Frequently asked questions about Orthodontics

Yes, unfortunately, it can not be avoid sometimes.

Of course, it is clear that we can not treat all children on a free Wednesday afternoon or at peak hours. Therefore, appointments can not be avoided during school hours. By law, it is so that the teacher is obliged to let go the students at this time. This should normally not be a problem, because the appointments are indeed already known at least 4 weeks in advance. In addition, of course, we try to put the appointments so, that they relate to a school lesson, in which the patient is not too much neglected (eg. gymnastics, drawing, religion, handicrafts, etc.) and the hours - if necessary - can be worked up without problems. So, that's why it is always important to have the school timetable by hand.

This question can- as mentioned above - clearly aswerd as no.

There is absolutely no separate tariff for the specialists. With the same concept and the same treatment goal certainly a specialist can be even cheaper, because he brings a lot more experience in the treatment, since he does nothing else. In addition, he can by his experience, respond faster and better to potential difficulties in the treatment.

Ja, leider lässt sich das meist nicht vermeiden.

Es ist natürlich klar, dass nicht alle Kinder an einem freien Mittwochnachmittag oder an Randstunden kommen können. Deshalb lassen sich Termine während der Schulzeit nicht vermeiden. Vom Gesetz her ist es so, daß der Lehrer verpflichtet ist, die Schüler zu diesem Zeitpunkt auch gehen zu lassen. Dies sollte normalerweise auch kein Problem sein, da die Termine ja schon mindestens 4 Wochen im Voraus bekannt sind. Zudem versuchen wir natürlich die Termine so zu legen, dass sie eine Schulstunde betreffen, in der der Patient nicht allzu viel versäumt (z.B. Turnen, Zeichen, Religion, Handarbeit etc.) und die Stunden - falls nötig - ohne Probleme aufarbeiten kann. Es deshalb sehr wichtig, dass sie den Stundenplan immer zur Hand haben bei der Terminvereinbarung.

Each treatment includes always certain, even though rather small risks. Nevertheless, parents and patients must be informed of this.

Besides the usual, very personal pain for 2-3 days after the "tightening" of the appliance (this can be handled with a simple painkillers very good), there are the following risks:

• No full treatment success in particularly a difficult initial situation (problem of growth) or in the absence of cooperation.
• Damage to teeth (caries) or on parodontium (gingivitis, periodontitis) under conditions of poor oral hygiene and a missing fluoride prophylaxis.
  
  
  Pictures left before and right after treatment
• Root shortenings (root resorption): This rare effect is unpredictable. In general, these reductions of the root length are only by a small extent and have no effect on the health and the stability of the teetht. They can occur generalized or individually. Especially patients with previously damaged teeth (accident, tooth decay, etc.), with already short, slender roots or whole-body (systemic) disease are vulnerable to such effects. Generally, such resorption are not externally visible, but they can be found on the radiograph, which is made by the dentist.
  
  
  Pictures left before and right after treatment
• Death or discoloration of teeth: Very rare, but it's most likely in already previously damaged by an accident teeth. Dead teeth have to be root treated; a orthodontic treatment, however, can be continued normally.
• Ankylosis of teeth: Direct adhesion of a tooth to the surrounding bone, which makes no more tooth movement possible. But is a rather rare side effect.
• Occurrence of TMJ problems, which are usually temporary and may also occur during growth (see. Hormonal changes, stress in adolescence, etc.).

Certainly orthodontic treatment are never something pleasant and can certainly cause pain. Especially during the first few days after at a fixed appliance ("Gartenhag/ Braces") was applied, changed or tightened. Should really occur severe pain, we recommend to take during this time a mild pain reliever.

