What’s your problem?- The first orthodontic consult

The first braces consultation appointment is an important one. This is when you find out more about your condition and what can (or cannot) be done to improve your smile. It is also for you to ask questions about the braces treatment so you know what to expect.

I usually start by asking the patient some questions to find out what their concerns about their smile are? It is relevant to know what the patient is unhappy about to make sure that the problem is addressed. Notice that I say addressing the problem, rather than solving the problem. This is because sometimes, what the patient is unhappy about cannot be corrected by wearing dental braces. But it should be discussed so that the patient knows what to expect, and what not to expect. Otherwise they might be disappointed at the end of treatment despite having their teeth straightened, because their expectations are not met. And the more specific they are in describing what they don’t like about their smile, the better it is.

For example, a patient might come in complaining of the “upper teeth sticking out”. In some cases, the teeth do not only stick out, but are also “too long” because the bone of the upper jaw has grown downwards. Wearing braces can bring the teeth in, but it can’t change the height of the bone. That means the teeth will still look “long”. So if the patient didn’t verbalize their concerns about their “long” teeth, they might not come to realize that it cannot be corrected and have unrealistic expectations.

However, most people aren’t so expressive about their orthodontic problems, and understandably so. Usually they will just say something general like “my teeth are not straight” or just flash their teeth at me when I ask them why they want braces. As the treatment progresses, more specific concerns might surface. Some problems are solvable or are in the process of being solved, but others aren’t solvable with orthodontics. Some problems are also not so apparent until the teeth start to straighten. However, most people are realistic and understand that there are some limitations to dental braces treatment. So before you come for your first orthodontic consultation, it is helpful to have a good look in the mirror and see what you don’t like about your smile. And if I look like I’m scrutinizing your face, don’t feel awkward, I’m just doing my job.

With the orthodontic problems identified, we can then discuss what problems can be treated, to what degree it can be treated and how it will be treated. Things that are discussed include the following:

  • Whether extractions are needed:
    • Some cases can be treated with or without extractions, but with different end results. Others are ‘clear cut’ extraction cases.
  • Estimated duration of braces treatment:
    • If you have a certain deadline to meet, for example your wedding photo-shoot, you should check if it is feasible to complete your treatment by then.
  • Type of braces appliances
    • The most popular choice is the traditional metal braces.
  • Braces treatment fees
    • The cheapest dental braces appliance is the metal braces. The treatment results are as good as any other appliance.
  • What to expect during treatment
  • Any possible limitations
  • Any special concerns you have

Once you have decided to proceed with braces treatment, you will have a set of pre-treatment records done. This usually consists of photos of your face and teeth, dental molds and x-rays. If time permits, you can do this on the first appointment.

For those that require extractions, a referral letter to indicate which teeth to be extracted will be given.You can come back to get the dental braces appliance placed after you have extracted the teeth. How long to wait after extractions? Most patients come back about a week after extractions to get the braces placed. You can come back earlier if there is no pain and you feel comfortable. However don’t take too long to come back as the neighboring teeth might drift into the extraction space, leaving us with less space to use.

So, what’s your problem?

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