An article from the desk of Dr. John Kelley
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
