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Expert Q&A: Braces Basics

Dental braces. For many of us, it’s a rite of passage in childhood and adolescence. If your child needs braces, knowing what to expect from treatment is important to ensuring its success.

Here, Dr. Jeffrey Chaffin, Delta Dental of Iowa’s Chief Dental Officer, answers questions about one of the most common dental treatments.

Q: What are the most common reasons dentists recommend braces for children?   

Dr. Chaffin: There are three large categories for braces. 

The first is crowding of teeth, which means the teeth aren’t fitting properly in the jaw. When your teeth are crowded, it not only affects the look of your teeth but also may prevent teeth from being properly cleaned. Correcting the crowded teeth may improve the teeth’s appearance and improve overall health by helping prevent cavities and gum disease, as those crowded teeth can often hide plaque and make that plaque hard to remove. And plaque is a major contributor to cavities.  

Spacing is a second issue that often requires braces. There may be extra spaces between teeth or there may be irregular spaces. Closing these gaps can give your teeth and mouth more pleasant appearance and not allow food and other items to get packed into those spaces. But spacing isn’t necessarily an issue that needs to be fixed: Some people have a large space between their front teeth and like that appearance. There is also an advantage to spacing in that it is easy to clean all aspects of those teeth. So, if you decide to use bracing to close a space, it requires better personal at-home cleaning.  

The other reasons for braces tend to be around the bite, which means how the teeth come together, such as when you open your mouth wide then bite down. Teeth may not align correctly when biting, and some of the issues are:

Overbite: when the lower teeth can hit the roof of the mouth, causing damage and pain
Underbite: may cause significant issues with chewing
Cross bite: may put uneven pressure on teeth
Open bite: when some of the teeth don’t come together when biting (For example, when a person has an open bite on the front teeth and they bite into a sandwich, they may get the bread but not the meat of the sandwich because the teeth don’t properly come into contact with each other.)

Q: Will you please share a brief overview of the types of braces available today? What are the pros and cons of each?  

Dr. Chaffin: We could categorize braces into two groups:  1) braces and 2) aligners. 

For braces, there are the traditional metal braces and the newer ceramic ones. These are secured to the front of the teeth, so they are visible to others. The brackets have become much smaller over time, so they’re not as noticeable as they used to be.  The ceramic brackets blend in better with the teeth, so they are less noticeable. 

Since traditional braces can’t be removed, it is harder to clean the teeth. Patients need to be extra careful to clean their teeth while using braces, as they don’t want cavities on their nice straight teeth after the braces are removed.   

Clear aligners are the other major category. Invisalign is an example of a company that makes aligners. The key to aligners is that they are removable and replaced with a new one every two to four weeks. Aligners are invisible, and patients can eat and drink whatever they want. The drawbacks of aligners are that they are easily lost, and patient behavior can be an issue. It’s easy for them to be removed, so if younger kids choose not to wear them sometimes, that means the movement of the teeth can be much slower and make treatment longer. This is also the most expensive option. But, on the bright side, they have the advantage of being able to be removed, which means it is easier to clean the teeth.

Q: How long does dental bracing treatment take?  

Dr. Chaffin: This totally depends on the age of the patient and the severity of the problem.  On average, an adolescent with mild to moderate dental issues can be treated with dental braces for 24 months, but this is totally patient dependent.  We don’t want to move the teeth too fast — moving teeth too fast can damage the roots underneath.

Q: What should I expect from the first visit with my child's orthodontist?  

Dr. Chaffin: An examination to include radiographs (X-rays). The X-rays are important to show the position of the teeth and the development of other parts of the face (the jaw, for example). The alignment of the jaws also plays an important role in orthodontic treatment.

Q: What are the best ways to care for braces? 

Dr. Chaffin: For traditional braces, excellent at home care through brushing and flossing is important.  Also, if involved in sports, a mouthguard is vital. The brackets and wires can hurt if jammed into the gums and cheeks during sports and not protected by a mouthguard.  Also, routine dental cleanings are especially important during these times.  For the clear aligners, home care is important, too, but it is a bit easier to brush and floss since the clear aligners can be removed.

Q: Are braces painful? That is, will orthodontist visits hurt? Will the braces cause pain between visits?  

Dr. Chaffin: Millions have braces each year, and there can be discomfort associated with them but not severe pain. Usually, the discomfort is for a few days after each appointment.  During those appointments, tweaks are made to help the movement of the teeth, and that may cause discomfort for a few days. We all adapt to the braces in our mouth very quickly. Occasionally, a bracket or a wire can break and cause some pain. You should report this to your orthodontist so it can be fixed — don’t wait until your next visit.

Q: How can parents help their kids have success with bracing? 

Dr. Chaffin: First, the child has to follow the “rules” of braces treatment.  If they are using traditional braces, the child needs to be willing to be a part of the treatment. The worst thing is to remove braces and see cavities underneath, which is a result of poor brushing and flossing. Ensuring your child follows the dentist’s instructions and supporting good home care are the keys to success for bracing. 

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Dental-friendly Holiday Recipe: Swirled Chocolate Bark With Almonds

The holiday season is a time to celebrate with some festive treats, but many sticky and super sweet candies are really hard on your teeth. Fortunately, you don’t have to avoid all delicious foods to protect your teeth.

When it comes to sweet treats, keep this simple tip in mind: Choose chocolate. Chocolate — especially dark chocolate — has several health benefits. First, chocolate is less likely to stick onto your teeth than caramel or toffee, for example. Also, the darker the chocolate, the lower the sugar. Cavity-causing bacteria feeds on sugar, so reducing sugar in your diet reduces your cavity risk.

Almonds add a great crunch to this treat, in addition to calcium and protein. And with just three ingredients, this treat might be a favorite of yours long after the holidays.


10 ounces dark chocolate, coarsely chopped

4 ounces white chocolate, coarsely chopped

1/4 cup almonds, whole or chopped


1. Line a baking sheet with parchment paper. The larger the baking sheet, the thinner your bark will be.

2. Heat the dark chocolate in a double boiler or a bowl set over a saucepan of gently simmering water. Make sure the bowl does not touch the water.

3. When the dark chocolate is a bit over half melted, remove it from heat and stir until it is completely melted.

4. Repeat the melting process for the white chocolate.

5. Spread dark chocolate onto baking sheet.

6. Drop spoonfuls of white chocolate randomly over the dark chocolate and use the tip of a knife to swirl the two chocolates together.

7. Scatter almonds over the swirled chocolate.

8. Refrigerate until firm, about 1 hour.

9. Break into pieces and enjoy.