What can you Expect During Orthodontic Treatment?


Level of Discomfort

Orthodontic therapy uses appliances that apply pressure to move teeth. When braces are placed, or clear removable appliances (aligners) are worn, or when adjustments are made, your teeth and gums may initially feel tender. The amount of discomfort varies from patient to patient, but usually does not last for more than two or three days.


Additional Orthodontic Appliances

Orthodontic therapy may include additional fixed or removable appliances (auxiliaries) to achieve the best results. These appliances are usually worn for a limited time throughout your treatment. These appliances may include removable aligners and their composite attachments, jaw expanders, elastics, jaw correctors (headgear, overjet correctors, functional appliances), and temporary anchorage devices (TADs). Please consult with your orthodontist regarding the potential need of these additional appliances.


Additional Records and X-rays

X-rays may be needed to monitor the progress of your treatment. In addition, after your treatment is completed, your orthodontist may recommend a final set of records. These may include X-rays or 3 dimensional images, plaster or virtual imaging models, and photographs. These new records will be used to plan your retention program, to check for tooth decay, and to determine the position and/or absence of your wisdom teeth. These records will also be used to gauge what changes might occur in the future due to tooth movement or growth.


Removal of Teeth

As part of the orthodontic treatment, teeth may need to be removed. Your orthodontist will recommend removal of one or more teeth if it improves your prospects for a pleasing result. Missing teeth, on the other hand, can make therapy more difficult. In such cases, treatment compromises may be necessary and an ideal result may be impossible to achieve.


Timing of Treatment

Starting orthodontic treatment may be appropriate when patients have baby teeth as well as permanent teeth. Your orthodontist will determine the appropriate timing of orthodontic treatment based on your specific needs. Phase 1 “interceptive treatment” may begin while baby teeth are still present. Phase 1 is the first phase of an anticipated two-phase treatment plan. This treatment occurs in a growing individual which corrects harmful conditions or when dental and orthopedic corrections are required. PHASE 1 TREATMENT USUALLY DOES NOT ELIMINATE THE NEED FOR FURTHER TREATMENT AFTER THE PERMANENT TEETH HAVE ERUPTED. In Phase 2 or “comprehensive treatment” full braces are used to adjust the position of the permanent teeth to develop a proper bite and enhance facial esthetics. This phase usually starts after the loss of all baby teeth, and is usually necessary after Phase 1 interceptive treatment.


Estimated Length of Treatment

Your orthodontist may have estimated the length of treatment based upon the complexity of your orthodontic treatment, timing of treatment, growth estimates, and his/her experience treating similar cases. It is only an estimate. Length of treatment time can be shortened or lengthened by your choice of treatment plan, patient cooperation, favorable or adverse growth, general medical and dental health, and the need for additional care by other health professionals.



When your orthodontic treatment is completed, you will wear a retaining appliance to “hold” your teeth in position. Retainers are just as important as the appliances you wore during your active treatment. There are different types of retainers. Your orthodontist will recommend the right one for you. Minor changes in alignment of the teeth after treatment are not a failure of your orthodontic treatment, but are changes that you can expect as you age. Your teeth will want to adapt to these changes. In some cases, spaces may appear or not fully close. Shifting or settling of teeth following treatment, as well as after retention, will most likely occur in varying degrees. Previously rotated teeth, mouth breathing, or other uncontrolled muscle habits are frequent causes. Some of these changes are desirable while others are not. Rotations, crowding of the lower front teeth, slight spaces in the extraction sites or spaces in the upper front teeth are the most common examples. Wearing your retainer as recommended by your orthodontist is the best way to minimize these changes. Further growth after treatment may influence the alignment of your teeth and jaw. In order to protect the result of your orthodontic treatment, you may require at least part-time war of your retainer for your lifetime. Your orthodontist may recommend, or you may request, a “permanent” or “fixed” retainer. Permanent retainers are not for everyone and they cannot be adjusted to correct alignment problems. Patients must spend extra time cleaning to avoid cavities and gum disease. As with any orthodontic appliance, care must be taken in the types of food eaten to avoid breaking a permanent retainer.


Facial Growth Pattern

Occasionally insufficient or excessive jaw growth can limit your orthodontist’s ability to achieve or maintain desired results. On rare occasions, it may become necessary to recommend a change in the original treatment plan. These changes may include the removal of one or more teeth and/or corrective jaw surgery.