We often have parents ask us “what age should I bring my child in to be seen by the orthodontist – they’re only 8, is that too young?”. Quite the contrary – around 8 years old is the ideal age to first see us. By that age, some of the permanent/adult teeth are beginning to erupt and it is possible to identify unfavourable growth patterns (e.g. crossbites, deep bites etc.), address bad habits (e.g. thumb sucking) or assist front teeth in erupting correctly. Moreover, it provides a good reference point to allow the orthodontist to monitor growth and dental development over time.

Often your orthodontist may be able to simply review your child on a regular basis, with the view to treat them when all of their permanent teeth are through. Conversely, early intervention is sometimes required to correct dental problems. Early treatment may not necessarily prevent the need for comprehensive treatment in the future, however, it may simplify later treatment or decrease the length of time spent in care. Additionally, it may help to avoid premature damage or wear to teeth that have erupted unfavourably.

Written by Campbell Watson.

In orthodontics, a mini-screw or temporary anchorage device (TAD) is a small metal implant that acts as a fixed anchorage point to help with more complex orthodontic tooth movement.

TAD’s are typically used to aid closure of large spaces, move multiple teeth at the same time, assist with movement of teeth that wouldn’t be otherwise possible with braces alone and/or hold teeth in a fixed position if required.

Their small and clever design makes the mini-screw a simple and effective tool to treat difficult cases in a time efficient manner and is well tolerated by patients.

The most common question we hear from patients is will braces hurt?  Rest assured that the process of putting the braces onto your teeth does not hurt – we simply glue to brackets to the teeth.  However, it is normal to experience some discomfort and pressure on the teeth about 4 hours after the wires have been placed as the teeth begin to move.

This mild discomfort generally lasts less than a week and you can take regular analgesics to relieve any pain.  To further minimise any discomfort, we also recommend that you eat soft foods such as pasta, rice and soup as you are getting used to the braces.

After the braces have been put on, you may also find it harder to talk and that you salivate more.  This is all normal and everything will improve over the next few days as you practice talking with the braces on.

Sometimes the braces can rub against the inside of your lips and cheeks and cause irritation or sore sports.  To prevent this, you can apply orthodontic wax over the brackets.  If you have any mouth ulcers, it is useful to rinse with warm salt-water to help them heal.

An important thing to remember with braces is that any discomfort that you experience is only temporary and can be easily managed.  Most importantly, you can always contact the clinic if you are unsure of anything or need any further support.

Written by Sher Fong.

Meet Elaine – our clinical coordinator at Sable and Pepicelli Orthodontists.

ELAINE

How long have you been working at Sable and Pepicelli Orthodontists?

I started working at Sable and Pepicelli Orthodontists in 2014.

What is your role at Sable and Pepicelli Orthodontists?

Clinical Coordinator

Have you ever had braces?

Yes I had braces twice, the first time round was in Germany when I was 13 years old however I stopped wearing my retainers after four years and my teeth moved. I then decided to get braces again at Sable and Pepicelli Orthodontists. I will never stop wearing my retainers.

Where did you grow up?

I was born and raised in a small village of just 10,000 people in Germany called Bad Ems.

What is your background?

My mother is from Malaysia and my father is from Hong Kong.  My parents moved to Germany for work. I moved to Australia in 2008 after completing my high school education in Germany.

 Do you speak any other languages?

My first language is German. I am also fluent in English, Cantonese and Mandarin. I am currently taking Japanese language classes and plan to learn French in the future.

What is most rewarding about your job as a clinic coordinator at Sable and Pepicelli Orthodontists?

I like seeing the practice run smoothly for the doctors and patients.

Where is your favourite place to visit and why?

I love to visit Germany to see my family and friends. I also love to visit Malaysia for the great food and shopping.

What are hobbies?

I enjoy taking my Rottweiler dog Stark to the dog park and beach. I also love travelling and eating different cuisines.

What is your favourite restaurant?

Tetsujin Sushi Train – Melbourne Emporium

Written by Stacey Ottaway.

Orthodontic Emergencies

The large majority of our patients make it through treatment with only minor inconveniences. Every now and again though, something can go awry and cause irritation or issue.

Here is Yvette’s guide to navigating orthodontic issues and emergencies:

Lip and cheek irritation

Initially, certain parts of the braces or orthodontic appliances may cause irritation to the lips and cheeks causing ulcers. This will subside as the body becomes used to the braces after a week or two. This can be easily addressed by applying wax to the appliance causing irritation. In conjunction with warm salty mouth rinses the area should heal within a week.

Tooth sensitivity

Patients will experience a continuous light pressure during treatment. It is possible for some teeth to become sensitive for a couple of days following a visit. This is normal. This will usually subside within 3-4 days and any pain can be managed with regular analgesics.

Broken and loose appliances

Brackets, wires and bands may become loose during treatment. If this occurs, please contact us immediately and we will organise to see you as soon as possible. However, if something happens to occur on a weekend, you can attempt to gently remove anything that is causing direct discomfort and we will endeavour to see you as soon as possible.

With all that said, prevention is the best cure so avoid hard or sticky foods to minimize breakages during treatment.

