Knowing the ropes.
Please select a topic of interest:
Is orthodontic treatment worthwhile at all at my advanced age, or is there anything that can be done at all at my adult age?
Throughout its life, the jawbone (like all other bones) retains the ability to grow and break down bone. This is the only way a broken bone can grow back together. This means that successful treatment is possible well into adulthood – our oldest patient was over 60 years old. Only the position of the upper jaw in relation to the lower jaw can no longer be controlled with growth as in childhood. Which solutions there are for an aesthetic appearance, but also for a permanently stable solution, must be discussed individually in a therapy meeting.
Corona - our position
Our greatest concern is the well-being of our patients, our employees and all families.
In order to do our part in slowing the spread of the coronavirus and the new lung disease COVID 19, we have decided to perform the treatments that are at risk of worsening if controls are not done.
Also, the braces that have already been made will still be used.
Postponable controls will be rescheduled.
Do I still have to go to the dentist if I’m going to the orthodontist anyway?
We do not want the contact with the family dentist to be interrupted, as this trusted doctor will usually remain with you for the rest of your (working) life.
The family dentist additionally monitors dental hygiene and dental condition and performs individual prophylaxis with fissure sealants and fillings, if necessary. Fluoridation should not be performed ½ year before the scheduled appointment, especially when gluing in fixed braces or adhesive points, so-called attachments for splint therapy!
We will nevertheless keep an eye on the condition of the teeth and fluoridate with various solvent-free agents (e.g. deep fluoride from the company Humanchemie) whenever necessary
Orthodontics | Treatment
What are "functional orthodontic" braces?
These include the following devices:
Function regulator according to Prof. Fränkel, bionator according to Prof. Balters, elastic open activator according to Dr. Klammt, double advancement plate.
With these devices, the function of the masticatory system, rather than mechanical forces, influences the bony development in the facial region and the masticatory system.
For patients under 18 years of age, where the tooth or jaw malocclusion exceeds a certain degree of severity, the statutory health insurance initially reimburse the orthodontic treatment to 80% (90% for the 2nd child).
The health insurance co-payment (20% or 10% of the health insurance costs) will be reimbursed by your health insurance company only after successful completion of treatment.
In particularly serious cases (if additional surgical dislocation of the jaw must be performed by an oral surgeon), the health insurance also covers the cost of orthodontic treatment for adults.
For services that are not or not fully reimbursed by the statutory health insurance (these are agreed individually in a separate therapy meeting), we can offer you a convenient installment payment. This also applies to patients over 18 years of age with statutory health insurance.
Privately insured patients have individually agreed contracts with their insurance, on which the reimbursement of orthodontic services depends – we recommend submitting the created treatment plan for approval before the start of treatment.
Patients eligible for subsidies submit the treatment plan to both the subsidy office and the insurance company.
What is digital X-ray and how harmful are the X-rays to health?
X-rays have an ionizing effect and can thus cause a reaction in the genetic material of individual cell nuclei that have been hit. Every day, we ingest radioactive substances through the air we breathe and the food we eat, and we are constantly exposed to cosmic and terrestrial radiation, e.g., during long-haul flights. Therefore, we must keep radiation exposure from medical X-ray applications as low as possible in order to reduce the overall radiation exposure for the patient.
The prerequisite for this is, on the one hand, the best possible implementation of necessary protective measures (e.g. use of X-ray aprons) and, on the other hand, the use of an X-ray device with digital X-ray technology. By using digital sensors, the radiation exposure can be reduced by up to 80%, depending on the density of the human tissue. We have changed our practice already in 1999 generally to digital X-ray diagnostics! This additionally results in an improved environmental balance, since the entire X-ray developer chemistry can be dispensed with.
Why is my hand being x-rayed by my orthodontist?
With the help of the hand x-ray, we can obtain a statement on the growth potential in the area of the temporomandibular joints. This is always of important interest if we still have to make an adjustment to the position of the lower jaw or inhibit excessive growth in this jaw.
As a small side effect, we can then also calculate the expected body length of our patients.
Why are x-rays taken more frequently by orthodontists?
In orthodontics, too, X-rays are only taken if the benefit of the expected image clearly outweighs the potential damage.
For example, we take X-rays at the beginning of treatment to determine whether all the teeth are set in the bone and whether the jaw and teeth are healthy.
An important x-ray, especially in orthodontics, is the teleradiograph, or FRS for short, which provides us with important information, especially on growth processes and positional relationships of the jaws in the skull, for planning orthodontic treatment.
After one year at the earliest, more likely 1.5 years, a follow-up diagnosis is necessary, in which plaster models and photos are taken in addition to X-rays, in order to monitor the progress of the treatment and also to document the already visible successes. The results of the “DIA” ( diagnostics) are presented and explained in a subsequent “DIA” discussion, also to motivate the patient and to pass on information to the parents.
How often do I need to come in for a checkup?
As a rule, at:
removable braces a control interval of about 8-14 weeks is agreed.
fixed braces, the control interval is shorter and is between 6-10 weeks.
What is a "real" orthodontist?
The training to become a specialist in orthodontics is at least 4 years after graduating from dental school.
