Introduction
If your child has dental braces or will be getting them, you should read this article. If you know someone that is considering getting braces, you should send them a link to this article.
I am going to explain to you a few things about wearing dental braces. How do I know these things, you wonder?
I just had my lower “adult” braces removed after wearing them for about a year. During that time, I learned many things that I want to share with you. I am writing this article to help all parents cope with their kid(s) (or themselves for that matter) when braces are being worn.
Scope and Background
This article will not be comprehensive with respect to all the methods, equipment, and techniques used in orthdontics, but you will get an idea of how braces work, in general.
Before I decided to get my braces, I looked for articles like this to help me understand what I would be experiencing, but I couldn’t find much information written by actual orthodontics patients. This is one reason why I decided to write this article.
Another reason I feel compelled to write this is simple. I was a parent to two kids that had braces when they were in middle school. Quite frankly, I paid no attention to what they were going through while wearing the braces for one to two years.
In retrospect, I realize that I was very insensitive to the plight that my kids were experiencing, as well as the reasons why they were needing braces. I was not tuned into what they were going through during that time and now I deeply regret that.
I had no idea of the issues that they were experiencing as they wore their braces. Now I know, from personal experience, what they went through. I wish I had this knowledge back then to help them cope with wearing braces. This is why I want to share this knowledge.
Background
I am a geologist by training. I understand concepts like stress and strain relationships. A stress and strain relationship simply means that when a stress is applied to an object (like braces and bands do to teeth), there is a corresponding strain (teeth movement) that occurs.
In geology, stress fields that operate over long time periods can build mountains. In people, braces impart stress fields on teeth that lead to beautifully aligned teeth over the course of several months to two years or so. This occurs because the rigid teeth are able to slowly move through the deformable bones in our upper and lower jaws. From a scientific point of view, dental braces are a very interesting topic.
How Braces Work
I’m going to keep things simple, although I did a lot of research on things like learning the role of osteoblasts and osteoclasts while I was wearing my braces. I wanted to understand the theory of why braces work, but this knowledge isn’t necessary for this article.
Essentially, brackets (ceramic or metal) are strategically glued to the teeth that need to be moved. I believe that the placement of these brackets is very important to get a great final result. These brackets have a channel that holds an archwire (Figure 1) that helps define a nice curved surface for the teeth to be moved into. The brackets also have little hooks and tangs that allow rubber bands and power chains to be installed.
Figure 1 – Braces are composed of brackets and archwires, along with bands and chains to impart movement.
The bands and power chains (the blue band, Figure 2) apply the stresses to the teeth to begin the process of moving the teeth. It is these bands that also cause the pain of wearing braces, as I will explain.
Figure 2 – A power chain, shown in blue, is stretched between teeth to impart the stress necessary to move the teeth.
Installing Braces
When you take your child for their braces, there probably will be pain involved. It is a good idea to give them some ibuprofen about an hour before the appointment to help them deal with new situation that will be imparted on their teeth. When the brackets are glued onto the teeth, that does not cause pain. It is only when the rubber bands or power chains are installed are the stresses applied that cause pain.
How and Why Do The Teeth Move?
When the stresses are applied to the teeth, there are bone cells called osteoclasts in our jaws that become activated. These cells begin removing bone in the location where the teeth are wanting to move, due to the stresses applied by the braces. On the trailing edge of the teeth, the osteoblast cells will secrete a matrix that leads to more bone formation. This new bone formation basically back-fills the space where the teeth used to reside.
In a series of small incrementally applied stresses over many months, your child’s teeth will slowly but surely move into new locations as dictated by the archwires, rubber bands and power chains. Every four weeks or so, the power chains will be replaced to create a new stress field. Each time this happens, there is pain. Once again, give the ibuprofen before each appointment to keep your kid happy.
Dealing With the Pain
During my treatment, I realized that two things really helped me deal with the pain that lasted about 3 days after each new power chain was applied. First, the ibuprofen really helped alleviate the intense pain that occurred when the new power bands were installed and in the hours afterwards. Secondly, using a vitamin D supplement seemed to help reduce the pain I experienced. The theory as to why this happens has to do with the functioning of those osteoclast and osteoblast cells I previously mentioned. Each one of those cells need vitamin D to function efficiently.
