FAQ

 

Fixed appliances (fixed braces)

What is a fixed brace?

It is an appliance which is used to correct crooked teeth. As the name implies, it is fixed and you can’t remove it.

Is there any difference between metal and clear braces?

Clear braces are made of ceramic and should not be confused with invisible brace aka Invisalign.

Clear braces are more aesthetically pleasing, but expensive and may chip or crack.

Metal braces are more economical and easier to maintain.

I might have/have metal allergy. Can I still have orthodontic treatment?

Yes. If you have been confirmed by sensitivity testing, we can offer you clear braces with clear wire. An upfront payment is needed if you opt for clear braces.  If you are not sure of your allergy status, it is always better to check with your medical doctor and discuss the possibility of doing a sensitivity test.

Damon braces/self ligating braces

Do you provide Damon braces?

Yes. We do provide Damon treatment upon request. An upfront payment is needed.

I heard/read that Damon provides faster and painless treatment

There is no robust evidence regarding the claimed advantages of Damon braces over any other type of braces as of today. Everything you heard/read from the internet should be interpreted with caution.

Do you recommend Damon?

Damon/Any form of self ligating braces will cost much more than the ordinary metal braces. Hence, we see no point in recommending our patients to choose a much more expensive option to achieve the same quality of outcome. However, if cost is not an issue for you, feel free to go for it. 


Any difference between self-ligating brace and normal brace in terms of appearance?

Both types are still metal braces. Self-ligating brace has metal door which holds the wire while normal brace has elastic tie which holds the wire.

Will I need to have teeth removed/ Why do I need extraction?

Rest assured that your orthodontist will always try to avoid extraction whenever possible. However, extraction of teeth may necessary to correct your teeth that are too crowded and also to correct your bite.

I don’t want extraction. There must be something you can do!

Absolutely. There are other ways of gaining space. In some cases, teeth can be narrowed down in width (interproximal reduction).  There is no “one size fits all”.  Hence, it is advisable to discuss this possibility with your orthodontist.

When can I get my braces?

When your teeth are absolutely sparkling clean. Otherwise, the braces are going to dislodge. If you need an extraction of teeth, this will also be done beforehand. We recommend putting on braces about 2 weeks after your extraction to minimize unwanted tooth movement.

Is it painful?

There won’t be any pain WHEN fitting the braces. However, no pain no gain! You will probably feel sore for about 3-5 days AFTER first fitting the brace and also after each adjustment appointment.

How often will I need an appointment?

Every 6 to 8 weeks or as proposed by your orthodontist.

Can I eat normally?

Yes. You just need to get used to eating AND not breaking the appliance at the same time. For your treatment to work well in the shortest time:

  • Avoid hard and chewy food such as apple, carrot, guava, spare ribs. Tips: Cut them into small pieces

  • No chewing of bone please

  • No chewing gum please

  • Avoid sugary snacks/drinks, fizzy drinks

Can I brush normally?

Absolutely! In fact, you need to brush even better than before you have your braces AND not breaking the appliance at the same time. Here are some useful tips:

  • Brush at least twice a day, 2 minutes every time using fluoridated toothpaste. You will need to brush after every meal

  • An interdental brush is a must-have!

  • Pay particular attention to where the gums meet your teeth

  • Daily alcohol-free fluoride mouthwash. Don’t use it at the same time as you brush your teeth to help maintain the fluoride concentration on your teeth. Avoid eating and rinsing for 20min after you use the mouthwash

Will orthodontic treatment damage my teeth?

Yes and no actually. Yes, the treatment will leave permanent white marks on your teeth and cause decay if you consume sugary snacks/drinks and don’t clean your teeth well. If you still fail to maintain good oral hygiene, your orthodontist will need to remove your braces, still leaving you with crooked teeth.

The good news is, this is totally preventable by maintaining good oral hygiene.

Oh no my braces broke! What should I do?

Yes, your braces might break. First, do not panic. Just give us a call to arrange for an emergency appointment.

If the brace is still attached to the wire, leave it as it is. You should try to keep every metal brace/parts that become dislodged and bring it with you when you see your orthodontist.

If you accidentally swallow the brace unknowingly, do not panic and it will be excreted.

