A smile is a curve that
sets everything straight
Our consultant orthodontist specialises in the diagnosis, prevention and correction of malpositioned teeth and jaws, for patients of all ages.
Braces for Children
Braces are most commonly done when patients are in their early teens. However, there are some special situations where braces can be done earlier. Below are some frequently asked questions about braces for children and teenagers.
When should a child first see an orthodontist?
Early orthodontic treatment can be carried out in children between the ages of 7 to 12. Most children start having braces around the age of 12 or when all their permanent teeth (except wisdom teeth) have come through.
What kind of common orthodontic problems can be treated early?
Removable appliance to correct crossbite of upper front tooth
Functional appliance to move the lower jaw forward
Partial braces (partial fixed appliance) to correct crossbite of upper front teeth
Will a child still need braces after early orthodontic treatment?
It depends. Some problems can be resolved without further treatment at a later stage. In some other cases, early treatment only reduces the severity of the problem and the child would need comprehensive treatment with braces later.
With greater dental awareness and demand for cosmetic dental procedures, it is not surprising that adults comprise a growing number of patients seeking braces. This demand is further fuelled by the numerous aesthetic options for braces. Below are some information if you are an adult thinking of having braces.
I’m already in my 50’s. Can I still have braces done?
Age does not preclude orthodontic treatment as long as the teeth and gums are healthy. So yes, you are never too old for braces.
I have missing teeth. What can braces do for me?
Firstly, if there are not many missing teeth, some of the gaps can be closed with braces.
If a decision has been made to replace the missing teeth with a prosthesis (e.g. denture, bridge, implant), then braces can be done to align the teeth adjacent to the gaps to facilitate the placement of the prosthesis. This is because if a tooth has been missing for quite some time, the adjacent teeth can tilt into the space from the missing tooth/teeth.
The photos illustrating our before/after clinical cases show consenting persons and the same patients appear, respectively, for the before/after result. These photos have not been retouched. Individual results may vary.
There are many types of braces available to suit the individual needs of patients. Each type of braces is custom-fitted to ensure proper tooth movement and comfort.
- Improve your smile by straightening crooked teeth
- Facilitate maintenance of oral hygiene as irregular teeth are harder to keep clean
- Retract/pull back protruding front teeth which reduces the chances of trauma to the teeth
- Reduce damage to the gums from improper bite.
- Straighten teeth which have undergone “drifting” in patients with gum disease (periodontitis)
- Realign teeth to facilitate placement of denture, bridge or implant
- Improve self-esteem and confidence
- Clear braces (e.g. ceramic, composite)– these clear brackets are more aesthetically pleasing. They cost more and are more brittle. These brackets are very popular amongst adults as well as some teens.
- Lingual braces – the brackets are fitted to the back of the teeth. Therefore, they are not visible when smiling. The drawbacks are higher cost and longer chairside adjustment time. Patients might take a longer time to adjust to the braces due to tongue irritation.
- Clear aligners – these are clear flexible plastic splints which the patient can put on and remove themselves. The most famous brand is Invisalign® but there are other alternative brands as well. They are most suitable for mild to moderate cases. The disadvantages are high cost and high patient compliance as they must be worn for at least 22 hours a day.
- Brackets are attachments which are glued to the teeth. Brackets can be made of stainless steel, titanium, plastic, ceramic or composite.
- Archwires are placed on the brackets to move teeth. Archwires can be made of stainless steel, nickel-titanium alloy or titanium-molybdenum alloy (TMA/beta titanium).
- The archwires are secured to the brackets using coloured elastic modules.
- Some brackets (ie. Self-ligating brackets) have special clips which hold the archwires in place without the need for elastic modules.
Conventional ceramic brackets with transparent elastic modules which have discoloured
Self-ligating ceramic brackets
1. Self-ligating brackets and treatment efficiency (Clinical Orthodontics and Research)
2. Efficiency of mandibular arch alignment with 2 preadjusted edgewise appliances (American Journal of Orthodontics and Dentofacial Orthopedics)
3. Systematic review of self-ligating brackets (American Journal of Orthodontics and Dentofacial Orthopedics )
4. Systematic review on self-ligating vs. conventional brackets: initial pain, number of visits, treatment time (Journal of Orofacial Orthopedics)
5. Self-ligating brackets do not increase treatment efficiency (American Journal of Orthodontics and Dentofacial Orthopedics)
6. A multi‐center randomized controlled trial to compare a self‐ligating bracket with a conventional bracket in a UK population: Part 1: Treatment efficiency (The Angle Orthodontist)
7. Treatment time, outcome, and anchorage loss comparisons of self-ligating and conventional brackets (The Angle Orthodontist)
8. Root resorption, treatment time and extraction rate during orthodontic treatment with self-ligating and conventional brackets (Head & Face Medicine)
9. Pain experience during initial alignment with a self-ligating and a conventional fixed orthodontic appliance system. A randomized controlled clinical trial (The Angle Orthodontist)
The process of fitting the braces do not hurt. Some discomfort during eating is expected following fitting of the braces. The pain and discomfort normally last for a few days up until a week. Painkillers (e.g. Paracetamol) can be taken if the pain is unbearable.
- Brackets can come off if you bite on something hard. It is advisable to avoid hard and chewy food throughout the duration of treatment.
- Pain or discomfort. There may be some discomfort in the first few days but the discomfort should go off after a week.
- Poor oral health. Cavities, white spot lesions (demineralization of the enamel) and gum disease can happen if excellent oral hygiene is not maintained.
- Multiple appointments. Braces treatment can take up to 2 years or more to complete. If you are planning to move abroad (e.g. for studies) within that time, then it may be advisable to defer treatment.
- Vacuum-formed retainers – these are clear plastic splints which can double as mouth guards if patients grind their teeth during sleep.
- Acrylic retainers (e.g. Hawley retainers) – these are made of acrylic/plastic and metal wires.
- Bonded or fixed retainer – these are wires glued to the back of teeth. Periodic check-ups are necessary in case the wire detaches from the teeth. Oral hygiene must be excellent to prevent gum problems.
- Reorganisation of gum (periodontal ligament) fibers around the teeth.
- After braces are removed, the gum (periodontal ligament) fibers around the teeth will reorganise to accommodate the new tooth positions.
- The process happens over a 3-4 month period.
- The retainers function to stabilise the tooth positions.
- Progressive narrowing of the inter-canine width (dental arch) with age1,2.
- The constriction of the dental arch with age will result in the lower front teeth becoming crooked again if retainers are not worn.
Straight teeth after braces
Crooked teeth due to relapse from not wearing retainers after braces
The most common advice is to wear the retainers for as long as you want straight teeth. This would normally mean lifelong retainer wear.
A study found that 2 out of 3 patients who stopped wearing retainers completely developed crooked lower teeth (crowding) after about 10 years1.
1. Stability and relapse of mandibular anterior alignment – first premolar extraction cases treated by traditional edgewise orthodontics (American Journal of Orthodontics)
1. The role of mandibular third molars on lower anterior teeth crowding and relapse after orthodontic treatment: A systematic review (The Scientific World Journal)
We look forward to seeing you!