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FAQs

Frequently Asked Questions

We have tried to anticipate questions you might have. Please feel free to email us if you have a question that can't be answered on this page. We will then add it in. Good information can be found on the ASO and AAO websites.


What is orthodontics?

Orthodontics literally means straight teeth. Orthodontics is the oldest dental specialty. It deals with the diagnosis, prevention and treatment of malocclusion. More >

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What is a malocclusion?

A malocclusion is a “bad bite”. Signs of malocclusion include dental crowding, protruding teeth, missing teeth, bite problems, jaw discrepancies, dentofacial deformities and asymmetries.
For more see here >

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What is an orthodontist?

An orthodontist is a specialist dentist recognised as such by the dental profession and the Australian Dental Board. To be registered as an orthodontist, a dentist - who has a Bachelor’s degree in Dental Science - must undertake further training in a university Master’s program for a period of 2 to 3 years. An orthodontist is normally expected to restrict his practice to orthodontics only. In other words, you wouldn’t ask your orthodontist to make you a new denture, fill a molar or extract a wisdom tooth. More >

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What are records?

Diagnostic records are necessary to give Dr Pepperell enough information to plan your treatment properly. Taking short cuts can have unfortunate consequences in treatment. We will need x rays, study models (virtual models or plaster casts) and photographs. X rays are taken by a radiologist. We take impressions (moulds) of your teeth for study models. We take photos with a digital camera and a macro lens.

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Why do some people need teeth taken out?

Some patients require extractions prior to treatment because it is not possible to fit all of their teeth in. Good examples here are severe crowding and protrusion (teeth that are too far forward). The Australian Society of Orthodontists and the University of Adelaide carried out a survey of Orthodontists in Australia and found that approximately 40% of patients needed tooth extractions. That means 3 patients in 5 do not need to have any teeth out.

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Will an expander correct my mouth breathing?

No. An expander used correctly will widen the upper jaw and dental arch, as it is designed to do. The provisos are that it is done at the right age and that a fixed expander is used.

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What are fixed appliances?

These are commonly referred to as braces and are mostly fitted to the outside of your teeth with a bonding resin. Usually braces are worn, on average, for 24 months although this varies a fair bit. The part bonded to the tooth is called a bracket (or a tube on the side of a molar tooth). Some teeth have a band that fits around the tooth and is cemented to it. A metal tube or bracket is welded to the stainless steel band before cementation. Brackets can be made of stainless steel or a non-metallic material like a tooth-coloured ceramic (eg Clarity™). More >

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Why can't I have Clarity on my lower teeth?

Clarity brackets are made from a ceramic material, which is very hard and more brittle than stainless steel. If your upper teeth bite on to your lower braces, it is possible to dislodge a lower bracket. If that lower bracket is ceramic, then the upper tooth might suffer from some enamel wear, simply because of the harder nature of the ceramic. The most visible teeth are usually the upper incisors so we bond Clarity on the upper teeth (6 to 10 brackets) and stainless steel (Victory ) brackets on the lower teeth. The stainless steel brackets are smaller and flatter too.

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What is an archwire?

An archwire connects the brackets and tubes of your braces and thus controls tooth movement. They come in various dimensions and alloy types such as stainless steel or titanium. The newer archwires are gentler and faster allowing for greater patient comfort and treatment efficiencies.

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What are elastics?

These are small rubber bands to help move teeth and are attached to different parts of the braces depending on what needs doing. If you are not sure how to put them on, or have forgotten where they are placed, please call us on 5564 7322 for advice. If you get it wrong, you may create movement in the wrong direction (and yes, it does happen).

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How are the braces fitted?

We use an indirect-bonding technique. Dr Pepperell bonds your braces to a plaster model of your teeth. Using a transfer tray – like a template – the braces are bonded to your teeth later, first the lowers and then the uppers. In other words your braces are not placed one bracket at a time. Gentle, superelastic titanium archwires are then placed to start your teeth moving and aligning.

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What are the advantages of indirect bonding?