If you accidentally swallow the brace and experience difficulty in breathing, it means that the part is trapped in your lungs and you should go to the hospital immediately. This is a medical emergency.

Will I need to wear anything in addition to the fixed brace?

It depends on an individual basis and stage of treatment:

  • Before braces are fitted, some appliances may be needed to hold the back molar teeth from moving forward following extraction

  • During the treatment, you may need to wear elastics inside the mouth during day and night to correct your bite

  • After treatment, you definitely need to wear retainers to retain the treatment results

What if I play sports?

You will need to wear a gumshield to protect your teeth and your braces during the activity.

What if I play musical instruments (excluding piano, violin, cello)?

This is only applicable if you play wind or brass instruments.

Can I continue smoking while on braces (including e-cigarettes)?

No. You should try to reduce the frequency and try to quit as soon as possible. Otherwise, you will be very prone to gum disease. If you are a surgical patient,  smoking before and after surgery will make you at high risk of infection leading to high tendency of treatment failure.

 

Functional appliances

What is a functional appliance?

It is a removable brace that works on both the upper and lower teeth at the same time that works the best when used on growing child/young adolescents.

Can I remove the appliance?

Yes you can but only for cleaning purpose. Otherwise, you will break the wire and increase the treatment duration.

How often should I wear it?

All the time INCLUDING sleeping time. Wear more = huge improvement.

How often will I need an appointment?

Every 6 to 8 weeks to tighten the brace.

How long will the treatment take?

An average of 12 months of FULL-TIME WEAR. You may then need to wear the appliance only at night for about 2 to 3 months. Failure to attend appointments and repeated breakages will prolong the treatment duration and incur additional costs.

I had completed this treatment. What is next?

You normally need another 12 months of fixed braces treatment and you will be advised on whether you need extraction of teeth or not.

Will it be painful?

It is likely to be sore for 3 to 5 days each time the appliance is adjusted. You can take a painkiller but do consult your medical doctor if you have any medical issues/drug allergy. Don’t stop wearing the appliance or you will have a further 3 to 5 days of discomfort when you start wearing it again.

I have an ulcer from the appliance. What should I do?

Please give us a call and your orthodontist will see you and smoothen the part of the appliance which is causing the ulcer.

I can’t seem to speak like my usual self after wearing the appliance. Is this normal?

Your speech will be different at first. You may also produce more saliva and have to swallow more than normal. Rest assured that this is normal and will quickly pass. Don’t be discouraged. Tips:

  • Read out aloud at home on your own

  • Wear the appliance all the time. Don’t be shy!

Can I eat normally?

Yes. Please remove the appliance from your mouth and keep it safely in a covered protective box. Common mistakes are wrapping the appliance in tissues or keeping it in your bag/pocket without the box. You will break it/lose it!

After each meal, clean your brace thoroughly under cold running tap water. For your treatment to work well in the shortest time:

  • Avoid hard and chewy food such as apple, carrot, guava, spare ribs. Tips: Cut them into small pieces

  • No chewing of bone please

  • No chewing gum please

  • Avoid sugary snacks/drinks, fizzy drinks

My appliance is loose after a few weeks. What should I do?

Yes. All you need to do it give us a call and book an appointment at your earliest convenience to let your orthodontist tighten the appliance. If it is too loose and you can’t attend to us immediately, do not wear it when you sleep at night for the fear of swallowing it in your sleep.

My appliance broke/I lost my appliance. What should I do?

Please give us a call and book an appointment at your earliest convenience. A mould of your teeth will need to be taken for some repair work and if you need a new appliance. An additional cost is implicated for broken/lost appliance.

What about tooth brushing? How do I clean the appliance?

Remove the appliance from your mouth for tooth brushing. Rinse the appliance under COLD running tap water. You can also gently clean the appliance with a soft brush without damaging the wire.

I swim/play football/taekwondo etc. (contact sports in general)

Please remove your appliance and keep it in a covered protective box.

Wind musical instruments (flute and brass)

Please remove your appliance and keep it in a covered protective box.

 

Impacted canine

Why do canines become impacted?

Nobody knows. Up to 3% of the general population will be affected. The canines can be impacted under the gum in the roof of the mouth in 85% of the cases.