Long wire or shifted wire

As the teeth move around and align during the initial phase of treatment it is not uncommon for the excess wire to protrude from the back teeth. This can also occur later in treatment if we are closing spaces. Depending on the amount of wire, this feeling can range from unnoticeable to quite irritating. Orthodontic wax can be used as a temporary measure, but we will need to see you for a more permanent solution.

Lost mods, power chains and separators

If any of the elastic components come adrift and your appointment is within seven days, there is no urgency to make a special trip in to see us. If however your next visit is more than a week away, we would prefer you call to come in and see us.

Loose Forsus spring

The Forsus rod can disengage from the spring on wide opening or yawning. If you feel comfortable doing so, you can try to reengage the rod by placing it back in the spring. If that is unsuccessful or you don’t feel comfortable doing that, do not hesitate to call and book an appointment.

Broken or lost retainers

If you lose or break your retainer, please contact us to make an appointment as soon as possible. Teeth retain the capacity to move throughout your lifetime, so the sooner we can see you the less likely they are to have moved.

Written by Yvette Ding

Elastics with braces; if you haven’t had them yourself, you’ve probably seen friends or colleagues wearing these small rubber bands connecting several teeth. But what are they, what do they do, and why do I have to wear them?

When we refer to elastics, we are referring to the larger colourless, elastic rubber bands that run between the upper and lower jaws. These are different to modules – the tiny, often coloured, O-rings that sit around each bracket and hold the wire in. Almost all our patients will have to wear elastics at some stage during treatment. Generally speaking, we commence the use of elastics about 6 months into treatment once in suitable wires, but depending on what we are trying to achieve we may start on your first appointment. But don’t fret – we will always let you know when, where, how and why you are wearing them, all of which may change over time during the various stages of treatment.

The burning question here is why? We understand they can be fiddly, annoying or sore at times, and we don’t just have you wear them for our enjoyment, so why do we include this experience in treatment?

Essentially, elastics do things the braces can’t. The elastics are designed to place a small, but constant force on the teeth in order to correct the bite. Initially (like braces), the teeth they attach to may be a little tender, but (like braces) this will dissipate after a couple of days. Like all rubber products, they do tend to age and lose their stretch over time, so for this reason we advise changing the bands at least once (ideally twice) per day to maintain that small but constant force.

The most challenging issue for us is compliance – patients either not wearing elastics at all, or only wearing them a percentage of the prescribed time. Rather obviously, not wearing elastics is not going to allow any improvement in the bite. No improvement means extended treatment time. But what about partial wear? Unfortunately, wearing elastics for half the time is equivalent to not wearing them at all. Why? Well without getting too bogged down in the detail, say we asked elastics to be worn for 24 hours per day, but were only being worn 12. For those twelve hours they were being worn, there’s force on the tooth and subsequent movement. Great! One step forward! But then then following twelve hours there’s no force on the tooth and the tooth relapses in the direction it came from. One step back. So a net result of zero movement, bummer. And before the myth about wearing twice as many for half the time arises, there’s unfortunately no truth in that either.

The take home message here is that we want your teeth to look great, but also function well. The way we improve function is through occlusion. One of the ways we improve occlusion is with elastics. Hopefully this has provided some valuable insight into why those pesky little elastics which seem to find their way around the entire house are so valuable to us, but more importantly, to you.

Written by Campbell Watson

As a child, I remember braces not being the trendy addition they are now. I often heard stories around the schoolyard about how ‘painful’ or ‘big’ they were and so I was slightly apprehensive about finally getting my own set in 2016. However I did, and to be honest, it hasn’t been anywhere near as bad as I expected. I’ve decided to share my experience with others to unravel some of the rumours surrounding my new fancy, but functional, dental bling.

Having been with the team at Sable and Pepicelli Orthodontists for several years now, I have collected a wealth of handy tips and forewarnings about the initial experience. However, a lot of these were not necessarily gained from my colleagues as you’d expect, but rather from the many patients I see as I accompany them through their orthodontic journey.

It has been four weeks since I had my braces placed and so far, I’ve found them to be a lot easier than I had imagined. The feeling of having little things stuck to all of my teeth has proved to be more of a challenge than the suggested ‘pain’ associated with them (I found it to be more of a low-level background ache or tenderness that lasted a couple of days). Initially my lips and cheeks did get caught on them (which caused a few ulcers) and I found I needed to be a lot more rigorous with my cleaning routine to get out all the little bits stuck between the brackets. After roughly two weeks, they just felt like any other part of my mouth.

There were a few unexpected challenges too. It turns out we really are right when we stay ‘stick to soft foods for the first few days’ (although this may have been exacerbated by the visit to Mr. Nastri’s rooms to have four premolars extracted). All I can say is thank goodness for EasyMac and pumpkin soup! The other surprise was the increased saliva flow from something foreign being in my mouth – it felt like I was dribbling constantly! Although the saving grace is that with all the extra saliva, the braces felt smoother to my lips and cheeks!

Granted I’ve only had my braces on a few short weeks, but it’s been incredible to see how quickly my teeth have moved and the difference it has made – already the spaces where my teeth were taken out seem to be closing and I’ve really embraced them!

I’ll keep everyone posted!

Written by Tracy Nguyen.