This includes one year of general dentistry and at least 3 years of full-time orthodontics. Of these, 1 year must be completed at a university clinic.
The highly qualified training is then completed with the specialist examination.
For patients, the distinction to dentists with activity focus orthodontics or to dentists with Master of science orthodontics is hardly possible. However, these have obtained their qualification only with a few weekend courses.
How long does orthodontic treatment take?
As a rule, it lasts four years: 1-1 ½ years with loose braces to create the space and adjust the bite and after the end of the tooth change again 1- 1½ years with fixed braces to eliminate the rotations. After removing the fixed braces, we must monitor the reattachment of the teeth with removable braces for at least one year.
A so-called bonded retainer in the lower jaw can be added to facilitate this.
Children | Teenagers
My child has a pre-bite / underbite - what can / must I do?
If the upper jaw is far in front of the lower jaw, or if the lower jaw has developed a large step with its teeth toward the upper front teeth, a consultation appointment should be made.
The size of the step is decisive as to whether treatment may be requested at the expense of the statutory health insurance.
My child has a crossbite - what can/should I do?
A lateral crossbite or also a “crossed bite” on the front teeth must be treated at an early stage, since this bite form prevents the upper jaw in particular from developing to its full size.
The legislator also sees it this way and has given us the possibility to treat this malocclusion with an early treatment for 1.5 years.
My child, my teenager still sucks his thumb or bites his fingernails - what can I do?
During a consultation, we take special time for this habit. The attention we pay to the patient already triggers the decision to quit in most people. And with the help of a few tricks such as plasters or elastic bandages, but also a contract in combination with an individual “sucking calendar”, a large number of patient children can be successfully helped.
Only when the sucking (no matter what!) has been permanently stopped can treatment begin. The teeth and the bones will thank us.
A baby tooth has been extracted early - what to do? What does a space maintainer do?
If a deciduous tooth has been lost prematurely for reasons of caries or fistula formation, but also due to accidents, a space maintainer should be inserted promptly (1-2 months). There are removable space maintainers that require the patient’s cooperation, or there are fixed solutions that do not require the patient’s cooperation.
This can counteract the migration of neighboring teeth into the gap and thus prevent a loss of space for the subsequent permanent teeth.
When is "early treatment" performed and how is it different from "early treatment"?
Early treatment” may exceptionally always be requested from the statutory health insurance if there are already significant deviations in the area of the upper jaw to the lower jaw in the primary dentition, as is the case, for example, with a crossbite or a strong step formation. A too early loss of milk cheek teeth and an expected lack of space in the posterior region also allows this application.
Early treatment” is strictly limited to a treatment period of 1.5 years. This is opposed by the “early treatment”, which is applied for much less frequently and is only used in the case of extremely severe growth changes of the jaw bones. This treatment is required for a long time because strong genetic components often have to be counteracted. The treatment is not regulated in terms of time and can be extended until the end of growth.
Is it all worth it or is it all postponing again?
Developing jaw bones at an early stage is our main focus, because especially with the very gentle functional orthodontics (FKO) by means of double braces (function regulator; bionator; elastic open activator (EOA)) a stable space in the jaw and especially the correct orthopedic position of the jaws can be achieved. Not infrequently, the subsequent treatment period with fixed braces to eliminate rotated teeth is also significantly shorter and, in the best case, no longer necessary at all! Over-extending jaws, as is often done with expansion plates or even incorrectly planned fixed braces, must inevitably lead to collapse of the dental arches after completion of orthodontic treatment. The less mechanical action on the jawbone, the more dimensionally stable it will remain.
In patients who are presented to us late with all permanent teeth for the first consultation, the mechanical way with fixed braces is often unavoidable. Then keeping the result with the final retainer braces is even more important and should rather be taken further seriously even after the official treatment is completed. We also do this by monitoring our patients even after completion. With the help of our recall system, we care for our young adults on a regular basis – until the age of 21 or the eruption of the wisdom teeth!
Brace | Retainer
Why is it often so hard to speak with most loose braces?
With the classic “plates”, i.e. removable loose braces for the upper and lower jaw, the palate in particular is covered with plastic. However, an important speech field is located in the front part of the palate, which means that speech is often blurred. We therefore use a functional regulator (FR) or an elastically open activator (EOA) wherever possible and chosen as a means of therapy, which leaves the speech field free of acrylic and enables much clearer speech.
How quickly must a loose bracket be reattached?
If it is in the anterior region, then please contact us as soon as possible for a free special appointment by mail or phone – we occasionally decide after consultation how quickly the bracket must be reattached. In the posterior region, it is still important to make an appointment for reattachment in the next 1-2 weeks.
What can I do in case of pain caused by the braces?
If we have used thermoelastic arches, but they are not covered by the statutory health insurance, the patient can help himself with cool water during the day, as these arches reduce the force peaks again when they cool down. If there is still a lot of pressure pain when going to bed, it is useful in the first few days in a few patients to give a simple painkiller to help them fall asleep.
Can I still talk / eat / kiss properly with the fixed brace?
As a rule, all this should be possible after a rather short acclimatization period. If we use a special treatment device that restricts speech, we will point this out in the therapy session!
