Services - Orthodontics
- treatment with removable (disc as well as functional)appliances
- treatment with fixed appliances
- Invisalign – „neviditelná rovnátka"
We deal with anomalies and defects of dentition and jaws which result in esthetic and sometimes also functional problems. Our objective is to achieve normal dental arches fitting in regularly. This result of the treatment makes your dentition one of the pillars of the harmony of your face and will open you the door to success in social as well as personal life.
Setting up the treatment plan
First it is necessary to prepare a correct treatment plan. Preliminary examination, documentation, X-rays, plast impression of dentition and photographs are the integral part of the plan. You will be acquainted with a detailed plan of the treatment and if you agree the plan becomes obligatory. Thus, it is not possible to ask a dentist - in the course of the treatment - to apply the appliance only in one jaw or to use a different type of appliance. Nor it is possible to revoke the already planned extraction of permanent teeth, surgical or prosthetic intervention. On the other hand, each patient is unique and the orthodontic treatment (as it is in other fields of medicine in general) may become complicated. Therefore, the orthodontist is entitled - after consultations with you, of course - to adapt the plan or to add a necessary procedure. Trust your dentist. All the changes in the plan are made to achieve the best possible result of the treatment. Some operations during regular check-ups of fixed appliances are performed by skilled orthodontic assistants according to instructions by and under supervision of an expert.
Active orthodontic treatment
We perform orthodontic treatment with both removable and fixed appliances. Removable appliances, which can be removed from the mouth by the patient, are used mainly to treat minor defects or to pretreat complex anomalies before the application of fixed appliance mostly in children. Removable appliances may be also used after the therapy with foxed appliance as a passive retention to stabilize the results achieved. Majority of defects are treated with fixed appliances, i.e. brackets and rings attached to teeth. Wires used in the appliances gradually form an ideal dental arch and teeth may be moved into the position required. With a long-term all-day operation of the appliance it is possible to achieve good quality results even in case of extensive defects of dentition. The mean time of the therapy with fixed appliance is between 1.5 - 3 years, depending on the defect. The technique was developed in the United States of America and in Scandinavia more than 50 years ago and therefore there is a lot of experience with the method. I can say we can provide you with the same quality treatment as in the countries mentioned. It is important for you to know that most teeth moves can be achieved by means of continually operating forces which can be assured only with the fixed appliance. The only correct alternative in patients who for some reasons do not want fixed appliances is not to treat them at all.
Cooperation of a patient
The perfect cooperation of a patient is the inevitable precondition of a successful orthodontic treatment.
One of the prerequisites is to make appointments regularly. In fixed appliances the check-ups are held usually once a month, in case of removable appliances once in 2 - 3 months. The appointments are not possible to plan only after classes; the other patients also attend schools or are employed. However, we help you to find a term in less important lessons and according to your transport possibilities. We are aware of the fact the time is precious for you, therefore, you need not to accompany your children. However, if you want to get informed about the treatment, you are always welcome. If the times of check-ups are not followed the treatment gets longer, of course. Moreover, the fixed appliance which is not properly examined may cause undesirable affects or even damage the dentition. If the terms of check-ups are not observed the patient may be excluded from the treatment before it is finished.
In some patients we use accessories together with a fixed appliance. They are mainly external traction and elastic gnathic tractions of various kinds. Our orthodontic assistants will instruct you in detail how to use them and how to apply them. In case of removable appliances it is necessary to follow the instructions of a dentist with regard to activation of inserted screws. The cooperation is inevitable, otherwise the result of the therapy may be thwarted. We want to treat only the patients who are really interested in the therapy and want to contribute to a good result.
The most important precondition of the successful treatment is perfect dental hygiene. Teeth with fixed appliance must be brushed and massaged with a brush and tooth paste after each meal for at least 3 minutes. Patients must take a tooth brush with themselves all the time, to school, to our surgery and to wherever they consume some food. In case of inadequate hygiene there form spots in teeth due to decalcification of enamel (see Treatment complications). Therefore, dental hygiene becomes the basis of orthodontic treatment and patients who do not meet this condition cannot start the treatment with a fixed appliance.
Poor dental hygiene is also the most frequent reason for premature removal of a fixed appliance.. We cannot devastate dentition due to the treatment of cosmetic defect. At the time of applying the fixed appliance each patient is well instructed how to take care of the appliance and is shown how to clean the apparatus correctly, he/she is also recommended suitable tools for cleaning. This is not covered by the insurance, however, we give you the instruction free of charge. However, if we find out during your visits the hygiene is poor, our dental hygienist will instruct you individually and you will pay for the instruction. It is well known that the patients who learned how to correctly and regularly brush the teeth in the course of orthodontic treatment follow the good dental hygiene for the rest of their lives.
Fixed appliance does not mean any handicap for you or for your child. On the contrary, today the brackets become a trend for young people. In all developed countries the orthodontic treatment with fixed appliances become a standard and means a good care of parents about their children or themselves.