You will spend much less time in one of our stylish and comfortable dental chairs. The lab time for bonding onto the model leads to greater accuracy in bracket placement and probably a shorter treatment time overall. It’s more relaxing for all concerned.

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Will it hurt?

We sincerely hope not! Most patients report some pressure and tightness from the braces in the first few days after the braces are bonded. This often occurs to a lesser extent after archwire changes and some other adjustments too. Some people have a lower pain threshold. Some are prone to mouth ulcers. Most find they tolerate most aspects of their treatment fairly well. Modern braces and wires are more comfortable and less of a nuisance than ever before. This is because of improvements in design, in smaller attachments and in gentler alloy wires. You are not supposed to suffer!

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What can I do if something is irritating or hurting me?

First of all, Dr Pepperell will check at each appointment that there is nothing that will obviously cause discomfort or irritation. If it’s due to pressure on your teeth, then some paracetamol or ibuprofen might be enough. For soft tissue irritation, a good first aid is a hot salty mouthwash, frequently. Something that sticks in or rubs can be cut off, turned in or smoothed over. If there is something we can do to help, we will. Please ring us on 5564 7322 or see here for advice.

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What can't I eat when I have braces?

It is best to avoid very hard foods, sticky foods and those tough foods that require lots of chewing. Ice can be a problem as can lollies and chewing gum. Healthy foods like fruit and vegetables are good, but it’s better if you cut them up into more manageable bite-sized bits. Try to limit your intake of sweet foods and sugared soft drinks. A healthy diet is best with the odd treat. Moderation, rather than abstinence, will work.

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What if something is broken or doesn't seem right?

We must avoid letting problems occur in the first place. Secondly, you may be able to do a little first aid, like putting some wax on to the part of the braces that’s rubbing. Very, very importantly you need to contact us for advice. We can help, that’s what we do. The sooner we fix it, the sooner we get back on track. The sooner we fix it, the sooner we restore comfort. Attending to any problem promptly optimises the efficiency of your treatment. Telling us when you have a problem means we can schedule an appointment in a timely way that is most convenient for you and everyone concerned. You can call 5564 7322 for an appointment or advice at any time (leave a message after hours) or email us.
More >

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Is a fee charged for breakages?

We do not want to charge a fee for running repairs, and we won't for the first few. There will be a fee charged for an excessive number of breakages. It is in everyone's interest to avoid these problems otherwise your treatment progress will be slower; your treatment may take months longer; and you will need a greater number of appointments. It's best to avoid the inconvenience - and we will help you in doing so - by doing all you can to keep your treatment on track. The next best thing you can do is to notify us promptly if you (think you) have a problem.

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How do you take off the braces?

We squeeze each bracket so it “peels” off. We then polish off the resin adhesive remaining. Your teeth will probably feel slimy for a while. Impressions are taken for retainers.

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Will my teeth move after my braces come off?

Yes. After your braces are removed, your teeth are at their least stable. The proper wearing of retainers will help stabilise your teeth in their newly-corrected positions. Teeth move naturally over your entire lifetime, even if you never have orthodontic treatment.

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Why do teeth continue to move over a lifetime?

The reasons are complex. Teeth are subject to resting muscle pressures and the face and jaws continue to grow, if only in very small increments, over a lifetime. If you grind your teeth you may experience more tooth movement over time. More often it is the lower front teeth which are affected the most. Remember to wear your retainers for as long as you want to keep those teeth from moving.

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Why do I need retainers?

Retainers are worn to prevent unwanted tooth movement. Invisible retainers are worn almost full time to start with before reducing to night time only and later less so.

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How long do I wear my retainers?

In our practice, we have a follow up period of 18 months after your braces are removed. By then you will probably be wearing your retainers every second night. However, as teeth tend to move over time, we would suggest you continue to wear your retainers for as long as you want to avoid unwanted tooth movement. Indefinite - even life-long - retention is the only way to be 100% certain that your teeth won't move.

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What if my retainers don't fit?

