Thinking about braces for yourself or a family member? You’re far from alone. About three-quarters of Americans develop some type of orthodontic issue by the time their permanent teeth have all grown in. At any given time, about four million of us, children, teens, and adults, have braces.
Esthetics is the main reason people opt for orthodontic care, but misalignment and overcrowding of teeth can have consequences for oral health, too.
Orthodontic treatment requires commitments of time and self-discipline. Most treatment programs last between six months and three years and require some lifestyle changes to promote success. As with many life choices, it’s helpful to go into orthodonture with realistic expectations. Life with braces is very manageable if you know going in what to expect and how to adapt.
The process of installing braces averages around two hours. The procedure itself is painless.
Many patients notice an increase in saliva flow as the process is completed, and this may continue for a few hours more. Your saliva glands react as if you have food stuck to your teeth, and try to rinse it away before “giving up” and accepting the braces as a permanent feature. The solution is to swallow a lot and spit if need be and convenient.
You may find yourself reflexively “exploring” your braces with your tongue and lips. Acceptance and adaptation usually take a day or so. If you can, it’s preferable to stop this activity when you become aware of it, since there’s some risk of irritating the soft tissues.
The glue that holds your braces to your teeth can take up to 48 hours to set completely. Time to transition to the soft foods you’ll be best off with throughout your treatment. This will help your braces settle in exactly as the orthodontist arranged them, and will help keep you comfortable.
You may well experience some soreness during the first days after your braces are put in. Research shows that for most people this discomfort is mild, peaks around 24 hours after installation, and resolves in about a week. The soft food diet helps a lot. Some people (with medical clearance) find over-the-counter pain medications like acetaminophen (such as Tylenol) and ibuprofen (such as Advil) to be helpful.
EATING WITH BRACES
One week in, you’ll have already altered your menu to accommodate your new braces. Dietary adaptation will last throughout treatment, maintaining comfort and minimizing damage to your appliances.
Your orthodontist is your go-to resource for advice on specific food items, but the general approach is commonsensical and easy, to sum up as a short list of “don’ts”. Don’t eat hard, chewy, sticky, or tough foods, and avoid “bitey” foods like corn on the cob and apples.
This may seem restrictive, but you’ll quickly discover that there are innumerable options in all the food groups that are not on the “don’t” list. Dr. Google will gladly return lists of substitutions when you ask about “foods to eat with braces”.
Children often need more support in this area, since their definition of good eats is usually as simple as “I like it!”. Once a child is in braces, parents should take care to keep the “don’t” foods out of sight and out of mind, while providing alternatives that are tasty and nutritious. It’s important to teach a child the reasons for these changes. Trading the banana in a school lunch for a taffy bar isn’t likely to end well.
ORAL HYGIENE WITH NOOKS AND CRANNIES
One of the benefits of normalized alignment and spacing of teeth is the improved effectiveness of daily home cleaning. While braces are on, though, the task is a bit more complicated. The hardware in your mouth may include bands, archwires, buccal tubes, elastics, and other components. New and hard-to-get-to spaces may be out of reach of conventional brushing and flossing. These spaces will become luxury resorts for bacteria feeding on trapped bits of food. Paying for that beautiful smile with more cavities is not a desirable trade-off.
You’ll adapt through increased attention to cleaning and by employing a few extra cleaning aids. Your orthodontist will have advice as to the specific tools best suited to your braces. These may include items such as floss threaders, interdental brushes, special toothpaste, oral irrigation systems (“water picks”) and rinses. Parents quickly realize that young children may have technical difficulties with the new cleaning aids, and teenage obstinacy can come to the fore. Extra support and appropriate incentives are called for with kids and teens.
Most people’s biggest concerns going into orthodontic treatment are not the cleaning and comfort challenges but focus on anticipated difficulties in everyday activities like speaking, socializing, and playing sports.
Everyone wants to present an attractive appearance. The folklore about braces promotes fears of bad breath, drooling, distorted speech, grotesque “metal grin”, ridicule, and mouth bleeds, among other terrors. Children and teens are especially vulnerable to these anxieties, though adults are by no means immune.
There’s not much basis in reality for these fears. Folklore loves drama! Stories about things proceeding quietly and calmly don’t make for interesting conversation. Unpleasant things can and do happen with braces, it’s true, but neither as frequently nor as dramatically as the legends suggest.
Most of the challenges of daily life with braces have practical solutions. Athletes wear specialized orthodontic mouth guards. Bad breath, or halitosis, is generally preventable with the hygienic approach we discussed earlier, reinforced by your dentist or by periodontal(gum) treatment when appropriate. Speaking issues usually resolve within two weeks, as we adapt to the new structures inside our mouths. Practicing can be a big help. Reading aloud, singing, and speech drill tapes have been effective for many.
A treatment option is available to some people anxious about how they look with braces. Ceramic braces, lingual braces, and Invisalign appliances are invisible or nearly so. Some whose treatment requires traditional metal braces overcome self-consciousness by doubling down. Nothing exudes self-confidence like braces with colorful bands and elastics. Social acceptance of braces has now reached a point where kids in Thailand and Malaysia are wearing fake braces just to look cool!
CROSSING THE FINISH LINE
Your fixed appliances will be removed in a process called ‘de-banding”, lasting between one and two hours in most cases. When it’s over, you’ll see the new you in the mirror for the first time. Your orthodontist will discuss retainers with you and make recommendations. Yes, you will almost certainly have to wear a retainer after your braces have been removed. How long and how frequently vary with the individual.
The single most important factor in adapting to life with braces is going into it with knowledge and confidence. Many have walked this path before you, and its twists and turns are well understood. You’ll focus on the esthetic and wellness benefits to which it leads. Your orthodontist will be with you every step of the way, inspecting and adjusting your appliances every 8-10 weeks or so, addressing any issues. You’ll meet any challenges cheerfully, and go with pride in your decision to improve yourself.