Why do I have to wear my retainers?

Teeth moved with braces need time after the braces are removed to become stable.

First, teeth are moved over a relative short time. The way they bite with teeth in the opposing arch changes. Teeth need to wear into their new position and bite. This process can be sped up with a secondary treatment called occlusal equilibration. This is the selective reshaping of the biting surfaces of the teeth so they fit better together.

Second, the bone and ligaments that hold the teeth need to re-form. The bone needs to increase density and the ligament needs to re-organize it’s fibers.

These processes take time. Just as a broken bone takes time to reach full strength, so does the bone surrounding your teeth after they are moved with braces.

The ligaments become stretched. This is especially problematic if a tooth is turned or rotated. The fibers of the attachment ligament can re-rotate the tooth if they do not re-position. These fibers can be forced to re-position by cutting them and allowing them to re-attach. This is an uncomplicated procedure done with local anesthetic.

Third, it is normal and natural for teeth to move over time. It is un-natural for them to stay perfectly straight like at the end of orthodontic treatment. To counter this natural ageing process, retainers must be worn long term. They can be used like any other tool to maintain good health and a great smile.

Why do braces cost so much?

The cost of braces varies in different areas. Our practice is in San Diego where there are many factors included in the both the fees and costs. The fee includes:
First, the dentist evaluating the patients needs, ordering diagnostic photos & x-rays.
Second, Evaluating the needs and desires of the patient and using the diagnostic records information, developing a treatment plan that satisfies all these requirements. This process takes anywhere from one to three hours.
Third, designing and applying the braces to the patient, usually one to two hours.
Fourth, reevaluating treatment progress and reshaping the treatment at each visit for appliance adjustment. Usually the appliance adjustments take 30 to 60 minutes each. Depending on how complex the treatment, there can be from six to thirty six appliance adjustment appointments.

Every time braces are placed on teeth is changes everything about the bite and appearance. The braces are expected to accomplish specific tasks during each adjustment period. They do not always get everything done as expected.

Braking a brace or wire can set back or delay the progress of treatment.

When braces are done, they need to be removed from the teeth, the adhesive removed and the teeth polished. This takes another 1 to 2 hours. Impressions of the teeth are made to have retainers fabricated. Delivering and fitting the retainers takes about half an hour, and then they will need to be adjusted several time during the first year.

All this work goes into a successful braces treatment. The average price in our community is between $5,000 and $ 6,000 for a typical treatment. Insurance can change the amount you need to pay.

The path to straight teeth.

To align teeth with braces is usually not like driving down a straight line highway in a  from point A to Retainers. The path usually is like driving through city streets with detours and heavy traffic.

Before any braces care can be started, the teeth and gums must be healthy. All cavities, fillings, and gum issues must be resolved and maintainable.

Since teeth have a limited work space and travel time, treatment must be done in an orderly manor. There should always be a detailed plan to work through. First order of care is to level and align the teeth. Space can be made for teeth blocked out of line. The heights of the teeth matched  and all extra spaces closed. Second, once the teeth are aligned, the bite can be addressed with rubber bands or other devices. Third,  is the cosmetics of the smile. Last is retainers after the braces are removed.

These are the most basic steps. The care plans can become far more complex including widening the upper jaw with an expander, removal of adult teeth to make room, surgical changes to the jaw structure in the middle of he braces treatment to final prosthetics (crowns, replacement teeth, veneers, etc.).