Potential Risks and Limitations of Orthodontic Treatment
The mouth is very sensitive so you can expect some discomfort due to the introduction and adjustment of orthodontic appliances. Nonprescription pain medication can be used if necessary to minimize the discomfort.
Decalcification and Dental Caries
Excellent oral hygiene is essential during orthodontic treatment as are regular visits to your family dentist. Inadequate hygiene could result in decalcified/discolored enamel and cavities. These same problems can occur without orthodontic treatment, but the risk of enamel decalcification and decay is much greater to an individual wearing braces or other appliances.
Length of Treatment
The actual treatment time is usually close to the estimated treatment time, but treatment may be lengthened if, for example, unanticipated growth occurs, if there are habits affecting the dentofacial structures, if periodontal or other dental problems occur, or if patient cooperation is not adequate.
Results of Treatment
We intend to do everything possible to achieve the best results for every patient. However, we cannot guarantee that you will be completely satisfied with your results, nor can all complications or consequences be anticipated. The success of treatment depends on patient cooperation in keeping appointments, maintaining good oral hygiene, avoiding loose or broken appliances, and following the orthodontist’s instructions carefully.
Completed orthodontic treatment does not guarantee perfectly straight teeth for the rest of your life. Retainers will be required and must be worn as instructed to keep your teeth in their new positions. Lifetime nightly retainer wear is necessary to prevent the shifting that occurs due to the natural growth and maturation (aging) processes that continue throughout life, as well as additional shifting caused by abnormal tongue thrusting, mouth breathing, and latent lower jaw growth. Minor irregularities, particularly in lower front teeth, may have to be accepted. Other changes may require additional treatment.
Some patients will require the removal of deciduous (baby) teeth or permanent teeth. There are additional risks associated with the removal of teeth which you should discuss with your family dentist or oral surgeon prior to the procedure.
Orthognathic (Jaw) Surgery
Some patients will require orthodontic treatment in conjunction with surgery. There are additional risks associated with this surgery which you should discuss with your oral surgeon prior to beginning orthodontic treatment. Please be aware that discontinuing orthodontic treatment without completing the surgery may result in a worse bite than before treatment began. Orthognathic (Jaw) Surgery Some patients will require orthodontic treatment in conjunction with surgery. There are additional risks associated with this surgery which you should discuss with your oral surgeon prior to beginning orthodontic treatment. Please be aware that discontinuing orthodontic treatment without completing the surgery may result in a worse bite than before treatment began.
The roots of some patients’ teeth become shorter during orthodontic treatment. It is not known exactly what causes root resorption, nor is it possible to predict which patients will experience it. If resorption is detected during orthodontic treatment, your orthodontist may recommend a pause in treatment or the removal of the appliances prior to the completion of orthodontic treatment.
Temporomandibular Joint Dysfunction
Problems may occur in the jaw joints (TMJ), causing pain, headaches or ear problems. Many factors can affect the health of the jaw joints, including past trauma, arthritis, heredity, tooth grinding or clenching, poor bite, and many medical conditions. Jaw joint problems may occur with or without orthodontic treatment. Any jaw joint symptoms, including pain, jaw popping or difficulty opening or closing, should be promptly reported to the orthodontist. Treatment by other specialists may be necessary.
A tooth that has been traumatized by an accident or deep decay may have a damaged nerve. Orthodontic movement may, in some cases, aggravate this condition. In some cases, root canal treatment may be necessary. In severe cases, the tooth may be lost.
Occasionally, patients can be allergic to some of the components of their orthodontic appliances. This may require a change in treatment plan or discontinuance of treatment. Although very uncommon, medical management may be necessary.
Impacted, Ankylosed, Unerupted Teeth
Teeth may become impacted (trapped below the bone or gums), ankylosed (fused to the bone) or just fail to erupt. These conditions generally cannot be anticipated. Treatment depends on the particular circumstance and the overall importance of the involved tooth, and may require extraction, surgical exposure, surgical transplantation or prosthetic replacement.
Periodontal (Gum) Disease
Gum disease can develop or worsen during orthodontic treatment due to many factors, but most often due to poor oral hygiene. You must have your general dentist or periodontist monitor your periodontal health during orthodontic treatment every three to six months. If periodontal problems cannot be controlled, orthodontic treatment may have to be discontinued prior to completion.
Injury From Orthodontic Appliances
Loosened or damaged orthodontic appliances can be inhaled or swallowed or could cause other damage to the patient. You should inform your orthodontist of any unusual symptoms or of any loose or broken appliances as soon as they are noticed. Removing orthodontic appliances, especially clear braces, can damage the enamel of a tooth or a restoration (crown, bonding, veneer, etc.). If damage to a tooth or restoration occurs, restoration of the involved tooth/teeth by your dentist may be necessary.
Orthodontic headgears can cause injury to the patient. Injuries can include damage to the face or eyes. In the event of injury or especially an eye injury, however minor, immediate medical help should be sought. Headgears are rarely if ever used in our orthodontic practice.
Due to the wide variation in the size and shape of the teeth, missing teeth, etc., achievement of an ideal result (for example, complete closure of a space) may not be possible. Restorative dental treatment, such as esthetic bonding, crowns or bridges or periodontal therapy, may be indicated. You are encouraged to ask your orthodontist and family dentist about this care.
If you have any questions at any time about any of these items, please do not hesitate to ask.