Can I do nothing about it?

Yes. This is an option if you still have your baby canine tooth.  As you know, any baby teeth are not meant to last forever. So you can keep your baby canine tooth till it is lost. Your orthodontist will monitor the impacted tooth and the surrounding teeth with Xrays every year.

I lost the baby tooth after 2 years. Now there is a gap.

The gap can be filled with denture/bridge/implant.  However, a baby tooth is much smaller in size. If you are happy with replacing the gap with a smaller-sized tooth, you don’t need braces.

To produce a good and symmetrical appearance,  you will need braces to get the right amount of gap to replace the tooth.

Are there any risks of leaving a tooth impacted?

Yes. There is a risk that the impacted tooth will damage the root of the teeth next to it. Another risk is the formation of a cyst around the impacted tooth.

I decided that I want orthodontic treatment. What are my options?

Your option will be determined by your malocclusion but to simplify, you have 2 options: Remove it or pull it down (traction).

How do you pull down the impacted canine with braces?

You will need to undergo a minor operation to uncover the impacted tooth, which involves a small “window” of gum and bone being removed over the impacted tooth. A gold chain will then be attached to the impacted tooth and your gums will be stitched back, leaving only the end of the gold chain visible in your mouth.

The gold chain acts as the “middleman”, connecting the impacted tooth to your braces to bring the tooth into your mouth.

How long will I need to wear the fixed braces to pull down the canine?

At least 2.5 to 3 years. It depends on the depth and position of the impacted canine. The deeper it is in the bone and the further away it is from the rest of your teeth, the longer the duration of treatment.

Can you guarantee that the impacted tooth will move down with gold chain & braces treatment?

There is no guarantee, especially in older patients. However, only rarely that the impacted tooth is fused to the bone and won’t move down.

 

Interproximal reduction

What is interproximal reduction (IPR)?

It is the mechanical removal of some of the outer tooth surface between teeth. The tiny space created can then be used to straighten teeth.

How much are you going to remove?

Up to 0.25mm/surface/tooth.  You will barely notice it!

Why do I need IPR?

When the orthodontist needs just a small amount of space to align your teeth and to correct your bite. IPR is also done to reshape your teeth.

How is it done?

Either hand-held abrasive strip or dental bur.

How long does it take? How many times do I need IPR?

The procedure takes only a few minutes. Some patients need to do it a few times to get the desired outcome.

Does it hurt?

No. This is because only a very thin layer of enamel is removed and enamel does not contain any nerves. You may feel a strange pulling/pushing pressure.

Any side effects of IPR?

  • Temporary sensitivity. Tips: Your orthodontist will apply a layer of fluoride varnish to help the enamel repairs by itself and you can use an alcohol-free fluoride mouthwash.

  • Plaque accumulation. Tips: Your orthodontist will smoothen and polish the involved teeth and you should continue to brush the areas well.

 

Orthognathic surgery (jaw surgery)

What is orthognathic surgery?/ Why do I need surgery?

Our upper and lower jaw bones must first be in the correct position in order to correct the position of teeth and provide a better functioning bite. If the jaw bones are too far off from their normal position, orthodontics alone cannot correct the bite. Hence, you may be advised to undergo surgery to move the jaws into the correct position so that the teeth can meet.

In brief, orthognathic surgery corrects the jaw position, orthodontic treatment can only correct the teeth position and improve your bite to a certain extent.

I am happy with my teeth alignment, I just want to improve my bite. So can I have orthognathic surgery without braces?

No. You will still need fixed braces to move your teeth so that your upper and lower teeth meet evenly after the surgery.

Will I look very different after the surgery?

You will definitely look different to some degree. The difference depends on the amount of jaw movement. The bigger the amount of jaw movement, the more different you would look. You should discuss your expectation with your oral surgeon and orthodontist.

Who will perform the surgery?

An oral and maxillofacial surgeon will perform the surgery under general anaesthesia.  Your orthodontist will do the brace work. It is a teamwork and requires careful planning before embarking you on this journey.

Surgery first or braces first?