Every orthodontist is trying whenever possible not to pull any teeth. But there are situations in which a removal of permanent teeth for additional space is necessary and indispensable. Especially when early deciduous teeth - without a subsequent placeholder - have been removed. Teeth are slipped from back to front, a thin bone base is present or simply teeth in diameter for the bone base are too large (see page "systems"). These and other factors lead to removing 4 premolars to make space for the remaining teeth, otherwise it occurs that they are standing outside of the bone and they are no longer covered by the bone. It must then be later expected that the gum can significantly retreat (recession) and the tooth necks are exposed accordingly (hypersensitivity). But teeth never should simply be removed without an overall concept created by the orthodontist. Almost always it takes a fixed appliance ("Gartenhag/Braces") then in order for the rest of gaps to be closed and that the teeth not just tip over. At the end of treatment so the layman sees no difference whether teeth were removed or not, because the whole rows are closed again. Whether the removal of the teeth is a problem for the entire system or not, can neither affirmed nor denied. The discussion must be leaded only on a esoteric level. From our side never any drawbacks or symptoms have been observed at the end of treatment in any case. But as said, an extraction treatment must always be well planned and should be performed only in appropriate cases.

Smaller treatments are certainly possible even at the general dentist, but has a treatment almost always to be seen in a wider concept. The orthodontist is trained to treat only such concepts. So he just makes dental regulations and usually nothing more. For this reason, the patient remains still for all other dental treatments in the care of the general dentist. Also must be assumed that a specialist is sometimes cheaper for the same treatment approach, since due to his experience, he treated faster and can better respond to the unexpected.

Switzerland has in Europe the most stringent guidelines for obtaining a specialist title of Orthodontics. During 3 years must be a contender back to the University (in other countries this is usually only a year) and is introduced there from base in the specialty of orthodontics and makes during this time also nothing else. During this time he is practically and theoretically trained, but also has to pass on his knowledge to students. But at the end of this period of training, he receives not like in other countries automatically the specialist title. He needs to demonstrate his skills also through the presentation of 10 different self-treated cases to a selected committee of specialists (new: 3 cases and a one day examination). These cases should cover a large range of treatments. Furthermore, an SSO member agreed to visit at least 80 hours of continuing education every year. It is thus obvious that the specialization in orthodontics is not easy to learn at a few weekend courses, as is the case with the so-called Master's courses ("Master of ....") for example the University of Krems. These are all purely theoretical in nature and do not include guided practical training in the patient. Thus such titles are never equated with a well-founded specialist dental training.

Basically, one can divide the treatments in a ortho-dontic (teeth movement) and a ortho-pedic (jaw movement) regulation. Furthermore, the therapy can be divided into a functional and an aesthetic treatment in general. While assessing the function is a orthodontist subject, assessing the aesthetic is a very individual thing. In the asthetic regulation the disussion with the patient shoul take place, but also the parents shoul place their wishes. The functional correction is usually connected with the growth and must be carried out with during this. Otherwise, a correction of this deformity without surgical intervention is usually later almost no longer possible. An aesthetic correction by shifting the teeth (orthodontic treatment) can also be made at any time and at any age, as long as the teeth are not already damaged.

"The Bionator is one in orthodontics used, removable device, which changes the bite, or should induce a bite elevation. It belongs to the group of functional orthodontic appliances, which also includes the activator (with us Monoblock/Headgear-Activator) and the function controller (Fränkel device). The transitions between these devices are partly fluent, all are made up of plastic sheets and wire elements. What makes the Bionator (as the Monoblock/Headgear) is that it acts on both jaws, but without performing too great forces the. On the contrary, the muscle power is utilized. With each act of swallowing and even speaking the muscle power is utilized to regulate the parodontium successively. The Bionator stretches the muscles in the jaw, tey will be trained and the bite will be normalized over time. To use the Bionator usually occurs in children and young people to ensure directly in development to obtain a functional jaw. In addition, the functional orthodontic appliances are generally most effective only during the growth phase."

Real bionators - such as Fränkel Devices - must therefore be worn for 24 hours, or the original forces will start to work again. Such devices must be worn almost 4-5 years on average, because the forces can change during growth (tongue, cheek, circumorale muscles etc.). For this reason, pure bionators or Fränkel-Devices can not really recommended by us, because simply no treatment success can be guaranteed. However, we use the principle in the Monoblock / Headgear - Combination Device (according to Dr. Teuscher, see page "systems"). We inhibit by external forces (Headgear) the maxilla in its forward displacement forward and stimulate through the monoblock in the lower jaw the growth in the TMJ. In addition, the cheeks and tongue are kept awya, what also helps the jaws in developping. With the Monoblock/Headgear-Activator only small tooth movements (eg. Maxillary anterior teeth) can be made. That's why this device is an almost pure otho-pedic device.

