Medicine
Q&A with RAVIKUMAR ANTHONY, BDS, MDS, MS, Board-Certified Orthodontist
Program Director, Orthodontics
Q: Is it ever too late for an adult to get braces or clear aligners?
A: No. Adults can benefit from orthodontic treatment at almost any age, provided their teeth and supporting tissues are healthy. Treatment may require additional planning when there is gum disease, missing teeth, implants, or extensive dental work, but age alone is rarely the limiting factor.
Q: How do I know whether I need traditional braces or clear aligners?
A: The best option depends on your bite, the tooth movements required, your treatment goals, and your ability to follow instructions. Clear aligners work well for many patients, while braces may offer greater control for certain complex movements; an orthodontic evaluation can determine which approach is most predictable for you.
Q: At what age should a child first see an orthodontist?
A: The American Association of Orthodontists recommends an initial orthodontic checkup by age 7. At that age, an orthodontist can identify developing concerns—such as crowding, crossbites, or eruption problems—and monitor growth so treatment, if needed, begins at the most appropriate time.
Q: How can a misaligned bite affect more than the appearance of my smile?
A: A misaligned bite can make chewing less efficient and may contribute to uneven tooth wear or difficulty cleaning crowded areas. The effect varies from person to person, so an orthodontic examination is the best way to determine whether a bite problem is affecting oral health or function.
Q: How long does orthodontic treatment usually take?
A: Most comprehensive orthodontic treatment lasts about 18 to 24 months. The actual timeline depends on the complexity of the bite, the type of treatment, growth, and how consistently the patient follows instructions and attends appointments.
Q: What happens after treatment ends? Will I need to wear a retainer forever?
A: Retainers are essential because teeth can shift throughout life. Most patients should plan on long-term retention—often nightly after an initial period of more frequent wear—using a clear removable retainer, a traditional wire-and-acrylic retainer, a fixed retainer, or a combination recommended for their needs.
Q: What should I expect at my first orthodontic consultation?
A: Your first visit typically includes a conversation about your concerns and goals, followed by an examination of your teeth, bite, jaw relationships, and facial balance. Photographs, digital scans, and X-rays may be recommended based on your needs; advanced imaging such as CBCT is used selectively when it is likely to add meaningful diagnostic information. After reviewing the findings, the orthodontic team will explain appropriate treatment options, timing, estimated duration, and fees.
Q: What distinguishes orthodontic care from braces or aligners provided in a general dental office?
A: Orthodontists are dentists who complete an additional two to three years of accredited specialty training focused on tooth movement, facial growth, and bite correction. General dentists may also provide orthodontic services within their training and experience, but an orthodontist’s practice is devoted to diagnosing and managing the full range of orthodontic problems. For patients with complex bites, growth concerns, impacted teeth, or surgical needs, specialty expertise can be particularly valuable.
Q: What is the difference between Phase I and Phase II orthodontic treatment?
A: Phase I treatment begins while a child still has a mix of baby and permanent teeth and is used for selected problems, such as crossbites, severe crowding, or growth-related concerns. Phase II is comprehensive treatment, usually after most permanent teeth have erupted, that aligns the teeth and establishes a healthy, functional bite.
Q: How do I care for my teeth while wearing braces or aligners?
A: Brush thoroughly at least twice a day with fluoride toothpaste and clean between the teeth daily, using floss threaders, interdental brushes, or a water flosser as recommended. Keep aligners clean, limit frequent sugary or acidic snacks and drinks, and continue regular dental checkups and professional cleanings throughout treatment.
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