave you in a worsen condition than prior to treatment. One key to
a great orthodontic experience is choosing a professional with the training and
experience to recognize if a case really is “simple” and short-term orthodontics
is the best option.
Orthodontists are dental specialists. They
receive two to three years of additional training beyond dental school. There
are many highly capable and talented orthodontists. We care about our patients,
their smiles and their health. Most orthodontists won’t compromise a case to simply
achieve a pretty smile. Braces aren’t forever. Isn’t an additional few months
of treatment worth it to get your smile and bite right the first time?
In today’s world, there are so few things in
which we have to wait. I am
thankful that I am part of a profession that teaches patience and the
importance of waiting. There are so many rewards to be gained in the process of
being still, patiently enduring, and simply waiting.
Grateful to wait with you,
Dr. John Kelley