Without good cooperation even the best orthodontist can't do anything, because he can not monitor 24 hours the patient. If the delivered equipment isnot worn, so they naturally will be useless and the treatmentwill become more difficult, more expensive and larger. It should be in the very interest of the parents, that the equipment be worn very well.

It is basically with in the orthodontic treatment as with all dental treatments in Switzerland: the patient has to pay the bill yourself. The parents themselves have to inquire at the health insurance, if they take over some of the costs. An assumption of the costs through the IV ("Invalidenversicherung"), as well as by the school dental care in the Canton Zug depends on very specific requirements in the mouth and jaw from (agenesis, Angle in the radiograph, strong over- and underbite, etc.). The clarification of these requirements is subject only to the specialists in orthodontics SSO. He is also obliged to notify the patient and the parents. A possible "IV"-permission is normally not visible from the outside and can be detected only after the making of X-ray images (eg. OPT, cephalometric etc.). An existing "IV"-permission on another affliction normally entitled not to the assumption of the cost through the "IV" for orthodontic treatment.

Basically, only a dentist with an appropriate graduation (not just the specialist) can make an orthodontic treatment. In dental cleanings and instructions is this different. Ask your orthodontist, dentist or assistant (normally also he / she is a trained dentist), that you want to be treated by him and not by an dental assistant. You have the right to do so, since the tariff is only designed for the dentist. Otherwise, the doctor obliged to apply the tariff of a dental assistant, which is significantly below the rate of a dentist.

This is very difficult to say, because each patient has a different kind of deformity. Likewise, you do not know how quickly the teeth will react, how big the growth and how good the cooperation is. The average of a larger treatment is normally about 2-3 years, but under certain circumstances up to 4 years can be achieved.

Normally for a fixed appliances ("Gartenhag"/Braces) about every 4-6 weeks. Of course, this span will vary depending on what kind of appliances the patient wears (eg. Monoblock/Headgear every 2-3 months) and what the kind of correction it is.

Also in the orthodontic treatment, there may be emergencies. Disturbing wires, detached brackets, shifted teeth after a stroke, broken wires, plates or mono blocks that no longer fit and can not be worn, etc.

Basically, you can try to cut off the disturbing parts, bend the wire (nail clippers scissors, etc.) or try to remove the bracket. What is simply important, that you don't use too much pressure or too hasty movements, so that no more breaks.

For larger accidents with dental involvement (ailing or even shifted teeth) it is very important, that you immediately inform us, your private dentist or - at the weekend - directly the emergency dentist (phone of the emergency dentist). To fill out a report for the insurance is extremely important for any long-term consequences.

For equipment that no longer fit (Monoblock etc.), you can however take almost nothing. Since it is important that you immediately contact us and come by. Very often a new erupting tooth or a loose baby tooth is in the way, so that the device has to be grind in.

As you may know from advertising or from friends or colleagues, there are many different types of braces and orthodontic appliances. Basically, however, they are always removable or fixed. There are visible (like the classic "Gartenhag"/Braces), semi-visible (such as Invisalign aligners or other Aligner Systems) and completely invisible (such as the Incognito system). But it is important, that you do not believe everything they promise in the advertising or is told you by others. Each appliance has its advantages and disadvantages, and everyone needs a different kind of correction, because everyone's different. For this reason it is also important, that you really get a personalized advice. Do not turn on a system, without having to get a guarantee for a good result. Maybe obtaining a second opinion is sometimes a good suggestion. At the end of the treatment not only the aesthetics, but also always the function has to be very well.

That is our ambition. We as specialists will honestly tell you, which system is right for your correction and actually leads to a result, with which you can be satisfied in the future and you probably at the end will not have more problems than at the beginning.