I accidently discovered this benefit about 6 months into my treatment when I started taking vitamin D due to low vitamin D levels that had been detected in my blood work. What I noticed was that the pain I had after each “power chain adjustment” lasted less time than before I took the supplements. Therefore, I continued taking vitamin D during the remainder of time I wore the braces.
As a parent who feeds your kid, please understand that during each one of those adjustment periods, your kid will be hurting for a few days. It can be very painful to chew food and sometimes it is nearly impossible. It is a great idea to feed them soft, nutritious foods. Consider feeding them nutritious smoothies so that they don’t have to chew so much. Don’t expect them to eat hard-shelled tacos, chips, or any other food that requires hard biting or cause percussions to occur on their teeth.
You can help make it easy on them by feeding them appropriately and by paying attention to their complaints about soreness and pain. Also, keep them away from sticky foods, and sticky candy and gum are definitely off-limits.
Dealing With the Other Issues
Kids with braces will probably be self-conscience. They will probably have trouble talking at times because their teeth are moving into new positions throughout the course of treatment. This can lead to temporary lisps and mispronunciation of some words because the tongue will not hit the teeth perfectly. This definitely happened to me and it drove me crazy, especially when I was teaching classes at work.
Explain to them that the braces are only temporary and that their brain and tongue will adjust to the new teeth position fairly quickly. Reinforce that they will have a beautiful smile when they are done and for them to look forward to that day.
When the braces are removed, there is a lot of pain. The removal of those brackets impart a huge stress on the teeth. The brackets are basically snapped off of the teeth and the shock to the teeth can cause some serious pain. Consider giving a double dose of ibuprofen to help them on the day the braces are scheduled to be removed. I had tears in my eyes, even with the ibuprofen on-board as those brackets were snapped off the teeth.
Finally, when the braces are gone, the pain doesn’t go away. When the hardware is removed, the teeth have more freedom to move because they are not interconnected in the way that they were during the treatment. You should continue to serve them soft foods for a while after the braces are removed.
Your child will also have a retainer that they have to wear at night. This helps keep the teeth in their new positions after the braces are gone. These things are tight when inserted over the teeth (they snap in place), and will instantly impart pain for about 2 to 3 minutes until the teeth calm down. When the retainer is removed in the morning, the same thing will happen as the stress field caused by the retainer is removed. The teeth will feel sore for a few minutes before settling down for the day.
Although it has only been a few months since my braces were removed, I can tell that it going to take a while for my teeth to feel solid again. I still experience significant movement (several millimeters) of the teeth throughout each day. The teeth relax during the day and push outward, followed by being pulled inward at night while wearing a retainer.
Therefore, there is a bit of sensitivity that is experienced in the months after the braces are removed. It is also very important to remind your kid to wear their retainer every night. Without this framework in place, the teeth can move back towards their original positions. In other words, the retainer is a very important part of the dental treatment and wearing it is a must if you want your kid to maintain that beautiful smile.
Final Thoughts
I hope this article helps parents understand what their kids are going through as they wear their braces. The experiences I recount in this article are still fresh in my mind, so I wanted to record them while I still remembered what I experienced.
This article is part 2 of a 3 part dentistry series I am writing. I was motivated to write this series to document the dental treatments I had over the past few years.
In part 1, went deep to explain a series of dental surgeries that I had to have because of a tooth infection. That article featured funny videos and deep insights as I took multiple trips to “La-La Land”. The incredible surgeon introduced in Part 1 made the recommendation to me to have the work in Part 2 done.
In the final upcoming article (Part 3), I will explain the process of having a tooth replaced. The technology behind procedure blew my mind and I’m sure you will be surprised by it, too.
Finally, I want to give a huge thank you to Dr. Joseph Hicks, who is exceptionally gifted in the field of orthodontics. Not only did Dr Hicks perform a minor miracle on my lower teeth, he became my friend and helped me understand what was happening throughout the course of my treatment.
To all of Dr. Hick’s staff, I want to say thank you for your brilliant work and understanding, as well as your patience as you answered my questions about the techniques you were using on me. I learned a lot from all of you during my treatment and I appreciate that very much.
Thanks for reading.