Our normal practice is braces first for around 1-2 years to align the teeth.  You may or may not need extraction of teeth. The braces will stay in your mouth before, during and after the surgery. During the surgery, the braces help the surgeon to position the jaws evenly; after the surgery, the braces help the orthodontist tidy up the bite by the use of elastics.

How long is the duration of treatment?

At least 3 years or so. The first 1-2 years to prepare you for the surgery and the last 6-12 months to tidy up your bite after the surgery. Failure to attend follow-up appointments or repeated breakages of the brace will add to the overall treatment time.

How do surgeons stabilize my jaws in the corrected position?

Small metal plates and screws are used to hold your jaws together. These plates are on the surface of the bone but beneath the skin. Only occasionally the plates need to be removed at a later date.

How long will I be in hospital?

Depends on your recovery. Usually 2-4 days.

Can I eat normally after the operation?

No. Immediately after the operation, you will need to have a very soft diet for the first few weeks. You will also need to pay extra attention to your oral hygiene to minimize the risk of infection. You will be advised on this by the surgeon as the day of operation approaches.

When can I get back to work/school? Any side effects/risks?

After 6 weeks or so. You will definitely have swelling and bruising after the surgery which will take an average of 3-4 weeks to subside.  Most common side effect of lower jaw surgery is numbness of the lower lip which will gradually recover after few weeks or even months. In very small number of patients, it is permanent numbness.

 

Removable appliances

Can I remove the appliance?

Yes you can but only for cleaning purpose. Otherwise, you will break the wire and increase the treatment duration.

How often should I wear it?

All the time INCLUDING sleeping time. Wear more = fast treatment.

How often will I need an appointment?

Every 6 to 8 weeks to tighten the brace.

How long will the treatment take?

Normally 6 to 12 months. Failure to attend appointments and repeated breakages will prolong the treatment duration and incur additional costs.

I had completed this treatment. What is next?

You may or may not need another 12 months of fixed braces treatment. If you don’t need fixed braces treatment as per your orthodontist, you may just need retainers and you are good to go!

Will it be painful?

It is likely to be sore for 3 to 5 days each time the appliance is adjusted. You can take painkiller but do consult your medical doctor if you have any medical issues/drug allergy. Don’t stop wearing the appliance or you will have a further 3 to 5 days of discomfort when you start wearing it again.

I have an ulcer from the appliance. What should I do?

Please give us a call and your orthodontist will see you and smoothen the part of the appliance which is causing the ulcer.

I can’t seem to speak like my usual self after wearing the appliance. Is this normal?

Your speech will be different at first. You may also produce more saliva and have to swallow more than normal. Rest assured that this is normal and will quickly pass. Don’t be discouraged. Tips:

  • Read out aloud at home on your own

  • Wear the appliance all the time. Don’t be shy!

Can I eat normally?

Yes. Please remove the appliance from your mouth and keep it safely in a covered protective box. Common mistakes are wrapping the appliance in tissues or keeping it in your bag/pocket without the box. You will break it/lose it!

After each meal, clean your brace thorougly under cold running tap water. For your treatment to work well in the shortest time:

  • Avoid hard and chewy food such as apple, carrot, guava, spare ribs. Tips: Cut them into small pieces

  • No chewing of bone please               

  • No chewing gum please

  • Avoid sugary snacks/drinks, fizzy drinks

My appliance is loose after a few weeks. What should I do?

Yes. All you need to do it give us a call and book an appointment at your earliest convenience to let your orthodontist tighten the appliance. If it is too loose and you can’t attend to us immediately, do not wear it when you sleep at night for the fear of swallowing it in your sleep.

My appliance broke/I lost my appliance. What should I do?

Please give us a call and book an appointment at your earliest convenience. A mould of your teeth will need to be taken for some repair work and if you need a new appliance. An additional cost is implicated for broken/lost appliance.

What about tooth brushing? How do I clean the appliance?

Remove the appliance from your mouth for tooth brushing. Rinse the appliance under COLD running tap water. You can also gently clean the appliance with a soft brush without damaging the wire.

I swim/play football/taekwondo etc. (contact sports in general)

Please remove your appliance and keep it in a covered protective box.

Wind musical instruments (flute and brass)

Please remove your appliance and keep it in a covered protective box (as illusrated below).