The treatment posits a certain change of eating habits. First few days after the application the patient may perceive some pain and prefers only mixed or liquid food. We call the period "a youghurt week". Later it is possible to eat everything with the exception of extremely hard meals, e.g. toasts, nuts, carrots, kohlrabis, etc. Brackets are attached to frontal part of teeth and therefore they may be ripped off, therefore it is better to cut food to smaller pieces. Never eat sticky candies, toffies or Turkish honey! The same applies to nibbling of pencils and other things. Chewing gums are acceptable, but always sugarfree chewing gums!
It is important for you to know that no matter we, the orthodontists, observe and examine the state of your dentition during your visits at our clinic, you have to make regular appointments at your dentist as well! If there is a caries found we - in coordination with your dentist - immediately deal with it.
During the treatment we often collaborate with other branches of dental medicine - in case of disease of gingiva (periodontist), in case of missing teeth (implantologist and orthotist), in case of reconstruction of narrowed teeth we apply white fillings (your dentist). Our objective is to coordinate each step adopted to achieve the best possible result of your therapy.
The top quality orthodontic treatment is, of course, economically demanding. In most patients the treatment is aimed at correction of a cosmetic defect, therefore the therapy by means of fixed appliance is covered by insurance companies only partially. Insurance companies will cover our professional work in the surgery during the whole treatment. They will usually not cover the material used in fixed appliances.We use exclusively materials of the first-class quality by foreign orthodontic producers at our clinic. The price of a fixed appliance is between CZK 12.000 - 15.000 depending on the amount of material used in the course of the therapy. Additional charges for removable appliances and retainers (see Retention) are considerably lower and are paid at the time of delivery. Some insurance companies cover - at least partly - orthodontic material. This is different in each company. You should ask your company for information. This is the relationship between an insuree and an insurance company and your company should give you a detailed information. Of course, we will provide you with all the data and documents required for a refund of fees.
Retention or stabilization phase of treatment is an important stage of your therapy as well. The result of the active treatment with fixed appliance must be stabilized to keep the final shape. Often, patients disparage the fact which may result in relapse, i.e. partial reversion. All teeth more or less show this tendency (to relapse) after each orthodontic treatment. Before the tissues adapt to a new situation it is necessary to retain the result achieved. Most often removable braces are used. It is necessary to wear them according to the recommendation by an orthodontist, i.e. during the first year each night and later less and less often. You should always obey the directions of the dentist who performed the orthodontic treatment! Besides, we attach a thin wire on the back surface of teeth, the so-called retainer that ensures 100% stabilization of the result in frontal segment. If the retainer gets loose it is inevitable to come to our surgery as soon as possible. Patients who underestimate this stage of therapy and do not follow the instructions are fully responsible for the consequences which may occur.
Complications of orthodontic treatment
Pressure on teeth or toothache are frequent early complications after the application of a fixed appliance. Problems are rather individual. They usually start the day after the application and do not endure longer than a week. On rare occassions it is possible to suppress these symptoms with analgesics. The difficulty may repeat after each check-up, however, it is not so intense and lasts only for a short time.
There may appear various scratches and bruises in the mucosa of face, lips or tongue. They are due to the brackets or protruding wires. You can use either protective wax or visit your orthodontist who may remove the problematic item. After that the problems subside quickly. Some patients show tendency for root resorption, i.e. the root becomes shorter, it "shrinks". The process may accelerate during the orthodontic treatment. Mostly there are only minimum changes in the length of the root which do not affect the function and longevity of a tooth.
Exceptionally it may happen that therapy does not correspond to the expected treatment plan. This may be due to unpredictable complications, e.g. the reaction of tissues of a patient or a patient´s growth.All these may prolong the treatment considerably or result in the fact that the results are not as good as expected.
However, spots due to decalcifications which are the result of poor dental hygiene are the most frequent complication of orthodontic therapy. Dental tissue under the brackets is not in danger, the brackets protect the tissue completely. The problem is the impure plaque aroud the brackets and between the teeth. The plaque contains microbes decomposing food. Acids form and etch enamel and this leads to decalcification of enamel. This process results in permanent white or yellowish spots in teeth. Sometimes we notice the effects during the treatment, however, we may observe them as a white round edge only after a fixed appliance is removed. It is unthinkable to achieve regular but spotted teeth as the result of the therapy! In some cases there may even form caries around the brackets.
Plaque is often the cause of gingivitis. The therapy is very unpleasant and rather complicated for an orthodontist (frequent bleeding, loosen brackets). It is also known that in the inflamed tissue teeth move slowly and ligaments holding a tooth in the bone are damaged. The patient is fully responsible for such irreversibly damaged dentition.
Dear patients, I was obliged to inform you about all the important aspects and difficulties of orthodontic treatment. However, I believe your cooperation, dilligence and patience will pay off and your reward will be a nice smile and ideal dentition.
I wish you the smile becomes the beginning of your successful life.
Yours sincerely, medical staff