When will the fixed braces come out again?
The duration of treatment with a fixed brace is on average 1½ years – longer than two years should remain an exceptions.
How do I clean my loose brace, splint, retainer properly?
We recommend inserting the braces with a special cleaning powder (Cetron), which acts as a solution for up to a week, for at least half an hour and then clean with a toothbrush. We can only advise against the use of “Kukis” or similar because of frequent wire breakage! These agents are often too aggressive. The use of a toothbrush and dishwashing liquid or diluted lemon vinegar is an alternative.
BUT NEVER put in the MICROWELLE or the steamer in the disinfection program!
Boiling also causes irreversible shrinkage or bending of the plastic.
Why do brackets come off more often for me - why do brackets come loose for me?
In some patients, extra fluoridation was carried out by the general dentist shortly before the fixed braces were fitted! This leads to a poor adhesive bond on the blocked-off enamel. The enamel must then be roughened separately to ensure the adhesive bond. Therefore, we ask you to inform your dentist ½ year before the planned installation of fixed braces that you do not need fluoridation. We fluoridate the teeth during the first control of the fixed braces!
Our Fuji-Ortho-LC adhesive additionally releases fluorine under the adhesive! Apart from that, we would like to point out the careful handling of the fixed braces, where biting off and biting through hard food is not allowed – however, the small cutting of e.g. carrots or apples still makes a healthy diet possible! Repairs are covered by the statutory health insurance only to a very limited extent.
Can I eat anything with fixed braces or what do I need to be aware of with fixed braces?
After the fixed braces have been fastened, we specifically point out the careful handling of the fixed braces in a conversation and with an instruction sheet. In particular, biting off and biting through hard foods is not permitted, as this would cause the brackets and bands to detach and the wire arches to bend uncontrollably. However, cutting carrots or apples into small pieces still makes healthy eating possible! Repairs are covered by the statutory health insurance only to a very limited extent!
Do the fixed braces break the teeth?
No, with sufficient care and punctual appearance, to check loose bands or brackets, no damage to the tooth enamel may occur. For this purpose, we use a special adhesive (fuji otho LC); a combination adhesive that also releases fluorine under the adhesive areas as additional protection.
When to start with the fixed brace?
Actually, only when all permanent teeth are fully erupted – only in special cases, at a time when milk teeth are still present in the mouth, a partially fixed brace is inserted by us.
What is a retainer?
Retainer means nothing other than “holder”. It refers to an internally bonded white gold wire that can be glued to the lower six front teeth on the day the fixed braces are removed. These front teeth are the ones that, as the “weakest teeth”, can easily shift again from the anchorage value in the jaw in case of poor cooperation with the loose retainer. The retainer should remain in the lower jaw until the wisdom teeth erupt. But then it should be removed again to allow the permanent splinting of the teeth back to a natural hold via correct dentition.
A retainer is also often offered on the anterior teeth in the upper jaw. However, since we often work together with osteopaths, manual therapists and chiropractors, we try to avoid this permanent splinting in the upper jaw, which has a completely different bony structure with its six small partial bones, wherever possible. We believe that these sutures of the upper jaw should move freely!
About our practice
Who will actually treat me in your practice if there are multiple dentists?
The physician with whom the initial consultation takes place is responsible for the overall treatment. He keeps the “red thread” in the therapy.
In the case of special appointments such as repairs or during vacations, it is possible that the doctor on duty at that time will carry out the treatment.
A change of the attending physician in the practice is possible in exceptional cases.
Teeth | Wisdom teeth
I am an adult and have lost a large molar. Teeth have fallen into the gap. That’s why it’s difficult for my dentist to make a bridge now. What can an orthodontist do to help?
When a tooth is lost, the neighboring teeth often tilt. In order for the dentist to be able to fabricate a statically well-planned bridge or insert an implant in an axis-correct manner, it is advisable to first straighten the teeth that have tilted into the gap. The abutment teeth of the bridge require less grinding, the tooth nerve is less stressed during grinding and teeth are loaded more favorably after straightening. This improves the long-term stability of the construction.
Therefore, orthodontic straightening of the abutment teeth should be clarified with the dentist before treatment.
Usually, such problems can be solved by means of a small brace, which is elegantly placed in the molar area, hardly visible, or also with an Invisalign® splint treatment. A lot is possible in ½ year. Even if the costs increase with it, a significantly longer preservation of the denture should be worth it to you. In a consultation, your individual solution will be proposed to you.
Do wisdom teeth have to be extracted?
The decision to extract is made in our practice only when the development of the roots of the wisdom teeth is complete. This rarely happens before the age of 20. Often the decision to extract is made too early, when there is still a lot of growth to be expected in the jaw angle with eruption of the wisdom teeth. Over the many years of follow-up after active treatment has been completed, we have accumulated image material that has taught us a gentler approach to these teeth.
Keeping this chance and maintaining the achieved result with a retainer, as well as the provided retaining braces, motivates many of our patients to wear their loose retaining braces until then. However, if the wisdom teeth do not adjust properly or lead to recurrent inflammation in the bone, we will also refer the patient to an oral surgeon for removal.