Call us soon so we can take a look. You will need to bring your retainers in with you. If retainers are worn consistently, they will fit comfortably. Otherwise, it generally means that you have not been wearing them enough. This, of course, means you have suffered from some tooth movement which retainers are specifically designed to prevent. Our best advice: wear your retainers as directed!

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Is a fee charged for lost or damaged retainers?

Generally yes. If you look after your retainers, they will usually last a very long time, perhaps a few years.

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Can I get new retainers?

Yes, if they are lost or if they wear out it’s simply a case of taking a new impression and moulding a new invisible retainer. (A fee will apply.) For most patients their invisible retainers will last years. Having replacements made and continuing to wear them one or two nights per week into adulthood is maintenance well done.

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Can you guarantee that my teeth won't move?

No, not unless you can guarantee perfect compliance in wearing your retainers. Orthodontists strive to position your teeth in balance with your facial and jaw muscles; in line with accepted standards of facial aesthetics; with regard to good oral function; and with the aim of enhancing the stability of your new bite and smile. The problem is that “Nature” changes things over time, whether we like it or not. There is no magic!

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Will my wisdom teeth cause my front teeth to crowd?

No, this is a myth. Sometimes we see lower incisor crowding in the late teens at the same time wisdom teeth are coming through. If that person has pericoronitis (inflammation and soreness of the gum around a tooth) associated with the wisdom tooth, then it may seem obvious to assume that the crowding was caused by the wisdom tooth “pushing” from the back. However, the crowding still occurs for those without any wisdom teeth. More >

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When is the ideal time to see an orthodontist?

It’s time to seek an opinion when you, or your family dentist, have a significant concern about the bite or alignment of your teeth. Although the American Association of Orthodontists says 7 years of age is ideal, we don’t need to panic if our children are not seen at this age. If you are concerned about your child’s dental development please call us on 5564 7322 for an appointment, or email us.
More >

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I've been told I've left treatment too late, is this true?

The treatment for most conditions is not absolutely critical in a time sense. Some, like expanding the upper arch to achieve a degree of bony (“orthopaedic”) change, is best done before the late teens. It’s really nice to treat during puberty and adolescence if good jaw and facial growth is going to help get a better bite correction. On the other hand some conditions (like excessive lower jaw growth) might benefit from delaying treatment until very late adolescence or early adulthood when growth is slowing down.

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What is Preventive & Interceptive orthodontics?

“Prevention is better than cure. A stitch in time saves nine.” Early and simple treatments are best if we can truly prevent a malocclusion from developing or worsening. Dr Pepperell will advise early treatment if it means he can produce a better result, avoid extractions or the need for braces later. Sometimes we treat early for other good reasons in the short term, as long as we honestly acknowledge and understand that later treatment is still likely. The evidence is that approximately one child in six will benefit from early treatment to the extent that they avoid braces later. (We can select those patients. We can diagnose them if we see them early enough. But, we don’t have to unnecessarily treat every primary school child who presents for assessment because the “recipe” calls for it.)

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When should my child start treatment in braces?

On average, we start later in boys because puberty commences later. That can mean at 12 years for girls and 14 years for boys, depending on their growth status.
Timing is also related to dental development (permanent teeth present); oral hygiene; and patient acceptance.

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Do I need a referral from my dentist?

No, however, we do like to know that you have a family dentist. He or she is the guardian of your oral health.

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Do I still have to see my dentist?

Yes! You will continue to see your family dentist for regular checkups. If Dr Pepperell has any concerns about your oral hygiene or oral health, he will contact your dentist. In addition Dr Pepperell will write to your dentist at certain stages of your treatment to keep him informed.

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Can I believe what I saw on television about orthodontics?

That depends on the TV program, as the purpose of some television is to entertain, not inform. Similarly, the internet and advice from well-meaning friends may not be valid sources of quality information. We now live in an age of content saturation. Information about your health needs to be rational and evidence-based. “The gold standard” is randomised, controlled trials. It is not impolite to ask that your orthodontic treatment be scientifically justified. If you have any concerns regarding the legitimacy of any proposed orthodontic treatment, please feel free to ask Dr Pepperell. An appointment can be made by phoning 5564 7322 or by email.

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