ORTHODONTIC
PAIN............
During
orthodontic treatment
No
pain, no gain
Most people feel some initial pain (although we call it
discomfort - sounds better, doesn't it!)
Orthodontic treatment results in
teeth moving through bone. This can hurt a bit. Having the
braces placed on the teeth is painless. The soreness doesn't
occur until sometime later. When this does occur it's natures
signal that something is happening - Heh! that's good.
Try some mild analgesics ( e.g. panadol or nuraphen - but
check the packet and with your parents first).
Cheek ulcers
Some people are quite sensitive to
the braces stuck on the teeth and they get ulcers where
these touch the skin in your mouth. We have wax we can give
you to help minimise the rubbing until your mouth gets used
to it.
Occasionally a small wire may get bent and point into your
gum or cheek. Try using a blunt instrument like a pencil
eraser to push it away from the gum and call us to make
an appointment so we can fix up the problem.
Sport
Yes you can play sport but we want
you to wear a customised mouthguard to protect your teeth,
lips, cheeks and braces.
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What can go wrong?
In most cases people
have orthodontic treatment without problems.
Problems can however occur:
Decay: YOU ARE WHAT YOU EAT!!!!!
Cleaning and diet are very important especially
with all the "plaque" attracting appliances in
your mouth. Sometimes damage to teeth is not detectable
until after braces are removed.
Tooth root changes: Minor rounding of the
tip of the tooth roots may occur. Generally this does not
lead to any problems.
It is possible on rare occasions to have a tooth nerve die
during orthodontic treatment. This is usually due to the
tooth having received a knock at some stage before or during
orthodontic treatment. The nerve would have died at some
stage, however, the orthodontics may have unmasked the problem
a little earlier.
In adults particularly, gum problems may be accentuated
by orthodontics.
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Orthodontic
Treatment Failures: Migraine Headache Pain
Correction of Occlusal Damage caused by braces
Orthodontic dentistry has long been known to be the treatment
of choice for correcting any number of dental issues involving
tooth alignment, tooth rotations, bite alignment and slow
erupting tooth structures.
In many instances, treatment plans
may be developed and initiated during late childhood that
can take excellent advantage of continuing developmental
events until a person's adult tooth structures complete
their final form.
Adults, both young and old, choose
to be treated with braces to correct certain alignment problems
that didn't self correct or other types of issues that arise
from continually shifting teeth. Orthodontic re-treatment
is a common experience with those individuals who fail to
use retainers that are often recommended to thwart potential
shifting.
For some patients however, orthodontic
treatment can cause unexpected problems that can lead to
distortions accruing to excessive adjustment.
One such patient, a young adult male
who had undergone ortho treatment and the use of metal braces
for 4 years, acquired an unusual distortion to the occlusal
plane. Soon after the start of treatment, the patient reported
having migraine headaches.
The headaches continued throughout
the 4 years of orthodontist recommended treatment. Consults
with his orthodontist and his physician were uneventful.
Based on appearances, both the orthodontist and the patient
felt treatment was progressing smoothly, in terms of aesthetics.
As in most orthodontic treatment
plans, the braces and wires were adjusted as needed to assure
healthy tooth movement into whatever optimal positions that
were defined as being functionally correct or balanced.
During tooth movement, physical forces
operate on the posterior tooth structures as upper and lower
arches are slowly influenced to move into predefined positions
determined by the treating doctor.
At the recommendation of the patient's
family physician who was treating the migraine pain, the
patient was evaluated from a TMJ Pain diagnostic perspective.
Surprisingly, technical data acquired
from studies of jaw movements, resting jaw positions and
articulation data revealed gross distortion of the patient's
posterior teeth and occlusal plane, attributed to the extended
use of orthodontic braces.
The adjacent photo of one of the
diagnostic models shows the unusual alignment of the posterior
teeth. It is apparent these posterior teeth cannot attain
normal resting nor biting and chewing relationships with
the lower arch.
This type of relationship causes
undue strain on the tmjoints which typically leads to excessive
strain and the eventual perception of generalized headaches
and migraine pain.
Migraine Headache Pain Resolution: Occlusion Adjustment
Correcting the distortions of an occlusal plane can be achieved
through the use of different types of dental components
ranging from new posterior crowns, gold onlays and porcelain
onlays. For some patients, orthotic devices can be used.
A correction process for this type
of anomoly occurs over an extended time period. Adjustments
are incremental, which allow the jaw structures to achieve
healthier repositioning through a natural process.
As treatment progresses, articulation
data acquired after each completed step becomes factored
into the amount of subsequent adjustments, until the jaw
structures and tmjoints have achieved optimal resting and
biting relationships. Attempts to readjust an occlusal relationship
in one reconstructive treatment typically result in failure.
COSMETIC DENTISTRY - ORTHODONTICS
